Hookworm infection: symptoms, causes and remedies

Definition of hookworm infection

Hookworm infection is a disease that occurs when the body is entered by parasites in the form of hookworms, which then develop in the body. These worms use the human body as an ideal environment to develop into adult worms.

Humans can catch hookworms while walking barefoot in areas contaminated with animal feces, such as in parks or beaches. In addition, parasites that stick to the skin can also come from damp objects, such as towels.

The most common types of hookworm infection are ascariasis and cutaneous larva migrans (CLM).

• Ascariasis
  When hookworms infect the body and multiply in the intestines, this condition is called ascariasis. Ascariasis can cause indigestion as well as intestinal disease.

• Cutaneous larva migrans (CLM)
  Cutaneous larva migrans (CLM) or creeping eruption is a parasitic hookworm infection that attacks the skin. The types of worms that usually cause this condition are hookworms which are commonly found in animals, such as cats, dogs, sheep, and horses.

How common is this disease?

Hookworm infection is a common disease in countries with tropical and subtropical climates, such as Southeast Asia, Africa, America and the Caribbean.

Hookworm infection can affect anyone. However, most of those who experience this infection are children. This is because children often play in open spaces without footwear.

In addition, hookworm infection is also a high risk for people who often spend time sunbathing on the beach without using mats or workers around contaminated construction areas or farms.

Types of hookworms

Hookworm infection is caused by hookworms that enter and multiply in the body. There are two types of hookworms that most often cause disease in humans, especially ascariasis, namely:

• Necator americanus
• Ancylostoma duodenale

The two worms above are only found in the human body.

There are also several types of hookworm parasites that cause skin infections found in animals, namely:

• Ancylostoma braziliense and caninum. This parasite is often the main cause of hookworm infection and is usually found in dogs and cats.
• Uncinaria stenocephala. This parasite is commonly found in dogs.
• Bunostomum phlebotomum. This parasite is commonly found in livestock.

As for several other types that are rarely found, but can lead to hookworm infection, are:

• Ancylostoma ceylanicum, sometimes found in dogs.
• Ancylostoma tubaeforme, sometimes found in cats.
• Strongyloides papillosus, sometimes found in goats, sheep, or other livestock.
• Strongyloides westeri, sometimes found in horses

Symptoms of hookworm infection

Not all people with hookworm infection experience symptoms, especially if the condition is relatively mild.

If the infection is severe enough, the sufferer may feel an itching, tingling or stabbing sensation within the first 30 minutes after being contaminated.

However, you can see the following symptoms on skin that is infected with hookworms.

• Reddened or discolored skin surface.
• Dense filled bumps on the skin (papules) appear.
• The surface of the skin is rough and scaly like a snake, 2-3 mm in size. Usually this will appear after a few hours and may get worse the next day.

Ascariasis symptoms

When the worms enter through the digestive tract, such as in ascariasis, the worms will develop into adult worms in the intestine. In cases of mild and moderate ascariasis, worms lodged in the intestines will cause worm symptoms such as:

• Unusual stomach pain
• Nausea and vomiting
• Diarrhea or bowel movements accompanied by blood

If there are too many worms in the intestine, the symptoms that will appear include:

• Severe stomach pain
• Fatigue
• Gag
• Malnutrition (malnutrition)
• Weight loss
• Worms are found in vomit and feces

If you experience persistent stomach pain, prolonged diarrhea, and nausea that doesn't go away, consult a doctor immediately.

Causes of hookworm infection

As previously explained, the cause of hookworm infection is the entry of hookworm parasites into the body.

Worms can enter the body through the mouth and skin, so they can cause 2 different types of diseases.

Causes of ascariasis

In ascariasis, you can become infected with worms if you come in direct contact with soil contaminated with worm eggs. The soil is usually mixed with animal or human feces that were previously infected with worms.

You can also catch it if you eat meat infected with worm eggs and do not cook the meat until it is completely cooked. In addition, drinking water contaminated with worm eggs can also cause the body to develop ascariasis.

Children who frequently play on the ground and put their dirty fingers in their mouths are also at risk for hookworm infection.

Broadly speaking, here are the phases of worm development after entering and infecting the human body:

• The worm eggs that hatch will produce larvae.
• The larvae then move to the heart or lungs via blood vessels.
• Larvae will develop in the lungs or heart for 10-14 days and will enter the respiratory tract, then up into the throat.
• When coughing, the larvae are swallowed and return to the intestines.
• In the intestine, these larvae will grow into adult worms. An adult worm can lay about 200,000 eggs a day, which can then pass through your feces and contaminate the soil.

Cause cutaneous migratory larvae(CLM)

The difference between CLM and ascariasis is the process by which worms enter the body. In CLM, worm infections pass through the human skin through warm, moist, and sandy surfaces. This is because worm eggs can hatch in this environment and penetrate the exposed skin.

When human skin is exposed to soil, hookworm larvae will penetrate the surface of the skin through hair follicles, cracked skin, or even healthy skin.

Unlike the cycle in ascariasis, the hookworm larvae in CLM are unable to penetrate the skin dermis and move toward the intestines. That is why hookworm infection only occurs in the outer layer of the skin.

Risk factors for hookworm infection

Everyone can get worms due to hookworms. However, there are various factors that can increase a person's risk of contracting hookworm. Some of them are:

• Children under 10 years, especially those who often play in the sand and dirt
• Living or being in a warm climate
• Living or being in a place with poor sanitation
• Eat meat that is not cooked until it is completely cooked
• Eat vegetables or fruits that are not washed and peeled properly

Diagnosis & treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

How is this condition diagnosed?

In the process of diagnosing, your doctor will ask about your symptoms and ask you to undergo additional tests.

The goal is to determine if there are live hookworms in your body, and determine the type of treatment that is appropriate.

Reporting from the Mayo Clinic, here are some of the tests needed to detect the presence of worms in the body:

• Stool test
  In this test, the doctor will examine your stool or stool for the presence of hookworm eggs and larvae. However, it is not common for worm eggs to appear in your stool for at least 40 days after you become infected. If you only have male worms, you won't be able to find eggs either.

• Blood test
  Blood tests can measure your levels of white blood cells. If you are infected with some kind of parasite, the level of white blood cells in the body usually increases.

• Image capture test
  This test is done to see firsthand the presence of worms in organs in your body, such as the stomach, intestines, pancreas, or liver. Several types of tests that can be done include x-rays, ultrasounds, and CT scans.

How to treat hookworm infection?

Generally, hookworm infection needs to be treated only if the disease is causing symptoms. In most cases, this disease can heal on its own.

Anthelmintic (worm medicine) is a medication that is often prescribed to treat hookworm infections. Some of them are:

• Albendazole
• Ivermectin
• Mebendazole
• Pirantel palmoat

To relieve itching from a worm infection on the skin, the doctor can also prescribe additional drugs, such as antihistamines and topical corticosteroids.

Prevention of hookworm infection

Although most cases of infection occur accidentally, there are steps you can take to reduce the risk.

• Always wear footwear when walking outdoors.
• Always wash your hands and feet after doing outside activities.
• Avoid bringing pets, such as dogs and cats, to the beach or parks to prevent contamination of public facilities.
• Give your pets deworming regularly.

Remember to always consult a doctor for the best solution to your problem.