37 Human Hookworms
Ancylostoma and Necator
37.1 Life Cycle
Added complexity is that it enters through your skin, walking through human faeces.
Filariform larvae burrow through skin
Intensely inflammatory rash, allowing breakthrough.
SO blood, to lungs, develop, cough up and swallow.
Lay eggs in gut. Eggs shat out. Stay in soil to mature and develop.
These feed off blood in duodenum not off food in gut
37.2 Epi
This is anthroponosis
Overlaps with trichuris and ascaris. The unholy trinity
Poorest countries, poorest patients
37.3 Presentation
37.3.1 Skin Penetration
- Itchy
- Resolves once larvae enter circulation and migrate to lungs
37.3.2 Lung Migration
Usually asymptomatic
But you can get an eosinophilic pneumonitis
37.3.3 GI Infections
Usually asymptomatic
Some nausea/abdo pain/diarrhoea
Late infections can cause a hookworm anaemia as they eat blood. THis can contribute to growth restriction in heavily infected children
37.4 Diagnosis
Fecal Ova and Parasites
37.5 Treat
Albendazole
or Ivermectin
Plus iron replacement.
Plus public health sanitation and shoes!
37.5.1 Vaccine?
Hmmm, not reality yet