by Dr. Iain Corness
A Damn Good Worming!
25 percent of the world’s population is
infected with ‘worms’. And when you talk about ‘worms’, most people think of
the threadworms that all children seem to get. When your child starts
scratching his or her bottom - think of ‘worms’. The answer for the worm
problem is always “a good worming”. Yes, we’ve all been down to the chemist
shop and bought a packet of ‘worming’ tablets.
However, you should not imagine that ‘worms’ stops there. I can assure you
that there are far more dangerous wrigglers in the community. And the sandy
beaches are the habitat for some of them.
My friends laugh at me when they see me walking along the beach. Instead of
letting the cool sand squish between my toes, I wear closed shoes. Does this
mean I am a pedantic pedestrian? Or a member of a weird anti-sandal sect?
Fortunately it is neither. I am just a trifle afraid of Ancylostoma
duodenale. And so should you!
Ancylostoma duodenale is one of the two hookworms that can get their hooks
into you (and me if I let them). The other is called Necator americanus.
These little chaps are roundworms between 7 to 13 mm long and are far from
rare. Approximately one-quarter of the world’s population is infected with
So how do you get infected? Easy, the hookworm eggs are passed in faeces (or
poop if you prefer) and infection results when you come in contact with the
eggs from the contaminated soil. The larvae enter through the skin and
travel to the lungs through the blood. They ascend the lungs through the
bronchi and trachea and are then swallowed. As the larvae pass into the
digestive tract, they attach themselves to the wall of the small intestine.
Here they mature into adult worms, mate and feed on the blood of the host.
And adult hookworms may live up to ten years.
Unfortunately many hookworm infestations do not produce symptoms; however,
there may be local irritation of the skin where the worm penetrated or even
an itchy rash. While going through the lungs, there may be asthma-like
symptoms or even pneumonia. The most common symptoms of Hookworm infection,
however, are from their taking up residence in the intestine. Hookworm here
can lead to abdominal pain, diarrhoea, weight loss, loss of appetite and
With long-standing infections, the intestine’s owner may become anaemic as
the worms feed on the individual’s blood. This in turn leads to the usual
anaemic symptoms including pale complexion, tiredness and weakness.
Diagnosis is done by looking for hookworm eggs in the stool (by using a
microscope). Blood tests will show the amount of blood loss and can be used
as a pointer towards the seriousness of the infestation.
Fortunately hookworm is treatable, generally with the drug mebendazole. This
drug cures more than 99 percent of all cases of hookworm if given twice per
day for three days. It kills both the worms and the eggs, but is
contraindicated during pregnancy. If anemia has become a problem, then iron
supplements can be given as well. Once treated, the symptoms settle quickly
in a few weeks at most.
So what can you do to avoid hookworms? Well since hookworm infection comes
from non-hygienic practices and fecal contact in the soil, my shoes sound
like a great idea, don’t you think? Never mind the problems with hypodermic
needles found in the sand in many countries these days!
Hookworm infections should be dealt with quickly and stringently. Known
symptomatic infections should be treated rapidly and treatment given to
asymptomatic family members or neighbors. Strict attention to cleanliness
and sanitary practices is needed when a hookworm infection is detected to
prevent its spread. This means hygienic disposal of human waste, limiting
skin contact with soil and even water, where there is untreated sewage.
Hookworm can be a very serious illness so it is essential to be aware of any
change in one’s health status. Any difficulty breathing, rapid heartbeat,
chest or abdominal pain, bloody diarrhea, blood with coughing, asthma-like
symptoms, skin rashes, abdominal swelling or bloating, lightheadedness or
weight loss should be brought to your doctor’s attention.
Me? I’ll just keep wearing shoes!