HOOKWORMS are parasitic round worms that tend to affect the lungs and small intestine in humans. People usually become infected by coming into contact with the eggs and larvae found in soil and faeces.

The hookworm infection affects hundreds of millions of people worldwide. Those who live in areas where sanitation is poor and in sub-tropical and tropical climates are most vulnerable.

You may ask why, as a podiatrist, I would be writing about hookworm. Well, the most common way of becoming infected with this parasite is by walking barefoot in contaminated areas or touching infected areas with the hands. When walking barefoot, this tiny organism will break through human skin. Once in the body, they will enter the lungs and trachea. They then travel to the stomach when you swallow. And when fully grown, they can live in the gut for over a year before they are passed out in the faeces. Infected patients may have symptoms of coughing, wheezing, fever, vomiting, nausea, constipation, and diarrhoea. Advanced infection may lead to anaemia, protein deficiency, abdominal distension, and cardiac failure.

Children who experience frequent infections may suffer retardation and slow growth.

A classic sign of early infection is a skin disease called cutaneous larva migrans or the “creeping eruption”. Here, the larvae migrate in tunnels in the outer layers of skin. This is presented as red lines and vesicular lesions. As the larvae advance, the rear portion of the lesion becomes dry and crusty. This is usually seen around the foot and ankle and the area is very itchy.

Diagnosis and treatment

Hookworm infection is usually diagnosed with the clinical presentation and a stool sample. Treatment is aimed at killing the parasites, improving the nutrition of the patient, and treating the anaemia that may have resulted.

Common medications used are albendazole and mebendazole for up to three days. An iron supplement and a protein-enhanced diet may also be advised.

To lower the risk of becoming infected, always wear shoes outdoors, especially in areas that may have faeces in the soil, animal or human. Wash your hands thoroughly after yard work, gardening or playing outside. Ensure that you have good sewage disposal and sanitation.

De-worm pets and localised animals (especially puppies and kittens) and make sure they have up-to-date vaccinations.

Those who are most vulnerable to infection are children, pregnant and lactating women, and people who work in professions that put them at risk, for example farmers.

Preventative treatment in the form of regular de-worming may be indicated, but always seek advice from your doctor first.

Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293-7119), Mandeville (962-2100), Ocho Rios (974-6339), Kingston (978-8392), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.