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Hookworm infection

Hookworm disease; Ground itch; Ancylostoma duodenale infection; Necator americanus infection; Parasitic infection - hookworm

Hookworm infection is caused by roundworms. The disease affects the small intestine and lungs.

Causes

The infection is caused by infestation with any of the following roundworms:

  • Necator americanus
  • Ancylostoma duodenale
  • Ancylostoma ceylanicum
  • Ancylostoma braziliense

The first two roundworms affect humans only. The last two types also occur in animals.

Hookworm disease is common in the moist tropics and subtropics. In developing nations, the disease leads to the death of many children by weakening their immune system and increasing their risk for infections that their bodies would normally fight off.

There is very little risk of getting the disease in the United States because of advances in sanitation and waste control. The important factor in getting the disease is walking barefoot on ground where there are feces of people who are infected with hookworm.

The larvae (immature form of the worm) enter the skin. The larvae move to the lungs via the bloodstream and enter the airways. The worms are about one-half inch (1 centimeter) long.

After traveling up the windpipe, the larvae are swallowed. After the larvae are swallowed, they infect the small intestine. They develop into adult worms and live there for 1 or more years. The worms attach to the intestinal wall and suck blood, which can result in iron deficiency anemia and protein loss. Adult worms and larvae are released in the feces.

Symptoms

Symptoms may include:

Most people have no symptoms once the worms enter the intestines.

Exams and Tests

Tests that can help diagnose the infection include:

Treatment

The goals of treatment are to:

  • Cure the infection
  • Treat complications of anemia
  • Improve nutrition

Parasite-killing drugs such as albendazole, mebendazole, or pyrantel pamoate are often prescribed.

Symptoms and complications of anemia are treated, if needed. Your health care provider will likely recommend increasing the amount of protein in your diet.

Outlook (Prognosis)

You will have a complete recovery if you get treated before serious complications develop. Treatment gets rid of the infection.

Possible Complications

Health problems that may result from hookworm infection include:

  • Iron deficiency anemia, caused by loss of blood
  • Nutritional deficiencies
  • Severe protein loss with fluid buildup in the abdomen (ascites)

When to Contact a Medical Professional

Contact your provider for an appointment if symptoms of hookworm infection develop.

Prevention

Handwashing and wearing shoes will reduce the likelihood of infection.

References

Diemert DJ. Nematode infections. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 327.

Hotez PJ. Hookworms (Necator americanus and Ancylostoma spp.). In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 318.

  • Hookworm - mouth of the organism

    Hookworm - mouth of the organism - illustration

    This photograph shows the front section of the hookworm, and the mouth parts which it uses to feed. The cutting plates, used to attach to the lining of the intestine where they suck blood for nourishment, are visible. Three species of hookworm cause infection in the United States, including this species, Necator americanus. (Image courtesy of the Centers for Disease Control and Prevention.)

    Hookworm - mouth of the organism

    illustration

  • Hookworm - close-up of the organism

    Hookworm - close-up of the organism - illustration

    This is the mouth part of the hookworm Ancylostoma duodenale. The hookworm uses sharp, curved cutting plates to attach to the lining of the intestine where it sucks blood for nourishment. (Image courtesy of the Centers for Disease Control and Prevention.)

    Hookworm - close-up of the organism

    illustration

  • Hookworm - Ancylostoma caninum

    Hookworm - Ancylostoma caninum - illustration

    This is a photograph of a hookworm on the lining of the intestine. (Image courtesy of the Centers for Disease Control and Prevention.)

    Hookworm - Ancylostoma caninum

    illustration

  • Hookworm egg

    Hookworm egg - illustration

    This is a hookworm egg. Hookworms hatch in damp vegetation. Their larvae can enter the human body through the skin, even without cuts or abrasions. Once through the skin, they begin the next step of their life cycle.

    Hookworm egg

    illustration

  • Hookworm rhabditiform larva

    Hookworm rhabditiform larva - illustration

    The larva of a hookworm is visible in the center of this photograph.

    Hookworm rhabditiform larva

    illustration

  • Digestive system organs

    Digestive system organs - illustration

    The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

    Digestive system organs

    illustration

    • Hookworm - mouth of the organism

      Hookworm - mouth of the organism - illustration

      This photograph shows the front section of the hookworm, and the mouth parts which it uses to feed. The cutting plates, used to attach to the lining of the intestine where they suck blood for nourishment, are visible. Three species of hookworm cause infection in the United States, including this species, Necator americanus. (Image courtesy of the Centers for Disease Control and Prevention.)

      Hookworm - mouth of the organism

      illustration

    • Hookworm - close-up of the organism

      Hookworm - close-up of the organism - illustration

      This is the mouth part of the hookworm Ancylostoma duodenale. The hookworm uses sharp, curved cutting plates to attach to the lining of the intestine where it sucks blood for nourishment. (Image courtesy of the Centers for Disease Control and Prevention.)

      Hookworm - close-up of the organism

      illustration

    • Hookworm - Ancylostoma caninum

      Hookworm - Ancylostoma caninum - illustration

      This is a photograph of a hookworm on the lining of the intestine. (Image courtesy of the Centers for Disease Control and Prevention.)

      Hookworm - Ancylostoma caninum

      illustration

    • Hookworm egg

      Hookworm egg - illustration

      This is a hookworm egg. Hookworms hatch in damp vegetation. Their larvae can enter the human body through the skin, even without cuts or abrasions. Once through the skin, they begin the next step of their life cycle.

      Hookworm egg

      illustration

    • Hookworm rhabditiform larva

      Hookworm rhabditiform larva - illustration

      The larva of a hookworm is visible in the center of this photograph.

      Hookworm rhabditiform larva

      illustration

    • Digestive system organs

      Digestive system organs - illustration

      The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

      Digestive system organs

      illustration


    Review Date: 8/26/2023

    Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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