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Hookworm Returns to the United States—Did It Ever Really Leave?

SEP 22, 2017 | KRISTI ROSA
“In poorer [areas of] Argentina, I have seen people with 1,000, 5,000, or even 20,000 eggs per gram of stool,” Dr. Mejia said. Because hookworms are unable to replicate inside human beings, the only way to have a larger number of the worms is through exposure to the larvae. Therefore, residents of Lowndes County, Alabama, may not have the daily exposure to the worms that those living in poorer developing countries might.

The fact that the soils do not drain properly adds to the problem, according to Dr. Mejia. If trenches overflow, the soil becomes contaminated, thus, increasing residents’ risk of hookworm infection if they are walking outside of their homes barefoot or with exposed ankles. The investigators also detected one Cryptosporidium species was in the soil studies; a serology assay found one (5.2%) Toxocara species as well.

The first signs of hookworm infection are itching and a localized rash; however, those heavily infected could experience any of the following, according to the CDC: abdominal pain, diarrhea, loss of appetite, weight loss, fatigue, and anemia. Although the infection is fairly easy to treat—usually requiring only 1 dose of albendazole—it appears to only serve as a temporary fix to a large underlying problem: poor sanitation.

Without proper sanitation, all education and awareness efforts are moot and hookworm will continue to plague individuals all over the world. Recently, however, the Alabama Department of Environmental Management released new tools to deal with sewage overflows. The first is a map that allows citizens to find the exact location of current sewage spills throughout the state, and the second is an email notification system that will make citizens aware of spills in the counties in which they reside.

These notifications can work towards helping individuals avoid these sewage spills and any kind of harmful parasites that may be residing inside of them.
Feature Picture: The micrograph depicts a hookworm (left) and a Strongyloides (right) filariform infective stage larvae. Feature Picture Source: CDC / Dr. Mae Melvin.
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