Hookworm is a vertebral disease caused by parasitic roundworms with hookworm nematodes. The disease has several more historically determined names. These are “scabies of miners”, “rash of miners”, “earthen scabies”, “Egyptian chlorosis”. This disease is called scabies due to the characteristic symptoms of percutaneous infection (through the skin).
Hookworm in humans
Among helminthic infestations, it is in 3rd place in frequency after pinworms and roundworms. Every 4th inhabitant of the planet is a carrier of these worms. Their prevalence is limited to areas with a warm humid climate - the tropics and subtropics.
Mines and mines in Africa, South Asia and Latin America are all endemic foci.
Life cycle hookworm
Human helminths - hookworms - round thin worms of light pink color, with a characteristic sharp twisted end, about 1 cm in length. They are heterosexual. The female is 13-20 mm in size, she has a reddish tint. The males in the tail have a bell-shaped formation - the sexual bursa. They have a characteristic bend on the back of the cephalic end, for which they are called the Curved Heads.
The very word "ankýlos" is translated from Greek. means crooked mouth. Here is their oral apparatus - a suction cup with teeth, with which they attach to the intestinal wall and bite through it. At the same time, the worm secrete an enzyme that prevents blood from clotting so that the parasite can suck out the host blood without hindrance. For a day, she can suck out up to 0.35 ml of blood. Together, wounds in the intestinal wall and anemia occur.
Helminths in humans go through a cycle of 3 stages: an egg - a larva - a worm. The female secretes barely noticeable transparent eggs that go out with feces, penetrating the soil. For helminth eggs to develop, it must be warm and moist. There are about 25-30 thousand eggs, but they cannot develop in the body. Need access to the external environment. Next, helminth eggs release larvae that can wait here for several months. During this time they go through 2 molt. After that, they climb plants and are here waiting for contacts with humans.
After a week and a half, they are already completely viable. Infection occurs only when larvae enter the body.
There are only two ways of infection with hookworm: through the skin and alimentary. Most often, invasion occurs in the second way - with the use of contaminated water and products; infection through the skin is not excluded. The parasite penetrates under the skin, causing irritation and itching, then penetrates the bloodstream. At the same time, part of the larvae enters the bloodstream, the other into the upper section of the small intestine.
Here, her favorite place is the duodenum (duodenum), which is why she is also called the duodenal hookworm. In KDP, she lives up to 5 years. When it enters the bloodstream, the larva enters the heart and lungs. In the heart, they reach the right atrium, exit through the walls of the alveoli and themselves migrate when coughing into the oropharynx. Here they are also swallowed with saliva and food and enter the small intestine. He is her ultimate goal, therefore the hookworm is also called the intestinal curved head.
With oral infection, the path of the larvae is much shorter, they immediately go to the intestine.
During this migration, after six months, the larva transforms into an adult, which is fixed in the intestinal wall.
Causes of hookworm
Ankylostomosis in people occurs where the conditions for it are better. The best choice is the tropics and subtropics. Here, the disease occurs in every second resident.
In temperate latitudes, those who work in wetlands, haymakers, and workers in open pits are affected. Disorders of hygiene and cooking techniques contribute to the disease. You can get infected through unwashed vegetables and fruits, dirty hands, eating berries from a bush, resting on the grass without bedding. The bad habit of biting a blade of grass, drinking from contaminated sources, walking in a mown meadow with wet grass - all this contributes to infection with hookworm. Parasites can affect pets - cats and dogs.
Helminth eggs can also be distributed by birds, including domestic ones, livestock farms are especially contaminated. Thus, a list appears, whose representatives may become infected: miners, farmers, children playing in gardens and parks, sandboxes, lovers to walk barefoot on the grass, lovers of natural attacks. More infections in wet seasons.
Manifestation of hookworm
When helminths enter the intestines, this marks a transition to the chronic stage. Up to 2 months, the worms do not show themselves. When introduced into the skin, a person feels itching or burning. In addition, migratory larvae often cause allergies. This is expressed in the appearance of a rash and swelling.
The migration phase is the end of the incubation period. Most often it takes 60 days. When the helminth enters the lungs, it causes inflammation, accompanied by fever, suffocation, dizziness, aching joints, sputum production. With a weak invasion, the course of hookworm in people passes without symptoms. All organs that the worm comes into contact with are damaged.
Ulcers appear in the intestines, parenchyma becomes inflamed in the liver, laryngitis occurs in the oropharynx, circulating larvae in the vessels accelerate the formation of cholesterol plaques.
Nematodes contribute to the activation of staphylococci, chlamydia and fungi, which together puts a strain on the body, causes myocarditis. Nematodes in the body parasitize from 5 to 15 years.
General symptoms of hookworm
Ankylostomosis in people begins to appear already at the stage of introduction of local changes on the skin. Manifestations of each are different, for some this is one symptom, for others there are many. Among them:
- allergy in the form of redness on the skin, vesicles and itching;
- pain and discomfort in the stomach;
- hypersalivation;
- heartburn and belching;
- vomiting, diarrhea often join.
Symptoms of hookworm from the lungs - shortness of breath, cough, even pneumonia. When nematodes get into the heart, cardialgia appears.
Of the common symptoms - a person becomes nervous, irritable and complains of increased fatigue, insomnia appears.
Clinic of percutaneous invasion
The acute phase of infection lasts 10 days and is manifested by the symptoms indicated above. At the injection site, the skin not only turns red, but also peels, swells, burns. Then these symptoms are replaced by pulmonary.
Pulmonary stage
The following symptoms are present at this stage:
- a feeling of sore throat, asthma attacks in the form of suffocation, severe cough with sputum, pneumonia;
- drowsiness and weakness, fatigue, headaches;
- spatial disorientation;
- back pain and sternum;
- temperature rise.
In the blood, an increase in eosinophils is observed.
Intestinal stage
It refers to the classic symptoms of invasion:
- decreased appetite, impaired taste and taste preferences, when you want inedible things or unusual food;
- cephalgia, blurred eyes and weakness;
- hypersalivation;
- vomiting and nausea;
- fever and fever;
- disorientation and feeling of lightheadedness.
Pain is almost everywhere: in the abdomen, chest, lungs and heart, in the right hypochondrium, stomach; disorders of the stool.
Blood pressure always decreases, palpitations are noted, tinnitus appears, and the skin turns pale. The intestinal phase is the most severe, so there is a vivid symptomatology. In the blood, reduced hemoglobin, albumin joins eosinophilia.
Important! When the hookworm gets into the digestive tract, it passes another, already 3 molt. During this transformation, toxic substances are released, as a result of which a severe allergic reaction can develop.
Signs of a chronic phase
After entering the intestines and the active life of the parasite, the symptomatology changes, especially as anemia develops against the background of constant loss of blood.
Chronic weakness appears, there are dizziness up to fainting, the skin is pale and dry, the hair falls out, the nails peel. There is bloating, constant pain in the epigastrium, intestines, discomfort.
Vomiting and nausea become more frequent, stool becomes unstable, appetite disappears and anemia develops - pallor and weakness appear. The pulse quickens, blood pressure decreases. On the ECG, dystrophic changes in the myocardium. Hookworm can also lead to menstrual irregularities. There are non-healing ulcers in the intestinal walls; internal bleeding is possible. In children, nematodes can cause a lag in mental and physical development, thinness.
Complications
If untreated, hookworm can cause:
- pneumonia, bronchitis, enteritis and intestinal bleeding;
- alopecia;
- anemia
- myocarditis, Quincke's edema, inflammatory processes in the digestive tract;
- ulcerative lesions in the duodenum;
- decreased immunity.
Among women:
- infertility;
- hormonal disruptions with irregular menstruation;
- in pregnant women - abnormalities of the fetus; miscarriages.
Complications are not always required. It depends on the severity of the process and the timeliness of treatment. Important! Immunity to hookworm is not produced, even with repeated infection.
Diagnosis of hookworm
When you go to the doctor, hookworm can be diagnosed easily, but the problem is that the manifestations of the disease are not specific and lubricated, the person is in no hurry to go to the doctor. He blames his mild weakness on working fatigue, periodic diarrhea on eating disorders; minor itchy wounds are not addressed at all. Gradually, the body of such people weakens, the pathogen safely lives in it for an average of more than 4 years.
The basis of the diagnosis is the study of feces on worm eggs. By the number of infested parasites, hookworm can have a mild, moderate and severe course.
A mild course implies the penetration of single helminths, the manifestations are minimal. The person does not go to the doctor. Anemia may not develop.
The average degree is the introduction of dozens of worms. Anemia develops within 4-6 months after infection, the symptoms are more marked. Hemoglobin up to 85-90 g / l; moderate degree is most common. Much less often worms occur when thousands are introduced, anemia will develop by 2 months already.
Hemoglobin decreases to 60 g / l, which causes the patient to be exhausted, there can be a fatal outcome.
In addition to the analysis of feces, a UAC is performed. Eosinophilia, a decrease in hemoglobin and a change in color index are noted. With fluoroscopy, intestinal hypotension and pulmonary infiltrates are detected. With a duodenal examination, the composition of bile, the state of the mucosa, are studied.
Treatment features
Treatment of hookworm in people does not cause particular difficulties in establishing an accurate diagnosis: 95 out of 100 people are successfully cured.
The goal of treatment is:
- the destruction of worms;
- restoration of lost functions of damaged organs;
- enhanced nutrition of the body.
Alternative methods of treatment are possible only with a slight infection.
Traditional drug therapy
The most commonly used antiparasitic drugs:
- "Mebendazole" - according to the scheme for 3 days.
- "Albendazole" - is taken once.
- "Pirantel" - a single dose at the calculated dosage in a course of 2-3 days.
- "Dekaris" - 3 days reception.
There is no need to remind that antiparasitic drugs should be prescribed only by a doctor.
Symptomatic therapy:
- to increase hemoglobin - iron preparations, folic acid and other vitamins;
- with abdominal pain - antispasmodics, etc.
- immunostimulants, probiotics, etc. are prescribed.
Preventive actions
Prevention of hookworm, first of all, is to observe personal hygiene, cooking technology. You can not drink raw water from unknown sources, if it is impossible to boil water, you should take preparations for disinfecting water with you on the road. Those in the occupational risk group should be regularly monitored prophylactically.