HOOKWORMS
Soil transmitted helminths
Blood sucking nematodes
Meromyarian type
HOOKWORMS
Necator americanus- American hookworm,
American murderer, New World hookworm
(Host: Human)
Ancylostoma duodenale- Old World
hookworm (Host: Human)
Ancylostoma braziliense- Cat hookworm
Ancylostoma caninum- Dog hookworm
NAME OF BUCCAL
HOOKWORM CAVITY
Necator americanus semi-lunar cutting plates
Ancylostoma braziliense 1 pair of teeth
Ancylostoma caninum 3 pairs of teeth
Ancylostoma duodenale 2 pairs of teeth
Necator
americanus
Semi-lunar
cutting
plates
Ancylostoma
braziliense
1 pair of
teeth
Ancylostoma
caninum
3 pairs of
teeth
Ancylostoma
duodenale
2 pairs of
teeth
Necator americanus
Necator- means
murderer
Living worms are
pinkish or cream
yellow in color or
grayish white
Small,cylindrical,
fusiform
Female
longer than male; about 9-11mm by
0.35 mm with a blunt posterior end
Male
shorter; 5-9mm by 0.30mm
bursa copulatrix or membranous
caudal bursa or umbrella-like
structure with rib like rays
posterior end
is expanded to form
a fan like bursa copulatrix
(organ for copulation)
The Morphological Differences between Two
Important Human Species of Hookworms
POINTS OF A. duodenale N. americanus
DIFFERENCES
Size larger smaller
Shape C-shaped curvature S-shaped curvature
Mouth 2 pairs of ventral 1 pair of semilunar
teeth cutting plates
Copulatory bursa Tripartite (3 digits) Bipartite (2 digits)
simple and not bristle-like and
barbed barbed
posterior end
is expanded to form
a fan like bursa copulatrix
(organ for copulation)
Hookworm Eggs
colorless to pale yellow, ovoidal;
surrounded by thin, transparent
hyaline shell membrane, measuring
56-60 by 34-40 microns
when passed to the feces, they are in
the 2-8 cell stage (MORULA BALL
FORMATION)
RHABDITIFORM LARVA
FEEDING STAGE OF HOOKWORM
short and stout
Long buccal cavity with FLASK-
shaped Esophagus
Inconspicuous (small) genital
primordium
Hookworm rhabditiform larva
FILARIFORM LARVA
INFECTIVE STAGE OF
HOOKWORMS
longer and slender
with a pointed posterior end
SHEATHED ( W/ SHEATH)
Important Notes
Final Habitat of Hookworms: Small
Intestine
Mode of Transmission: SKIN
PENETRATION
Infective Stage- FILARIFORM
LARVA
WITH HEART TO LUNG
MIGRATION
Pathology
1. the skin at the site of entry
2. the lung during larval migration
3. the small intestine
Pathology of Human Hookworm
Larval Stage:
“ground itch” (severe itching due to allergic
reaction at the site of larval penetration )
Maculo papular lesion with erythema
Itching, edema and papulovesicular
eruptions
Upon heart to lung migration it can cause
pulmonary lesions- (petechial hemorrhages
with eosinophilic and leukocytic infiltration);
bloody sputum and possible pneumonia,
pneumonitis & bronchitis
Pathology of Human Hookworm
Adult Stage:
Abdominal pain, Enteritis
Hypoalbuminemia; diarrhea with blood
& mucus; eosinophilia
Blood loss leading to Iron-deficiency
anemia (microcytic, hypochromic
anemia)
N. americanus- 0.03-0.05ml/day
A. duodenale- 0.16-0.34 ml/day
Pathology
Exertional dyspnea
Weakness
Dizziness
Lassitude
Rapid pulse
Edema and albuminuria
Pathology of Non-Human
Hookworm
Larval Stage:
A. braziliense and A. caninum
CREEPING ERUPTIONS
CUTANEOUS LARVA MIGRANS
DIAGNOSIS
Direct Fecal Smear (DFS) look
for Hookworm eggs
Harada-Mori Culture Technique
(for hookworm and threadworm)
Kato technique/ Kato katz
Concentration technique- Zinc
sulfate flotation and FECT
Harada Mori
1. Place 7 ml distilled water in a test tube
2. With an applicator stick take half a gram
of feces and smear thinly on filter paper
laeving about 5 cm at both ends of the
filter paper unsmeared.
3. Insert the paper to the test tube with the
unsmeared part touching the water
4. Cover with aluminum foil to prevent flies
and dust
5. Keep in dark place at room temperature for 10
days. Larva will develop to filariform
6. Immerse the test tube in hot water for 15
minutes to kill the larvae
7. Remove the filter paper with a forcep and
transfer the contents of the test tube to a
centrifuge tube
8. Centrifuge for 3-5 minutes. Pipette and throw
away the supernatant carefully
9. Transfer the sediment to a slide , put a cover
slip and examine under the microscope
RISK FACTORS
suitability of the environment
for the eggs and larvae
mode and extent of fecal
pollution in the soil
mode and extent of contact
between infected soil and skin
or mouth
Epidemiology
Over 576-740 million people are infected
Associated anemia causes at least 50,000
deaths/yr
Greater in agricultural areas
Prevalence is bet 40-45% nationwide
Campostela valley province- more than
50% in late 1990s
A. ceylanicum in 1968 ( woman fr Ilocos
Norte
Out of 1,958 positive,97 were N.
americanus, 1% A. duodenale and 2%
were mixed infection
Davao del Norte-13.6%
Manila- 22.7%
Cebu- 14.8% among food handlers
A. duodenale – Europe and Southwestern
Asia
N. americanus- tropical Africa and the
Americans
Prevention, Treatment and
Control
Mebendazole/ albendazole ( drug of choice)
When the anemia is very severe- what should be
done?
Proper disposal of human feces
Personal hygiene
Health education/ treatment of infected individuals
Mass chemotherapy/ protection of susceptible
individuals
WASHED
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