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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