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by l.wafa menawi

Hookworms
The hookworms cause hookworm
disease, which is one of the five major
parasitic disease in China(malaria,
shistosomiasis, filariasis, kala- azar and
hookworm disease). At least two species
of hookworms infect man, Necator
americanus and Ancylostoma
duodenale. They live in small intestine.
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Ancylostoma duodenale

Egg

Rhabditiform
larva

Adult
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Hookworms
Ancylostoma is found in

Europe around the

Mediterranean, on the
West coast of South
America and in parts of
China and India
Necator is found over much
of the western hemisphere,
Africa and South East Asia
More than a billion people
infected
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Hookworms
Acylostoma was found

coal and other mines

throughout Europe

At the turn of the last

century, severe
hookworm disease was
an officially recognized
occupational hazard in
German coal mines and
an eligible disease for
workmans compensation

parasite lab
by l.wafa menawi

Hookworms
Hookworms were wide spread in

the Southern USA .

Hookworm control programs were
a big part of the public health
campaign in the South during and
right after World War II
1972 12% of school children from
rural costal Georgia tested positive
for hookworm infection
parasite lab
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Morphology
1. Adults: They look like an
odd piece thread and are
about 1cm. They are white
or light pinkish when living.
is slightly larger
than.The males posterior
end is expanded to form a
copulatory bursa.
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Eggs: 6040 m in size, oval in. 2

shape, shell is thin and colorless.
.Content is 2-8cells

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Differences between two hookworms

Adults of A. duodenale

Adults of N. americanus

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Acylostoma duodenale & Necator

americanus -- human hookworms
Small nematodes (1-1.5

cm)
Head is slightly bend
(hook) and the mouth
carries characteristic teeth
(Ancylostoma) or plates
(Necator, note that these
are not real teeth but
cuticular formations of the
buccal capsule)
The posterior end of the
male worm is elaborated
into a copulatory bursa
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 Scanning electron micrograph of the mouth capsule of

Ancylostoma duodenale, note the presence of four

"teeth," two on each side.
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 Scanning electron micrograph of the mouth capsule of

Necator americanus, another species of human hookworm.

Note the presence of two cutting "teeth.

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 Ancylostoma duodenale - copulatory

bursa and spines of male(a side

view) parasite lab
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 Copulatory bursa of N.

americanus(a side view)

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Left picture: Copulatory bursa and spines of N.

americanus(a side view);

Right picture: copulatory bursa of A. duodenale(a
top view)
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 Morphologically it is not

possible to differentiate
between A. duodenale and
N. americanus.
Interference contrast.
400. Enlarged by 5.4.

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The Morphological Differences between Two

species of Hookworms
_____
A. duodenale
N. americanus
Size
larger
smaller
________________________________________________
Shape
single curve, looks like C
double curves, looks like S
_____________________________________________
Mouth
2 pairs of ventral teeth
1peir of ventral cutting plates
_______________________________________________
Copulatory circle in shape
oval in shape
Bursa
(a top view)
(a top view)
________________________________________________
Copulatory 1pair with separate
1pair of which unite to form
spicule
endings
a terminal hooklet
________________________________________________
caudal spine
present
no
________________________________________________
vulva position
post-equatorial
pre-equatorial
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Life Cycle
1. Final host: man
2. Inf. Stage: Larva 3 or filariform larva
3. Inf. Route: by skin
4. Food: blood and tissue fluid
5. Site of inhabitation: small intestine
6. Life span: Ad 15years, Na 3-7years
7. Blood-lung migration:
skin, cavum, right heart, lungs
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Life cycle of hookworm

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parasite lab
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 Adult worms live in the small

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intestine and female lay 510000 eggs a day over 5 years

Eggs are passed with the feces
Larvae develop outside the
body and molt twice
The filariform or L3 larvae move
to the surface in search for a
host
If they come into contact with
the host they penetrate the skin,
enter blood vessels and leave
the circulatory system into the
alveoli
The larvae move up the trachea
into the esophagus, are
swallowed and finally reach the
intestine, where they molt twice
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more
before they reach maturity

Pathogenesis and Clinical

Manifestations
1. Larval migration

(1) Dermatitis, known as "ground

itch" or "stool poison".The larvae
penetrating the skin cause allergic
reaction, petechiae 0r papule with
itching and burning sensation.
Scratching leads to secondary infection.

parasite lab
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(2) pneumonitis (allergic

reaction), Loeffier's syndrome:
cough, asthma, low fever, bloodtinged sputum or hemoptysis,
chest-pain, inflammation
shadows in lungs under X-ray.
These manifestations go on
about 2 weeks.
parasite lab
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2. Adults in small intestine

(1) Epigastric pain as that of a duodenal
ulcer.
(2) A large worm burden results in
microcytic hypochromatic anemia
(character manifestation). The symptoms
are lassitude, edema, palpitation of the
heart. In severe case, death may result
from cardiac failure or physical exhaustion.
parasite lab
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(3) Allotriophagy (orpica) is due

to the lack of trace element iron .
(4) Amenorrhea, sterility, abortion
may take place in women.
(5) Gastrointestinal bleeding
(6) Infantile hookworm disease

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Adults in intestinal mucosa

parasite lab
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Diagnosis

Criterion:
1. hemoglobin is lower than 120g/L in
man, 110g/L in woman.
2. find hookworm egg
Method:
1. saturated brine flotation technique
2. direct fecal smear
3. culture of larvae
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Treatment
1. Albendazole
2. Mebedazole

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Prevention
Unified measures:
1. sanitary disposal of night soil
2. individual protection
3. health education
4. cultivate hygienic habits
5. treat the patients and carriers.
parasite lab
by l.wafa menawi

parasite lab
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