Hookworms

The hookworms cause hookworm

disease, which is one of the five major
parasitic disease (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.

Hookworms are the voracious blood

feeders of the nematode world.

 Necator americanus known as the

American killer also known the new
world hookworm.
 Ancylostoma duodenale known as
the old world hookworm.
Morphology:

1- Adult female is about 9-13 mm, and the male is

smaller than 5-11mm.
2- The anterior end have buccal capsule
(analogous to mouth) armed with two ventral
pairs of teeth.
3- The posterior end of the male has copulatory
bursa to attach the female during the copulation,
females have simple conical tail.

I. 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♂.
2. Eggs: 60×40 µm in size, oval
in shape, shell is thin and
colorless. Content is 2-8cells.
 Differences between two hookworms

Adults of A. duodenale Adults of N. americanus

Buccal capsule

Ancylostoma duodenale
Necator americanus
Scanning electron micrograph of the mouth capsule of
Ancylostoma duodenale, note the presence of four "teeth,"
two on each side.and Necator americanus with two cutting
"teeth“.
 Left picture: Copulatory bursa and spines of N.
americanus(a side view);
Right picture: copulatory bursa of A. duodenale(a
top view)

Egg
• Shape : oval with an empty space between the shell and content
• Size: 60 x 40 μm
• Shell: thin egg shell
• Color: colorless and transparent
• Content: 4-8 cell unembryonated
• Immature eggs pass in feces (20,000 eggs ⁄ day).
 ‫ﺣﻔﻆ ﻣﺨﺘﻠﻒ‬

3.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
_______________________________________________________

II. 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
 Life cycle of hookworm

Ground itch or “dew itch”

Feeding hookworms

Hookworms do not permanently attach in one spot,

but move around the gut and reattach when they are
ready to feed.

Diagnosis:

1-history: farmer, handling mud

2-Clinical: pallor
3-Blood tests(CBC): microcytic hypochromic aneamia and
eosinophilia, nutritional deficiencies, particularly iron
can help to confirm the diagnosis.
4- parasitology: Diagnosis can be determined by looking
for hookworm eggs in a recently collected stool sample.
Principles of Control

1. Chemotherapy: Albendazole; Mebendazole

2. treat the patients and carriers
3. Sanitary disposal of human feces is the most effective
control measure in preventing the spread of infection
with the hookworms
4. Protection of the susceptible population
5. 3. health education, cultivate hygienic habits,.
6. Do not walk barefoot or contact with bare hands in
areas where hookworms is common or there are likely
to be feces in the soil or sand.

Case scenario (critical thinking)

 A 24 years old girl complain from sever abdominal pain following by
diarrhea. The patient sometimes suffers from non-productive cough.
GSE was done, the stool showed two distinct forms , the first one is
ovale in shape consist of amorphous mass of protoplasm surrounded
by thin shell. The second is rounded in shape consist of thick shell with
undeveloped embryo.
 A- name the forms and the parasite(s)
B-describe the diseases according to the intestinal and respiratory
symptoms
C- what are the laboratory test other than GSE should be done.