Necator Americanus

NECATOR AMERICANUS
Necator americanus, commonly known as the new world hookworm,

is a species of hookworms that infects humans.It is an obligatory
parasitic nematode that lives in the small intestine and feeds on
blood.
Epidemiology
The epidemiology of Necator americanus shows

Prevalence and intensity of infection tend to increase with age, peaking
between 6-10 years old and plateauing in adulthood.Prevalence is
generally higher in males, but females (especially pregnant women) and
infants are most vulnerable due to low iron stores.Infection rates are
highest in areas with warmer temperatures and greater rainfall.
In the United States, 95% of hookworm cases are caused by N.
americanus, primarily in economically deprived rural areas.The
frequency distribution of N. americanus is overdispersed, with a small
proportion of hosts harboring the majority of worms.There is evidence of
density-dependent regulation of female worm fecundity.
Morphology
 The morphology of Necator americanus, the New World hookworm, is characterized
by:
 Adult worms are about 1 cm long, with males slightly smaller than females.
 The buccal capsule has two pairs of cutting plates (dorsal and ventral) around the
anterior margin, and a pair of subdorsal and subventral teeth near the rear.
 Eggs range from 65-75 μm x 36-40 μm and are virtually indistinguishable from those
of Ancylostoma duodenale.
 The first larval stage has a rhabditiform esophagus with a large bulb separated by an
isthmus.
 The third stage infective larvae have a filariform esophagus without a bulb.
 Males have fused spicules on the bursa at the posterior end.
 The cuticle has three main outer layers made of collagen and other compounds
secreted by the epidermis.
 The key distinguishing features from A. duodenale are the structure of the buccal
capsule and the trifurcated ends of the dorsal rays on the male bursa.
LIFE CYCLE
 The life cycle of Necator Americanus, the new world Hookworm, involves several
stages:
 Egg stage: Adults worm in the small intestine of the host produce eggs, which are
passed out with the feces into the environment.
 Larval stage: The eggs hatch in soil within 2 days, releasing rhabditiform
larvae.These larvae molt twice within 10 days to become third-stage filariform
larvae.
 Migration:The filariform larvae penetrate the skin, travel through the body to the
lungs, and are then coughed up and swallowed again, reaching the small intestine.
 Adult stage:The larvae molt twice more to become adult worms, which attach to
the intestinal wall using their cutting plates and feed on the blood.Adults worm can
live for 3-5 years.
 Reproduction: Adult worms mate in the intestine, and the female produces eggs,
which are passed out with the feces, starting the cycle again.
PATHOGENESIS AND SYMPTOMS
 The pathogenesis of Necator americanus hookworm infection involves the following key
steps:
 Infective larvae penetrate the skin, typically on the feet, and migrate through the
bloodstream to the lungs. This can cause a pruritic, erythematous rash known as "ground
itch" at the penetration sites.
 In the lungs, the larvae break into the alveoli, ascend the bronchial tree, and are swallowed,
reaching the small intestine. Migration through the lungs may cause mild cough and
pharyngeal irritation, but is usually asymptomatic.
 In the small intestine, the larvae mature into adult worms that attach to the intestinal wall
and feed on blood. This causes intestinal blood loss, which can lead to iron-deficiency anemia
in moderate to heavy infections.
 Adult N. americanus worms can live for 3-5 years in the human host. The female worms
produce thousands of eggs per day that are passed in the stool, continuing the life cycle.
 Patients with light hookworm burden tend to be asymptomatic, while those with moderate to
heavy burden may experience symptoms like epigastric pain, nausea, dyspnea, joint pain,
fatigue, and impotence. Fatality is relatively rare, but infection can cause discomfort and
disability
TREATMENT
 Treatment for Necator americanus hookworm infection includes:
 Anthelmintic medications like albendazole, mebendazole, or pyrantel
pamoate to get rid of the parasitic worms in the intestines.
Albendazole or ivermectin can also be used to treat infection by
hookworm larvae.
 Iron supplements to treat anemia caused by blood loss from the
infection. Nutrition support and other supplements like folate may be
needed if there is severe anemia and malnutrition.
 In rare cases of severe anemia and congestive heart failure,
hospitalization may be required for treatment.
 Lugol's iodine (1% povidine iodine) can be used to kill hookworm
larvae on exposed skin
PREVENTION
 The prevention of Necator americanus hookworm infection involves the following

key measures:
 Improved sanitation and hygiene, including proper disposal of human feces to
prevent soil contamination with hookworm eggs. This breaks the life cycle of the
parasite.
 Wearing shoes when walking in areas where hookworm is common to prevent
infective larvae from penetrating the skin. Avoiding direct skin contact with
potentially infested soil is also important.
 Treating domestic animals like dogs and cats for hookworm to reduce
environmental contamination with hookworm eggs.
 Periodic mass deworming of populations at high risk, such as children, at 3-4
month intervals in endemic areas. This reduces worm burden and transmission.
 Improving iron status through dietary measures and supplementation to mitigate
the effects of hookworm-related blood loss and anemia

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NECATOR AMERICANUS

Necator americanus, commonly known as the new world hookworm,

The epidemiology of Necator americanus shows

 The prevention of Necator americanus hookworm infection involves the following

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