Hookworm, also known as Cutaneous Larva Migrans (CLM), is a skin infection primarily caused by Ancyclostoma braziliense hookworms. It is acquired by walking barefoot or sitting on soil or sand contaminated with dog or cat feces containing hookworm larvae. The hookworm eggs hatch in the soil or sand and the larvae migrate through a person's skin forming red burrows or tracks underneath the outer skin layer.
Cutaneous Larva Migrans is prevalent in tropical and subtropical areas of the Caribbean, South America, Asia, and Africa, but can also occur during the hot months in temperate regions. Travellers taking beach vacations are at greater risk.
Usually symptoms include itching (which can cause a secondary bacterial infection), mild swelling, and redness at the place of larval penetration, typically on a person's feet or buttocks. The burrows or tracks usually appear 1 to 5 days after exposure, but sometimes can take weeks to show up. In the majority of cases the infection suddenly disappears after a few weeks. Treatment includes applying anti-itch creams and taking anthelmintic drugs.
Always wear shoes or sandals.
At the beach, always sit on a towel and wash it after each use.
Wash your hands and feet with soap and water, or if not available, use an alcohol-based hand sanitizer after touching sand or soil.
There is no preventive vaccine or medication against Hookworm.
Information last updated: January 2020
McCarthy JS, Moore TA. Toxocariasis and Larva Migrans Syndromes. In: Guerrant, R; Walker D; Weller P, eds. Tropical Infectious Diseases. 3rd ed. New York: Saunders Elsevier; 2011: 763-767.
Montgomery SP. Cutaneous Larva Migrans. In: McGill, A; Ryan, E; Hill, D; Solomon, T, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 9th ed. New York: Saunders Elsevier; 2013: 862-863.