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ishment. Heavy hookworm infestation can cause considerable damage to the intestinal wall. while one hookworm extracts only a fraction of a teaspoon of blood from the circulation every day, more severe infestations can be more serious. Since children cannot replace lost blood quickly, this may cause an iron deficiency and malnutrition. Chronic infestation with worms can lead to slowed growth and impaired behavioral, cognitive, and motor development. occasionally hookworm infestation can be fatal (especially in infants). Since transmission of hookworm infection requires development of the larvae in soil, hookworm cannot be spread person to person.

Symptoms

There may be no symptoms in a minor infestation; in more severe cases, the worms can cause abdominal pain, anemia, cough, diarrhea, mental slowness, and pneumonia, in addition to an itchy rash.

Treatment

In the United States, hookworm infections are generally treated for one to three days with medication such as mebendazole to kill the worms. The drugs are effective and appear to have few side effects. For children under the age of two, the decision to treat should be made by a pediatrician.

Another stool exam should be repeated one to two weeks after therapy. If the infection is still present, treatment will be given again. Iron supplements will be ordered if the patient has anemia.

Prevention

The best prevention is to improve sanitation so that transmission cannot occur, which is how hookworm infestations were eradicated from the southeastern United States. Children should not walk barefoot or contact the soil with bare hands in areas where hookworm is common, or where there is likely to be feces in the soil or sand.

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