By Peter Hotez, MD, PhD
President, Sabin Vaccine Institute
No, you’re not looking at a screenshot from a Steven Spielberg horror film. That image of the white blob with teeth is a hookworm, an intestinal parasite that affects nearly one tenth of the world’s population, or almost all of the world’s poorest people (“The Bottom Billion”), and is the leading cause of anemia and protein malnutrition, particularly in pregnant women and children.
Hookworm is widespread in tropical and subtropical regions where the temperature of the soil is suitable for the growth of the hookworm larvae and many people live in abject poverty.
Hookworm larvae are found in human feces and transmitted to humans from contaminated soil through the skin, usually due to contact with contaminated soil or in some cases accidentally ingesting contaminated soil. Once inside the body, larvae are carried through the bloodstream to the lungs and mouth where they are swallowed, digested and passed to the small intestine. There, the larvae mature into half-inch-long worms which attach themselves to the intestinal wall and feed on human blood.
Currently, there are efforts underway to reduce infection rates including improving sanitation by building or increasing use of outdoor latrines; educating communities on the causes and symptoms of hookworm infection; and distributing annual doses of donated Albendazole or Mebendazole.
It’s devastating to visit the endemic areas of the world’s poorest countries, to see children with profound anemia and malnutrition from hookworm is truly tragic. I have been conducted research on hookworm infection for the last thirty years beginning when I was an MD/PhD student. It is my dream and hope to one day see this ancient scourge controlled or eliminated in the low-and middle-income countries of Africa, Asia, and the Americas.
In 2000, I established the Human Hookworm Vaccine Initiative (HHVI) to develop the world’s first-ever safe, affordable, vaccine against human hookworm infection. A hookworm vaccine would help alleviate the worldwide suffering of more than a half-billion infected people, 44 million of whom are pregnant women; and prevent disease in 3.2 billion people that are at risk, and, most importantly, it would provide immunity against the infection and ensure that fewer and fewer generations are susceptible to infection in the future.
As you can see, her abdomen is grossly distended–the tell-tale sign of a major worm infection. In many severe cases like hers, you can even physically palpate the worms on the outside of the abdomen.
