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Species-specific identification of human hookworms by PCR of the mitochondrial cytochrome oxidase I gene.

Significant differences in the life histories of the human hookworms Ancylostoma duodenale and Necator americanus necessitate their differentiation for epidemiological studies and the design of control programs. Current methods of identification require time-consuming, labor-intensive techniques. A polymerase chain reaction (PCR)-based method that enables rapid species identification is described. The mitochondrial cytochrome oxidase I genes of both species were sequenced, and species-specific primer sets were designed. The primers were used in PCR to amplify 585-bp fragments of the cytochrome oxidase gene from individual hookworm eggs, larvae, and adults. The technique was also able to identify mixed infections containing equal amounts of eggs from each species. The technique is rapid, technically simple, and sensitive and will permit the accurate identification of human hookworms in epidemiological field studies.

Ancylostoma↗

[The Influence Of Ultraviolet Irradiation Upon The Development And Infectivity Of Hookworm Larvae]

The eggs and rhabditoid larvae of canine hookworm were irradiated with ultraviolet rays for one hour at a distance of 10, 20, 30, and 40 cm. The infective stage larvae of the same parasites were irradiated for l, 3, 5 and 14 hours from the same distances. The infective larvae were also exposed under direct sunlight for l, 2, 3 and 4 hours. PARASITES: Ancylostoma caninum was used. Eggs were collected in vitro from female adult worms. The worms were kept at 37 degrees C in petri-dish filled with Kreb's Ringer solution. There was an average of two cell stages, and they were used as early as possible before the morula stage. Rhabditoid larvae were obtained by culture of the above eggs for twenty-four hours in 25 degrees C incubator. The larvae reached the infective stage in seven days culture at the same condition. IRRADIATION OF ULTRAVIOLET RAY: Kingston ultraviolet light (100 volt, 10 watt, 50 cycles, 0.230 ampere) was used. The potential U.V.R. power was 1.8 watts. The distances between the material and the light were 10, 20, 30 and 40 cm at a temperature of 25 degrees C in each case. The samples were smeared on the tile in order to keep them in saturated moisture. Fully wetted ten ply gauze was laid underneath the tile. The tile was surrounded by 2 x 5 cm rectangular piece of glass in order to prevent the spread of the larvae to the outside. All of the samples received irradiation for one hour and were cultured for a period of seven days. The hatching of the egg and the development of the larvae were observed. For the purpose of the study, the infectivity and pathogenicity of the irradiated samples, were inoculated into mice orally. The lungs, livers and carcass were examined three days after the infection. A routine pathological examination of the organs was also carried out. In order to study the eggs productivity, the larvae were given to the proper host, dog. The eggs in the feces were examined from three to 6 weeks after infection, both quantitatively and qualitatively. As a supplementary experiment, the infective larvae of canine hookworm were exposed four hours under direct sunlight (September 25), and the infectivity and pathogenicity of the host were examined. HATCHING, DEVELOPMENT AND INFECTIVITY OF IRRADIATED EGGS: Hatchability of the irradiated group for one hour according to the distance from the light to the sample were 48.0 % at 10 cm, 60.3 % at 20 cm, 85.2 % at 30 cm and 88. 2 % at 40 cm respectively. None of them developed to the infective stage. They remained rhabitoid for several days and were destroyed. None was found alive in the host. 93.0 % of the control group hatched and developed to the infective stage. DEVELOPMENT AND INFECTIVITY OF IRRADIATED RHABDITOID LARVAE: None of the irradiated group reached the infective stage. Under irradiation they coiled and died soon after straightening out again. Only the group irradiated at the distance of 40cm survived for six days. They finally granulated. There was no manifestion of irradiated larvae alive in the host tissue. LIFE SPAN, INFECTIVITY, PATHOGENICITY AND EGG-PRODUCTIVITY OF THE IRRADIATED INFECTVE STAGE LARVAE: All were destroyed in the group of fourteen hours irradiation at 40 cm distance. Thirteen precent survived in the five hours irradiation group at the same distance. The survivability of larvae was reduced by the period of irradiation and at the shortest distance. The infectivity to mice was only 0.8 % at 30 cm, and 8.2 % at 40 cm in the three hour irradiation group. The recovery of the infected larvae from the host tissues was reduced as the irradiation period was increased and the distance shortened. The pathogenicity was paralleled with the vitality of the irradiated larvae. From the groups of one hour irradiation and ten cm distance, three hour irradiation and ten to thirty cm distance, the egg-productivity was all negative. But as the irradiation period decreased and the distance lengthened the egg-productivity tended closer to normal. The infective stage larvae which were exposed to direct sunlight were destroyed within three hours, but survived 81 % in the one hour exposure group and 20 % in the two hour exposure group. The summary of the results is as follows: 1. The hatching of eggs was reduced to half for one hour irradiation at the ten cm distance. Even hatched larvae did not develop to infective stage. 2. Infectivity was inhibited by the irradiation to at the ten cm distance for one hour. About ten percent of the irradiated infective stage larvae were recovered from the infected animal among the group of 40 cm distance for one hour. The egg-productivity became lower in the group of one hour irradiation at 40 cm distance. 3. The pathogenicity of the irradiated group was mild compared to the control group. 4. The direct sunlight destroyed the infective stage larvae within three hours. In general, the ultraviolet ray showed the inhibitory action in the hatching, development, pathogenicity and egg-productivity of the hookworm. The grade was paralleled with the period of irradiation and reversed to the distance between the light and samples.

Journal Article↗

Treatment Of Hookworm Infection With Furfurol.

Furfurol("Furfudol"), a new anthelmintics, was administered to 7 adults and 21 children (6-12 years old) in total amounts of 15.6 mg(base) for 1 to 3 days. It has proven to be effective against hookworms. The anthelmintic effect against hookworms with a single dose of 15.6 mg of furfurol was similar to that of a single dose of 2.5 gm of bephenium hydroxynaphthoate. However, when a total of 15.6 mg of the base was given to both children and adult, the side reactions were so mild that the drug can be administered for therapeutic regimens in mass treatment. Minor abdominal discomfort was the only common side effect. This is the primary advantage of furfurol as compared with bephenium hydroxynaphthoate. These results have indicated that furfurol is safe in therapeutic dosage and is an effective agent to treat patients infected with hookworms.

Journal Article↗

Pyrantel Embonate And Bephenium Hydroxynaphthoate In The Treatment Of Hookworm Infection.

A total of 100 hookworm infested patients were divided into two groups. One group of 49 received pyrantel embonate in a single oral dose of 10 mg as the base per kg body weight and the other group of 51 a single oral dose of 5.0 gm bephenium hydroxynaphthoate for a comparison of efficacy on hookworm infestation and other intestinal helminths. Forty-two(85.7%) cases of hookworm treated with pyrantel embonate were cured and there was a 99.9 per cent mean reduction in fecal egg count. Of the 51 patients who received bephenium hydroxynaphthoate complete cure occurred in 76.5 per cent and the mean reduction in fecal egg count was 91.8 per cent. These results plus the lower incidence of side effects recorded in the pyrnatel group suggest that pyrantel embonate is the more desirable trestment. Pyrantel embonate was highly effective against Ascaris lumbricoides, Trichostrongylus orientalis and both drugs were moderately effective against Trichuris trichiura. During the course of the study measurements of hematology, biochemistry and examinations of urine specimens were carried out. All values were normal throughout the study and no significant difference was observed between pyrantel embonate and bephenium hydroxynaphthoate treated subjects. Side effects were more common in the bephenium hydroxynaphthoate treated group.

Journal Article↗

[An imported human case of hookworm infection with worms in the rectum].

An imported case of rectal hookworm infection was diagnosed by stool examination and recovery of adult worms from the rectal mucosa by sigmoidoscopy. The chief complaints of a patient were diarrhea, abdominal pain and weight loss for about 1 month after returning from his travel abroad to the Southeast Asia. Leukocytosis(16,750/microliters) and peripheral eosinophilia(33.7%) were noticed without anemia. Typical hookworm eggs were detected by stool examination, and 3 worms were collected by sigmoidoscopy from rectal mucosa of this patient. Those worms were confirmed as adult worms of Ancylostoma duodenale(male:1, female:2) based on their morphological characteristics. The symptoms were relieved after treatment with anthelmintics. This case was considered as one of the imported parasitic infections in Korea, and a rare case of hookworm infection on human rectal mucosa.

Ancylostoma↗

Factors affecting high and low human IgE responses to schistosome worm antigens in an area of Brazil endemic for Schistosoma mansoni and hookworm.

We have previously examined the antibody isotype responses to schistosome worm and egg antigens in human populations living in areas of Kenya and the Philippines endemic for Schistosoma mansoni and S. japonicum, respectively. Here, we have analyzed antibody isotype responses to S. mansoni adult worm (AW) antigen and soluble egg antigen (SEA) in more than 500 Brazilian individuals, and found similar relationships with age and sex as in the Kenyan and Filipino populations. Isotype responses to AW antigen broadly increased with age whereas isotype responses to SEA decreased, and a higher proportion of males than females had detectable IgE against AW antigen. Most isotype responses to AW antigen and SEA correlated positively with intensity of infection with S. mansoni except AW antigen-specific IgG2, which correlated negatively. The overall prevalence of infection with S. mansoni in this area was relatively low at only 39.5%; hookworm prevalence was higher at 57.4%. The majority of those infected with S. mansoni were also infected with hookworm (76%). Those individuals with high IgE responses to AW antigen were matched for sex, age, and total IgG to AW antigen as closely as possible with individuals with low levels of AW antigen-specific IgE. The two groups were compared for factors potentially influential in IgE production. No difference was found between the high and low IgE responders for 1) intensity or prevalence of infection with S. mansoni, 2) relative exposure to S. mansoni, 3) number of previous treatments for schistosomiasis, or 4) prevalence of infection with hookworm, but differences were found in other isotype responses to S. mansoni. The high IgE responders had higher IgA and IgG4 against both AW antigen and SEA but lower IgG3 responses to AW antigen than the low IgE responders. The IgE responses to three S. mansoni antigens (paramyosin, Sm22.6, and a 12-kD AW antigen band) were detected in individuals with IgE against AW antigen only.

Adolescent↗

Molecular cloning and purification of Ac-TMP, a developmentally regulated putative tissue inhibitor of metalloprotease released in relative abundance by adult Ancylostoma hookworms.

A cDNA encoding a putative tissue inhibitor of metalloprotease was cloned from an Ancylostoma caninum adult hookworm cDNA library by immunoscreening with anti-hookworm secretory products antiserum. Ac-TMP (A. caninum tissue inhibitor of metalloproteinase) is encoded by a 480-bp mRNA with a predicted open reading frame of 140 amino acids (molecular weight, 16,100 Da) that contains one potential N-linked glycosylation site and an N-terminal Cys-X-Cys consensus sequence. The open reading frame corresponds to a putative hookworm tissue inhibitor of metalloproteases (TIMP) with 33% identity and 50% similarity to the N-terminal domain of human TIMP-2. Analysis by reverse transcriptase-polymerase chain reaction indicates that transcription of Ac-tmp is restricted to the adult stage. The protein was isolated from A. caninum adult secretory products by reverse-phase high-performance liquid chromatography and identified as one of the most abundant proteins released by the parasite. To our knowledge, this is the first description of a TIMP from a parasitic invertebrate.

Amino Acid Sequence↗

Human enteric infection with canine hookworms.

OBJECTIVE: To describe a zoonotic ancylostomiasis (canine), acquired from domestic pets by patients living in developed, urban communities. DESIGN: An 8-year, retrospective case study. SETTING: A clinical gastroenterologic practice in Townsville and a university parasitology department in Brisbane, Australia. PATIENTS: Nine patients, each with enteric hookworm infection diagnosed by finding a single organism in situ; five were treated by us, and the rest were referred to us for parasite identification. MEASUREMENTS: Clinical and demographic data, complete blood examinations, total serum immunoglobulin E assay, and serologic testing with enzyme-linked immunosorbent assay and Western blot using excretory-secretory antigens of Ancylostoma caninum. Gut biopsy specimens were examined histologically, and hookworms were identified using morphologic criteria. RESULTS: The infections in three of the patients were diagnosed during the initial 6 years and six in the last 2 years. All owned a dog and described activity potentially exposing them to infection with canine hookworm larvae. Three patients had a laparotomy for acute abdominal pain, and six had colonoscopies (five with pain and one without symptoms). Six of the nine had blood eosinophilia (mean, 0.97 x 10(9)/L), and five of eight had elevated immunoglobulin E levels (mean level, 756 micrograms/L); six of eight had eosinophilic inflammation of the gut. In six patients, the worm was identified as A. caninum, whereas in three, damage to the specimen did not allow specific identification; however, they were unlikely to be human parasite species. Although all parasites were in the adult stage, none were sexually mature. Positive serologic findings in seven of the eight patients tested confirmed presence of antibody to the parasite. CONCLUSIONS: Human enteric infections with A. caninum are being diagnosed more frequently in northeastern Australia. Although infection may be subclinical, the chief symptom is abdominal pain, sometimes sudden and severe. The pathologic finding is focal or diffuse eosinophilic inflammation caused by a type 1 hypersensitivity response to secreted antigens. Infection by sexually immature worms is scant and nonpatent, indicating poor adaptation to the human host. Serologic testing assists in identification of occult infection. Advanced hygiene and sanitation afford little protection because the parasite reservoir is a large and growing pool of infected domestic pets.

Abdominal Pain↗

Protective immunity in mice elicited by living infective third-stage hookworm larvae (Shanghai strain of Ancylostoma caninum).

OBJECTIVE: To elucidate the mechanisms of protective immunity in mice elicited by living hookworm (Ancylostoma caninum third-stage infective larvae (L3). METHODS: The number of migrating infective larvae recovered from the lungs was used as an endpoint for vaccine immunity. The timing of maximal L3 lung entry was determined by counting the number of lung larvae at several time points after infection with 500 or 1000 L3. Mice were immunized either orally or subcutaneously with 500 L3, followed by two boosts of L3 once every two weeks. The immunized mice were challenged orally with 500 L3 one week after the final boost. To evaluate the protective immunity, the number of L3 recovered from the lungs of the immunized mice during the time of maximal larval entry was compared with that of controls. Host immunity was also evaluated by comparing circulating anti-L3 antibodies between immunized and controlled mice, using both enzyme immunoassays and immunoblotting techniques, and by lung histopathology. RESULTS: The peak time of larval entry into the lungs occurred 48 hours after infection. Mice immunized either orally or subcutaneously with L3 exhibited a marked reduction (90.2% and 86.2% respectively) in the number of recovered lung larvae in comparison to controls (P < 0.01). The protection might be associated with circulating anti-L3 antibodies, including antibodies directed against 132-200 kDa L3 antigens, as well as three major antigens ranging from 28 to 51 kDa. Larvae migrating through the lungs of vaccinated mice showed cuticular damages accompanied with host-inflammatory cell invasion. CONCLUSIONS: Immunization with living L3 protects mice against lung invasion after challenged with hookworm infection. Vaccine immunity is associated with circulating antibodies against L3 antigens and lung inflammatory responses. The mouse model is potentially useful for developing a hookworm vaccine.

Ancylostoma↗

Resumption of feeding in vitro by hookworm third-stage larvae: a comparative study.

Third-stage infective larvae of the canine hookworm Ancylostoma caninum resume feeding in vitro in response to several stimuli. Experiments were conducted to characterize the in vitro feeding behavior of several hookworm species. Reduced glutathione and, to a lesser extent, canine and human serum stimulated third-stage larvae of Ancylostoma duodenale to resume feeding. Glutathione-induced feeding reached a maximum by 16 hr and was concentration-dependent between 0- and 15-mM glutathione. Oxidized glutathione and the reducing agents dithiothreitol and L-cysteine failed to induce feeding, suggesting that reducing conditions alone were not stimulatory. Serum incubated with glutathione was the most efficient stimulus for Ancylostoma ceylanicum, Ancylostoma braziliense, and Ancylostoma tubaeforme larvae, whereas Uncinaria stenocephala larvae responded best to canine serum alone. Necator americanus larvae did not resume feeding in response to glutathione, serum, glutathione plus serum, or linoleic acid (0.1-10 mM). These differences in feeding behavior suggest that generalizations concerning hookworm biology must be interpreted cautiously.

Ancylostoma↗

Detection of excretory/secretory coproantigens in experimental hookworm infection.

This report describes the detection of hookworm excretory/secretory (ES) antigens in soluble hamster fecal extracts by an enzyme-linked immunosorbent assay (ELISA). A rabbit polyclonal IgG antibody against Ancylostoma ceylanicum ES was used to capture hookworm coproantigens that were then detected using pooled, high-titer, infected hamster serum. The ELISA was capable of detecting ES proteins over a range of 10 ng/mL to 10 mug/mL when the antigens were diluted in buffer or uninfected fecal extract, and ES could be detected in infected hamster feces at dilutions up to 1:256. Examination of the kinetics of coproantigen production demonstrated that detectable amounts of ES were produced as early as four days after A. ceylanicum infection, whereas fecal eggs were not observed until day 17. Moreover, fecal ES levels correlated well with intestinal worm burden and could be detected in wet or dry stool samples stored for 14 days over a temperature range of -80 degrees C to 37 degrees C. The fecal ELISA was then adapted to analyze the excretion of AceES-2, a novel immunogenic ES protein recently cloned from A. ceylanicum cDNA. AceES-2 was found to be excreted in feces with kinetics similar to that of whole ES. Examination of individual hookworm antigens by this method will provide new insights into the molecular host-parasite interaction and may form the basis for future diagnostic methods.

Ancylostoma↗

Hookworm in dogs and cats in the area of Jakarta.

An investigation of the distribution and prevalence of hookworms in dogs and cats was carried out during the year 1976 in the area of Jakarta. Sixty-eight percent of the dogs harboured A. caninum, whereas 37% harboured A. ceylanicum and 18% A. braziliense and 32.1% as A. ceylanicum. Hookworms were recovered from 78% of the fifty cats; 72% of the cats were infected with A. braziliense and 24% with A.ceylanicum. Among the 1895 hookworms in cats, 73,5% were A. braziliense and 24.5% were A. ceylanicum. Only one female A. tubaeforme was found in one cat.

Ancylostomiasis↗

Comparative single/dose treatment of hookworm and roundworm infections with levamisole, pyrantel and bephenium*.

One-hundred and forty-five farmers aged 7-45 years who were infected with Ancylostoma duodenale and/or ascaris were treated with a single dose of levamisole, pyrantel, or bephenium. The percentage cure rates were ascaris 100 per cent ahd hookworm 93 per cent for levamisole; ascaris 90 per cent and hookworm 78 per cent for pyrantel; and ascaris 73 per cent and hookworm 81 per cent for bephenium. The 3 drugs were well tolerated. The opinions and assertions contained herein are the private ones of the authors and are not to be construed as official or as reflecting the views of the Department of the Navy or The Egyptian Ministry of Healty.

Adolescent↗

Hookworm infection and blood changes in the rural population of Dezful area in Khuzestan, South-West of Iran.

Hookworm infection and blood changes relationship in the 937 infected persons in 6 villages of Dezful area in Khuzestan, South West of Iran, were studied. The most prevalent intestinal helminths in the area were Ascaris lumbricoides 21%, Ancylostoma duodenale 35%, Trichostrongylus spp. 17% and Hymenolepis nana 17%. Only 2% of the hookworm infected persons showed high intensity of infection which accompanied with rather low haemoglobin level of 9.4 g/100. The eosinophil level was 12-d16.5%. The results of this study indicates that the anaemia produced by hookworm infection in Khuzestan is not significant.

Adolescent↗

[Epidemiology and control of hookworm infection in Fujian province].

Fujian province has been known to be endemic for mixed hookworm infection with Ancylostoma duodenale as the predominant species. The infection rate was 50% before 1980. As a result of mass treatment starting from 1980, the infection rate was decreased in most areas. And, infection foci were changed from sweet potato fields to the banana, sweatcane and asparagus fields where the infection rate tended to increase. It is stressed that the current endemic characteristics of hookworm infection should be paid more attention in implementing the control programme of hookworm infection.

Adolescent↗

Observations in 2001 on hookworms ( Uncinaria spp.) in otariid pinnipeds.

Uncinaria spp. were recovered from the milk of California sea lions ( Zalophus californianus) collected from the: (1) teats of a cow just after parturition (one parasitic third-stage larva, L(3)), (2) stomach of her nursing pup (two L(3)), and (3) stomach of a dead pup about 2 days old (one L(3), one headless, probably L(3), and four L(4)) on San Miguel Island, California in May 2001. This, in addition to earlier research, indicates transmammary transmission of hookworms in this host. Uncinaria spp. were found in dead northern fur seals ( Callorhinus ursinus) in the: (1) intestines of 2 of 75 pups (either one or two adult specimens in each infected pup) and (2) ventral abdominal blubber of 3 of 78 subadult males (one to seven L(3) in each infected seal) on St. Paul Island (SPI), Alaska in July and August 2001. These findings verify the low current prevalence of Uncinariaspp. in fur seals on SPI. Rectal fecal samples taken from 50 live Steller sea lion ( Eumetopias jubatus) pups, about 1 month old, on Rogue Reef in Curry County, Oregon in July 2001, were all negative for the eggs of Uncinaria spp. The apparent zero infection rate in these pups is possibly because the rocky terrain of this rookery is not suitable for hookworm transmission.

Ancylostomatoidea↗

Penetration of the small intestine of a California sea lion (Zalophus californianus) pup by adult hookworms (Uncinaria spp).

During a study on the mortality of California sea lion (Zalophus californianus) pups born on San Miguel Island, California in 2002, two adult female hookworms (Uncinaria spp) were found penetrating the serosal surface of the intestinal wall and protruding into the peritoneal cavity of one pup. Documentation and a description of this unexpected finding and associated lesions are presented here. Also, adult hookworms were found in the peritoneal fluid of two other dead Z. californianus pups.

Ancylostomatoidea↗

Infantile hookworm disease in China. A review.

Hundreds of cases of infantile hookworm disease which shows bloody stools, melena, anorexia, listlessness and oedema, have been reported in China since the 1960s. Hookworm eggs were detected in due course in the faeces of the reported cases. With the exception of a single worm identified as Necator americanus, all the adult worms expelled following chemotherapy or examined at autopsy were Ancylostoma duodenale. Many children showed clinical manifestations and eggs in their faeces on day 1-26 after birth, and more cases occurred within 3 months of birth. Evidently, these infections were mostly transmitted from the mothers by transplacental and/or transmammary routes.

China↗