Ankylostomiasis

　　Ancylostomiasis is a disease caused by the parasitic nematode Ankylostoma duodenale or Necator americanus in the human small intestine. The larvae can invade the human skin, causing hookworm dermatitis, with small red papules appearing locally. The adult worms attach to the villi of the small intestinal mucosa with their mouthparts to feed on the mucosal epithelium and blood. The adult worms frequently change their attachment sites and secrete anticoagulant substances, so the mucosa attached to the hookworms continuously bleeds, causing chronic blood loss and plasma protein loss.

　　Hookworm disease is a disease caused by hookworms寄生ing in the human small intestine, which may lead to anemia heart disease. Pregnant women with severe infection are prone to pregnancy poisoning, premature delivery, stillbirth, and other complications.

　　The symptoms of hookworm disease are mainly caused by larvae and adult worms, but the symptoms caused by adult worms are more long-lasting and severe. The specific clinical manifestations of hookworm disease are as follows.

　　1. Symptoms caused by hookworm larvae

　　1. The skin at the site of invasion by the hookworm larvae is initially very itchy and burning, followed by small hemorrhagic spots, papules, and small vesicles. Dermatitis often occurs between the fingers and toes, on the sole, and the ankle, and can disappear within a few days. Scratching may lead to secondary bacterial infection, local lymphadenopathy, and occasionally transient urticaria.

　　2. Three to five days after infection of the respiratory system, patients often have cough, itching in the throat, and hoarseness. Severe cases may present with severe dry cough and asthma attacks, characterized by eosinophilic asthma, with blood丝 in the sputum.

　　2. Symptoms caused by adult worms

　　Patients with hookworm infection are those who have hookworm eggs in their feces but no obvious symptoms. Those with hookworm eggs in their feces and chronic clinical symptoms are called 'hookworm disease'.

　　1. Most patients gradually develop upper abdominal discomfort or pain, decreased appetite, diarrhea, fatigue, and weight loss within 1 to 2 months after infection.

　　1. After 3 to 5 months of severe infection, progressive anemia may gradually appear, manifested as dizziness, tinnitus, palpitations, and shortness of breath. Long-term severe anemia can lead to heart disease, manifested as cardiac enlargement and increased heart rate. Severe anemia is often accompanied by hypoproteinemia, resulting in edema of the lower limbs or the whole body. The degree of anemia directly affects the circulatory system, especially the heart's metabolic function. Patients may have pale skin and mucous membranes, slight edema of the lower limbs, and feel short of breath and palpitations without exertion. The limbs are weak, there is tinnitus, dizziness, and intellectual decline. Severe infected patients may have significant edema, severe shortness of breath and palpitations, and chest pain after slight activity. The pulse is rapid and weak, the heart is enlarged, and there are significant systolic and diastolic murmurs. When heart failure occurs, liver enlargement and tenderness, lung rales, and ascites may also be seen.

　　3. Other aspects

　　Children with severe disease may have growth and development disorders, intellectual decline, incomplete sexual development, dwarfism, and other symptoms. Adult patients often have amenorrhea, impotence, decreased libido, infertility, and other symptoms. Pregnant women with severe infection are prone to pregnancy poisoning, premature delivery, stillbirth, and other complications.

　　Currently, the research on vaccines for preventing hookworm disease is still in the experimental research stage. Preliminary studies using nematode-secreted protein-1 have shown that it can stimulate animals to produce antibody-dependent immunity, but it is still too early to use it in humans. Prevention of the disease should also be paid attention to in daily life. The specific preventive measures for the disease are as follows.

　　1. Manage the source of infection

　　In epidemic areas, a general survey and treatment are carried out every winter.

　　2. Cut off the transmission route

　　Strengthening fecal management, paying attention to the harmless treatment of feces, prohibiting the use of fresh feces for fertilization, and adopting high-temperature composting or using drugs to kill the eggs inside the feces are key measures to prevent the disease. Avoid eating unclean raw vegetables to prevent infection by hookworms through the mouth.

　　3. Protect susceptible populations

　　Avoid bare-handed operation in environments prone to infection. In addition, applying protective drugs to the skin also has a certain effect.

　　If hookworms are found in hookworm patients, they can be directly sent for examination. The clinical examination of this disease is usually as follows.

　　1. Fecal egg examination.

　　2. Fecal occult blood test may be positive.

　　3. Blood count: There is often varying degrees of anemia, which belongs to small cell hypochromic anemia, and eosinophils may increase.

　　4. X-ray chest film examination: May show increased pulmonary vessels, scattered patchy shadows, and reticular structure of pulmonary interstitium.

　　Hookworm patients should pay attention to cook their food thoroughly before eating and can eat more garlic appropriately. Patients should also avoid eating raw food and drinking raw water. The following are the dietary therapy formulas for this disease.

　　1. Ginger Eel Drink:100 grams of eel (sliced without bones), 10 milliliters of ginger juice, mix the eel with ginger juice, peanut oil, and a little salt, wait until the rice is almost cooked, place the fish slices on the rice surface, cover it tightly, and simmer over low heat for 15 minutes until cooked and served.

　　2. Codonopsis and Red Date Tea:20 grams of Codonopsis pilosula, 10 dates, boil the water together and drink as tea.

　　3. Garlic Porridge: 30 grams of purple garlic, 100 grams of glutinous rice. Peel the garlic, boil it in boiling water for 1 minute and remove it, then cook the glutinous rice in the water used to boil the garlic into a thin porridge, and then add the garlic back (if the patient has tuberculosis, 5 grams of white peony powder can be added), and cook it into porridge.

　　4. Roast Garlic: 10g to 12g of garlic with skin, roasted in fire ash until熟, peeled and chewed.

　　Hookworm patients mainly present with anemia and hypoproteinemia, so it is very important to give adequate iron supplements and supplement a high-protein diet to improve anemia and eliminate symptoms. In general cases, iron supplements should be supplemented after deworming treatment, but for severe infections with severe anemia, it is advisable to correct anemia first. Blood transfusion is only suitable for pregnant women or severe anemia patients with concurrent anemia cardiomyopathy heart failure, and blood transfusion can help improve cardiac function. There are many types of deworming drugs for hookworm disease, and it often requires repeated treatment to be cured. For severe infections and mixed infections, combined therapy can be used.