Ankilostomidoz

Ankilostomidoz - helminthic infectionscaused round worms - ankilostomidoze. There are a hookworm, the agent which is Ancylostoma Ancylostoma duodenale duodenale, and necatoroz, the agent which is Necator americanus. The size of Ancylostoma: female 7-15 mm, male 5-11 mm At the head end of the body of worms there gaping oral capsule surrounded the ankylostomas (Fig. 1) two pairs kruchkovich bent chitin teeth, nektorov (Fig. 2) - two cutting chitin plates. The head end of a body at ankylostomas slightly bent on the ventral side, some sharply curved dorsal.
Ankilostomidoze live in the upper section of thin intestines of man, being attached to the wall with the oral capsules. They draw in a capsule the regions of the mucous membrane, hurt her with his chitinous education and feed on blood, resulting from the wounds. Fertilized females lay daily 6000-10, 000 eggs released out with faeces. Eggs, caught in favorable conditions, 24 hours larvae that live in the soil. In 5-10 days larvae become invasive and can live in the soil for up to 15 weeks. Necator americanusIn the case of adverse conditions on the surface of the soil (dry, sharp increase or decrease of temperature) larvae go into the lower layers to a depth of 1 m; can also climb wet plant stems to a height of over 20 see
Invasive larvae of some penetrate into human organism through the intact skin, are introduced into the blood capillaries, the blood is recorded in the lungs, which through the bronchi, trachea and the esophagus into the intestine, where after 8 to 10 weeks develop into adult parasites start to lay eggs.
Larvae of the hookworm fall in the human intestine mainly through the mouth and in 4-5 weeks reaches a Mature stage.
In the USSR ankilostomidoz logged in Georgian, Azerbaijani, Turkmen SSR, on the black sea coast of Krasnodar region. Eggs and larvae can develop in soil only at temperatures from 14 to 36 degrees. Infection necatorosis occurs during walking barefoot, lying on the ground contaminated with larvae.
Hookworm become infected by eating vegetables, berries and fruits, which can be larvae, which as a consequence of fertilizers gardens no untreated faeces, less often when walking barefoot. The infection is seasonal.
Larvae sencibilisiruet body products of metabolism and decay, causing the development of allergic reactions.
Adult parasites absorb the blood, and often contribute to the development of hypochromic iron deficiency anemia (see).
In the early phase of the invasion, there are skin rashes, itching of the skin, respiratory and lung (bronchitis, pneumonia, volatile infiltrates), accompanied eosinophilia of blood.
In the intestinal phase of infection - pain in podlojecna area, decrease in appetite, sometimes disorders of the chair, headaches, weakness; in the development of anemia - shortness of breath, dizziness, noise in the ears. In the blood, reducing the number of hemoglobin, the number of erythrocytes (up to 800 000 - 1 000 000 1 mm3 blood), reducing the color indicator (0,3-0,5), acceleration ROHE.
The diagnosis is based on detection of eggs or larvae in Calais (see Helminthological research methodsand results of serological reactions (latex-agglutination, the haemagglutination).
Treatment Saptamona within 1-5 days in a daily dose for adults and children older than 5 years 5 g, for children up to 5 years is 2.5, the Daily dose pour 50 ml of warm sugar syrup and give one dose for 0.5-1 hours before meals. When anemia is used iron supplements in large doses and vitamin B12.
Prevention. Of great importance for a sanitary measures for protection of soil from pollution and disposal of faeces used for fertilizer gardens. In endemic areas it is not recommended to walk barefoot, to lie on the ground without bedding. You should thoroughly wash vegetables and fruits.


Ankilostomidoz (ancylostomidоses) - a group of worms, uniting the hookworm, the agent which is Ancylostoma duodenale, and necatoroz caused Necator americanus.
The main endemic foci ankilostomidoze are located in the tropical and subtropical zones, but the disease may occur in the temperate and even cold climate (in deep mines with constant relatively high temperature and humidity). Ankilostomidoze affected more than 25% of the world population. The most widespread A. in some southern States of the USA, the countries of the Lat. America and South Asia, North-Eastern Australia, Africa, the Pacific Islands and other European countries hookworm disease is most common in Italy. In the USSR endemic foci A. registered in the Western part of Georgia, on the Lankaran lowland and Zagatala district of Azerbaijan SSR, in some areas of the Turkmen Soviet socialist Republic, Krasnodar region, Dzhambul region, Kazakh SSR, Bukhara region of Uzbekistan. Mines in the USSR free from A.
Etiology. Ancylostoma and some small nematode, pinkish-yellow; the size of the male - 6-D1 mm, females - 10 -13 mm Head end of the body supplied oral capsule, armed chitin teeth (ankylostomas) or cutting blades (have some).
The ankylostomas head end is bent in the direction of the General bend body, some - in the direction opposite to the bend of the body. The tail end of the body of the male equipped sexual copulative Bursa with blades (Fig. 1-3). Adults inhabit the duodenum and the upper division of the jejunum. The life span of parasites in intestines 4-8 years and more, but the main part of it is allocated in the first year of life. In the human gut female parasite lays eggs (from 5000 up to 25 000 per day). Eggs of helminths of both species similar in size and shape - oval with blunt rounded poles, with thin transparent membrane. Development occurs in soil. For egg development and preservation of larvae Ancylostoma in the external environment, sufficient heat, humidity and air access. Favorable temperature for egg development 15 to 35 degrees (optimal 30 - 32 degrees). Under these conditions within 24 to 36 hours. in the egg Matures larva, which prosurvival shell eggs and leaves it (Fig. 4). The larva goes through three stages of development: radiovideo, filedialognew (Fig. 5) and invasive. Further development of larvae occurs in the human body. Invasive larvae, contact with skin, quickly penetrate it and through the blood and lymphatic ways get in the lung capillaries. From here they actively penetrate into the bronchial tubes and move up the bronchial tubes in the lungs, throat, mouth, then swallowed and get into the intestine, where after 3 to 6 weeks to reach sexual maturity. By ingestion of larvae directly in the mouth development occurs without migration. Ankilostomidoze recorded in the intestine with the help of the oral capsules. On the mucous membrane bleedings, the extent of which is determined by the intensity of infection and property of the parasite often to change the place of fixation. Ankilostomidoze secrete a substance that lowers blood clotting.
Epidemiology. Source invasions is infected man who faeces allocates eggs Ancylostoma. Dispersion of eggs and larvae in the external environment conducive no latrines or unsanitary content, erosion faeces storm water; eggs and larvae disperse well as pigs, dogs, chickens, rats and sparrows. Most of the eggs of ankilostomidoze passed through the digestive system of animals, capable of further development in the external environment. The spread of invasive material may contribute to the use of no untreated sewage for fertilizer. Human infection occurs at contact naked body areas with contaminated soil invasive larvae (barefoot in the gardens, fields, mines, and others), sometimes through contaminated drinking water, vegetables and fruits.
In the pathogenesis of hookworm are set to blood loss of the body and the impoverishment of its iron and proteins (power parasites in blood, toxic and allergic reactions as a result of action of metabolic products of worms, inoculation microbial flora in areas of mechanical damage, serverelement influence. Clinically A. when there are heartburn, vomiting, lack or increased appetite, sometimes taste perversion, pain in podlojecna area, simulating ulcers disease duodenal ulcers, pain in the liver, in severe anemia, weakness, dizziness, shortness of breath, palpitations, weakness, drowsiness, forgetfulness, children stunted intellectual and physical development. When the larvae passing through the respiratory tract can cause bronchitis, pneumonia, eosinophilic infiltrates, and pleural effusion. The most typical manifestation of a is iron deficiency anemia hypochromic of varying severity, depending on the intensity of infection, the General condition of the organism, the nature of the power of the patient.
Diagnosis A. put on the basis of clinical examination of patients and find the eggs of helminths.
Forecast when A. almost always favorable treatment leads to full recovery. In severe cases, without treatment, death can occur.
The treatment is carried out mainly in day hospitals; in the most severe cases - in hospitals. Specific therapy A. is carried out mainly by Saptamona (alcover). The preparation is administered on an empty stomach for 1-2 hours before Breakfast. Daily dose (one-time) for adults and children older than 5 years - 5 g, for children up to 5 years is 2.5, the Drug poured in 30-50 ml lukewarm sugar, stir well and drink at once. Naftalan has laxative properties and therefore purgative not appointed. Preliminary preparation and proper diet is not required. Treatment usually lasts for one day; when intensity of infection - up to 3 days. In testimony treatment repeated every 2-3 weeks. Naftalan contraindicated in diseases of the liver with sharp violation of its functions. There may be nausea, vomiting, multiple chair, who quickly stop the removal product. Applied also tetrachloro-ethylene and thymol. To ensure ankilostomidoze anemia use drugs iron: Ferrum reductum, Ferrum carbonicum on 0.5 - 1.0 g 3 times a day after meals with obligatory drinking after divorced hydrochloric acid. You can assign and tincture malic iron (Tinctura ferrum pomatum) on 15-30 ml 3 times a day. It is also recommended that a combination of iron with aloe (Sirupus Aloe cum Ferro) on 40 drops 3 times a day after meals. If necessary, simultaneously with drugs iron enter campolon, Antianemic or vitamin B12. In especially severe cases, resort to blood transfusion.
Prevention: identification, treatment and examination of patients A., sanitary-hygienic measures and destruction of larvae in the external environment. When there is Sewerage and comfortable latrines mass deworming carried out throughout the year, and in the absence mainly in autumn and winter, when the eggs and larvae of Ancylostoma in soil perish. To prevent pollution of the external environment eggs of Ancylostoma need to improve San. the state and conduct San. cleaning of settlements and mines, to prohibit the use of no untreated faeces to fertilize the soil, to observe personal hygiene. The great value has health education and raising the level of sanitary culture of the population. To prevent skidding A. on mines and elimination of its foci should survey all newly hired and transferred from other mines miners; infected A. eligible for underground works only after a full recovery.
For the destruction of eggs and larvae Ancylostoma in soil treated with an area of about latrines and microsocial 20% suspension of bleach, and well - hydrated or bleach the rate of 0.5 kg per 1 m2 floor space. At detection of larvae in ground mines processing to produce crystalline salt every 5-10 days at the rate of 0.5 - 1 kg of salt on 1 m2. Cm. also Nematodes.

Fig. 1. Ancylostoma chiodenalc (left) and Necator americanus (right): 1 - females; 2 males.
Fig. 2. Ancylostoma duodenale: 1 - female; 2 - male; 3 - oral capsule front; 4 - oral capsule side; 5 - the tail end of the females; 6 - the tail end of a male.
Fig. 3. Necator americanus; 1 female; 2 - male; 3 - oral capsule front; 4 - oral capsule side; 5 - the tail end of the females; - the tail end of a male.
Fig. 4. Eggs of Ancylostoma different degrees of maturity.