An Unusual Outbreak of Hookworm Disease in North India

A. Koshy Departments of Gastroenterology and Microbiology, All-India Institute of Medical Sciences, Ansari Nagar, New Delhi-110016, India

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V. Raina Departments of Gastroenterology and Microbiology, All-India Institute of Medical Sciences, Ansari Nagar, New Delhi-110016, India

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M. P. Sharma Departments of Gastroenterology and Microbiology, All-India Institute of Medical Sciences, Ansari Nagar, New Delhi-110016, India

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S. Mithal Departments of Gastroenterology and Microbiology, All-India Institute of Medical Sciences, Ansari Nagar, New Delhi-110016, India

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B. N. Tandon Departments of Gastroenterology and Microbiology, All-India Institute of Medical Sciences, Ansari Nagar, New Delhi-110016, India

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An unusual outbreak of hookworm disease occurred after a game of “kabaddi” (a local game which results in much body contact with the ground) in 27 young males from one village. It was characterized by an immediate incapacitating dermatitis, followed by severe pulmonary symptoms. Progressive weakness, abdominal pain, weight loss and anemia developed within a few months. Ancylostoma duodenale was found in all except four patients who had received antihelminthic treatment. Specific treatment for hookworm resulted in complete clinical recovery. Features of the outbreak were: 1) the hitherto unrecorded mode of infection; 2) severe dermatitis; 3) pulmonary symptoms lasting more than 3 mo; 4) abdominal symptoms suggestive of subacute obstruction starting 4–6 mo after exposure; and 5) severe disability with weight loss for a period of 1 yr until specific treatment was administered.

Author Notes

Senior Research Officer in Gastroenterology.

Junior Resident in Gastroenterology.

Lecturer in Medicine (Gastroenterology).

Assistant Professor of Microbiology.

Professor of Medicine, Head of the Department of Gastroenterology and Human Nutrition.

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