Cutaneous Larval Migrans (Hookworm)
Cutaneous larval migrans (CLM) is a zoonotic infection caused by hookworm larvae migrating through the skin. Several species of hookworm have been implicated in this disease, but it is most commonly caused by larvae of the species Ancyclostoma braziliense and Ancyclostoma caninum, both of which are intestinal parasites of dogs, cats and other carnivores. The eggs are passed in the feces of animals and develop into infective larvae in six to 12 days. The larvae can then survive in the environment for up to four weeks. Humans develop cutaneous larval migrans when larvae come into contact with exposed skin. This can occur when an individual walks through contaminated soil or sand in bare feet or sits in contaminated soil or sand. Disease occurs more commonly in tropical or subtropical areas. Humans are considered dead-end hosts for these parasites, and human-to-human transmission does not occur.
The larvae penetrate and migrate through the skin causing inflamed tracts in the skin. These tracts are extremely itchy, and secondary bacterial infection is common due to self-trauma produced by scratching. The larvae continue to migrate through the skin for two to eight weeks, after which they die and the disease spontaneously cures itself. CLM can be treated with antiparasiticides and antibiotics for secondary bacterial infections if necessary.
Animals associated with cutaneous larval migrans include:
- Cats: Cats can have hookworms in their intestinal tracts and shed the eggs in their feces.
- Dogs: Dogs can have hookworms in their intestinal tracts and shed the eggs in their feces.
- Other carnivores: Other carnivores can also have hookworms in their intestinal tracts and can shed the eggs in their feces.
Steps to reduce your risk of cutaneous larval migrans:
- Clean your pet's living area at least twice a week. Feces should be either buried or bagged and disposed of in the trash. Wash your hands after handling pet waste. Keeping your pet’s living area clean will prevent environmental contamination.
- Take your pets to the veterinarian to prevent infection with hookworm. Your veterinarian can recommend a testing and treatment plan for deworming.
- Wear shoes and other protective clothing to avoid contact with contaminated soil or sand.
- Travelers to tropical or subtropical climates should wear shoes and protective mats to prevent skin contact with soil or sand.
Cutaneous larval migrans resources:
Last updated: 09/16/2014
Zoonotic Disease Program