A Sunshine Coast woman who contracted hookworm through her feet after a beach holiday in Vietnam says it was an “horrific” experience in which she could feel the parasites moving.
The 42-year-old, who did not want to be named, has holidayed on Asian beaches regularly for the past 10 years with her family.
During those holidays she’d regularly walk barefoot on the beach without issue, but this recent three-day holiday on Vietnam’s Anh Bang Beach was different.
“I didn’t actually have that much contact with the sand apart from getting up and walking straight into the water,” she said.
“The kids, they were burying themselves in the sand and they spent the whole time in the sand and they never had a problem.
“Just goes to show the bad luck of it all.”
As the woman’s foot made contact with the sand, she unwittingly stood on microscopic hookworm larvae, believed to be from animal faeces.
She was unaware at the time, but the worms were able to burrow into her feet.
She had no symptoms until a week later.
“I woke up and went ‘What is wrong with my feet?'”
“It was the worst feeling I have ever had, they were swollen, the most intense itching I have ever experienced in my life, swelling, my veins were poking out.
“It was like nothing I’ve ever experienced before.”
She sought advice from a pharmacist who advised to use a steroid cream to ease the itch but advised she see her GP.
In the meantime, her mother-in-law alerted her to a news story about a couple who contracted hookworm in the Dominican Republic.
“It was just after she sent that to me that I started feeling itching, tingling and wriggling … I could actually feel movement in my feet.”
She said the GP was at a loss to understand the condition until she happened to mention the news story about the couple.
“And he was like ‘That is what it is … I’ve never had a patient with it before’.”
The woman was prescribed medication, which was couriered from interstate.
She said because the worms entered her body via the skin and were not digested, the regular over-the-counter worm treatment the family normally applied after Asian holidays would not be sufficient.
The ‘dying off’ most painful
Within hours of taking the medication she was in excruciating pain.
“I had the worst night I’ve ever had in my life,” she said.
“It’s called the dying off and it’s when the hookworm is dying and it’s trying to escape your body so every symptom I’ve ever had came back but times 10.
“The itching and the swelling and the burning — it was just like nothing I’d ever experienced before.
“I was crying, like literally crying and could not sleep. It was just horrific.”
She said the next morning there were track marks, or lines which resembled small, red veins in her feet.
“What they are are the microscopic track marks of where they’ve travelled and it’s not like the worm is massive itself — it’s just that the track mark is left behind.”
Mark Pearson, a senior research fellow at the Australian Institute of Tropical Medicine at James Cook University, said the red marks were known as a creeping eruption.
“This is associated with that phase of the infection which is called larvae migrans and that refers to the migration of the larvae through the skin,” Dr Pearson said.
“That explains why she can actually feel the worms crawling around because that’s literally what they’re doing.
“You can be infected from a single hookworm larvae.”
Tips for travelling
Dr Pearson said there appeared to be an increasing trend of hookworm cases in Australia over the last 10 years.
“Purely due to the amount of people who are travelling now to Asian countries and more undeveloped countries, I mean we’re all getting more and more adventurous as travellers.”
He said hookworm was particularly a concern in developing countries with poor sanitation and hygiene.
“The eggs are eventually passed in the faeces so if you are in a country where the sanitation is not as good as in Australia, these eggs are going to find their way into the environment and people are going to come into contact with them when they step on them.”
Dr Pearson said the hookworm ideally would head for the gut where it would feed off the person’s blood.
He said hookworm infestation was a leading cause of anaemia in developing countries.
The Sunshine Coast woman said she felt fortunate that the infection was only two weeks old by the time it was diagnosed and treated because the medication allows the patient to make a full recovery.
She said she will continue to holiday on Asian beaches but would be less inclined to have bare feet on beaches where there were dogs present.
“The only thing with this Vietnam holiday was that there were more dogs on the beach than what I had been used to seeing,” she said.
“Thongs won’t really help, you’ve got to wear closed in shoes.”
Dr Pearson agreed.
“Wear shoes where you can, that’ll pretty much stop them because they won’t be able to get into your feet,” he said.
“It’s important when you get back if you feel unwell or have any of these symptoms to go see your travel doctor or GP.”