Nectar americanus - Clinical Manifestation, Complications, Prognosis, Reservoir, Prevention, Control

Clinical Manifestations of Nectar americanus

Parasitic infections caused by Nectar americanus are symptomatic in 20% to 40% of cases. Depending on the site and phases of infection, the clinical manifestation of Nectar americanus includes:

1. Skin manifestation

2. Respiratory manifestation

3. Intestinal Manifestations (anaemia)

Skin manifestation

• lesions include small itchy papules

  * such papules are observed 7 days to 10 days at the site of skin penetration by the filariform larva

• dermatitis and ground-itch, which is more severe in Nectar americanus, is the earliest and an important symptom which is seen in a previously sensitized individual

• seen in and around feet- mostly between the toes

• symptoms include itching, oedema, erythema, rash

• secondary bacterial infections cause complications

Respiratory manifestation

• caused by the migration of hookworm to the lungs

• symptoms include low-grade fever, cough, pharyngeal dyspnoea, haemoptysis

• dyspnoea occurs when hookworms first break into lung alveoli from the venous circulation

• in severe cases, bronchitis, and pneumonia with pulmonary consolidation may occur

Intestinal manifestations

In the early stages, intestinal manifestations of Nectar americanus include low-grade fever, vomiting, nausea, abdominal discomfort, anaemia, diarrhoea, etc.

The disease may manifest as iron-deficiency anaemia or hypo-albuminaemia.

Anaemia

The occurrence of anaemia during Nectar americanus infection is dependent on the worm load present in the intestine as well as the nutritional status of the host. In cases of high hookworm load in addition to poor iron intake or iron deficiency, hypochromic microcytic anaemia occurs.

Anaemia is of three types:

1. Mild anaemia

2. Moderate anaemia

3. Severe anaemia

Mild anaemia

• may not produce clear clinical symptoms

Moderate anaemia

• includes gastrointestinal symptoms such as loss of appetite, diarrhoea, indigestion, constipation

• other symptoms include numbness, headache, tingling sensation, fatigue

Severe anaemia

• results in spleen enlargement, liver enlargement, palpitation, dyspnoea, a low systolic pressure bot normal diastolic pressure

• in children, the prolonged infection may result in mental and physical retardation

• in most cases eosinophilia is common

Complications of Nectar americanus

Nectar americanus infection in cases with low protein intake may result in oedema and hypoalbuminaemia.

Prognosis of Nectar americanus

Infection by Nectar americanus is rarely fatal and is easily treated. So, the prognosis is excellent.

Reservoir, Source of Nectar americanus

Human faeces is the only source of infection as well as the reservoir for Nectar americanus infection.

Prevention, Control of Nectar americanus

Prevention, and control of Nectar americanus is done by:

Individual prophylaxis

Individual prophylaxis of Nectar americanus is done by

• improved personal hygiene such as proper washing of hands with soap after defecation and before eating food

• treatment of water before drinking such as boiling, filtering the water used in a 0.22-micrometre membrane, iodination with tetracycline hydro per iodide

• drinking bottled water while travelling to areas endemic to necatoriasis

• if salad is to be consumed, treat the vegetables with acetic acid or vinegar for 15 minutes

• not performing sexual acts that involve faecal-oral contact

Community prophylaxis

Community prophylaxis of Nectar americanus is done by

• improvement of the water management system to avoid faecal contamination

• improvement of sanitation by installing latrines for proper disposal of human faeces