Hookworm infection in returning travellers and migrants: a 10-year case series at a German center for tropical medicine

Human hookworm infection is a neglected tropical disease, affecting mainly poor and disadvantaged communities in tropical and sub-tropical countries.Worldwide almost 800 million individuals are infected mostly in Sub-Saharan Africa, Asia, Latin America and the Caribbean. 1,2Hookworm disease is most commonly transmitted through walking barefoot on contaminated soil and is caused by nematodes belonging to the family Ancylostomatidae, mainly Ancylostoma duodenale and Necator americanus.The zoonotic nematode Ancylostoma ceylanicum contributes to human cases mainly in Southeast Asia.Hookworms can live over years in the human small intestine, feeding on blood.In endemic regions, this infestation is associated with chronic intestinal blood loss and iron deficiency anaemia. 3In non-endemic countries, hookworms are mainly detected in migrants or travellers to highly endemic areas. 4 -6 Contrary to the situation in endemic regions, the clinical presentation and impact of hookworm infection in returning travellers and migrants is less well described.Here, we report the clinical presentation and laboratory features of a 10-year case series among returning travellers and migrants with proven hookworm infection and evaluated potential peculiarities between both groups.