Subscribe to
Fully Vetted
Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Worms in paradise: On hookworm larvae, freaked Floridians and stray cat eradication

December 27, 2010 / (16) comments


Thinking about coming down to South Beach, Fla. this year? It's a perfect winter destination if what you want is gorgeous weather, pretty people, a rollicking nightlife — not to mention miles and miles of beautiful sandy beaches. Too bad there's a wee spot of trouble in paradise. Trouble in the sand, to be precise; in the cat poo in the sand, if you want to get graphic about it.

 

You see, some cats carry the infectious stage of the hookworm parasite. Stray cats in a ten block stretch of the beach — the beach where I grew up making sand castles at my grandmother's condo, in fact — have deposited their hookworm-riddled feces on the sand here, sending people screaming (my embellishment) to the dermatologist for treatment of the squirrely hookworms that creep under your skin if you've been standing or lying on their poopy terrain.

Just in case you disbelieve, it's called "cutaneous larva migrans." (You can see pics here, but beware — they're gross.)

It's kind of crazy. Hookworms are not a terribly uncommon thing to find anywhere that cats and attractive beaches intersect, but people in Miami are fa-reeking out about them. I mean, how hard is it to wear flip-flops and lie on a towel, right?

Still, I thought I'd do my veterinary duty and write about it for The Miami Herald's general audience. Here's what I wrote for last weekend's edition:


Q: My dog has hookworms and I'm almost positive he got them by eating cat poop on the beach. I hear there's an epidemic of these parasites in cats, dogs and even people. My veterinarian has given us pills for Sparky and she says not to worry about him passing the parasites to us but I'm still worried my kids will get it. How do I keep them from being infected?

A: It's true that scores of visitors to Miami Beach have been infected with hookworms over the past few months. It's also true that here in South Miami I've confirmed more hookworm infections since last summer (in both dogs and cats) than any year I can remember.

Luckily, I've not yet heard of any human infections among anyone but those reported by the news media — all skin infections among humans visiting a small stretch of cat stool-strewn beach (mostly affecting their feet). Nonetheless, I urge caution whenever I detect hookworm eggs in a patient's stool.

After a positive result on this simple and inexpensive diagnostic test (one any veterinarian can run in her/his office, I advise my clients not to walk barefoot in their yard or anywhere their pets may have defecated –– that is, until the infection is cleared. If local cats are about, I suggest no one walk barefoot or lie bare-skinned on the ground ... ever.

That's because the hookworm larvae have a way of lodging in the skin and slowly migrating to the human host's digestive tract. Usually it's detected in the skin way before migration occurs.

Dogs and cats, on the other hand, don't tend to get this skin form of the parasite. Theirs is a fecal-oral route of transmission, meaning they have to ingest the infective eggs of the hookworm parasite. Because the adult hookworms lodge in the canine and feline large intestine and suck blood, both diarrhea and anemia can result.

Thankfully, the parasite is easily eradicated by a variety of parasiticide preparations. Preventing them is usually a snap, too. Most monthly heartworm medications (a must in South Florida dogs and cats) are also approved for prevention of wormy intestinal parasites like hookworms and roundworms (which can also cause severe disease, especially in children).

As to Sparky's infectiousness, consider that the drugs he's been given work quickly. Still, I'd give it a month before going footloose and fancy free on the lawn. Good luck!

Here's hoping I can talk people down off the ledge with this one. Because, predictably perhaps, there's been lathered talk of cat eradication on Miami Beach. Stay tuned for future posts on the impending battle to come. In the meantime, come down and enjoy paradise anyway. After all, the worst of the worms are not in the sands ... they're in the clubs.

 

 

 

Dr. Patty Khuly

 

 

Pic of the day: "Looking for prey" by Giorgos~

 

 

Subscribe to Fully Vetted
COMMENTS (16)
1
Off the Ledge, Please
by on 12/27/2010 04:02am

I, too, hope people can be talked off the ledge—though the “cat debate” lends itself to all kinds of irrational and deceptive statements (often by those who clearly know better).

This, I’m afraid, is just one more bit of ammunition for feral cat/TNR opponents—something to strengthen their rather flimsy “public health threat” argument. (Of course, these same people offer no workable—not to mention humane—solution of their own, but that’s a topic for another time.)

First it was rabies, now hook worms. Let’s put things in perspective here…

According to the Florida Department of Health, something like 22,000 of the state’s residents have died of the flu or pneumonia since 2006 (you can view the report here: http://www.doh.state.fl.us/disease_ctrl/epi/swineflu/Reports/reports.htm#P-and-I). Actually, that figure accounts for only 24 of Florida’s 67 counties, so the total is surely much higher. Yet, we’re expected to believe that free-roaming cats are a significant concern?

In terms of public health, I think we’re all better off focusing on frequent hand washing, sneezing into our sleeves, and, in this case, flip-flops—as opposed to, say, exterminating this country’s most popular companion animal by the millions.


Peter J. Wolf
http://www.voxfelina.com

by on 06/05/2011 03:57pm

This comment has been flagged as inappropriate.

2
Egads!
by on 12/27/2010 07:04am


Egads! I wonder how many horrible diseases I must have had as a child because everyone let their pets run free and all the kids in the neighborhood went barefoot in the summer.

NOT!

My mother flea-bombed the house from time to time, but that's it. I don't remember for sure, but I don't think we were even very fastidious about hand-washing.

We brought in stray animals. We played with any critter that wandered into the yard.

Gosh, the children in our family were rarely ill. How did that happen?



3
People can be crazy
by on 12/27/2010 09:09am

Last year, when the "non-epidemic" of H1N1 (mistakenly labeled "swine flu") hit the first pigs on a pig farm in Canada, all the pigs were euthanized and the farmer had to bury them because he couldn't even get a rendering plant to take the carcasses. Then they realized that it was really just another strain of flu to pigs, not particularly debilitating, certainly not deadly and easily avoided with a new vaccine.
People tend to overreact (Kill them ALL!) before being brought back to reality. Hope you can get the message out before too many cats are killed, doc.

4
Picking on Cats, Now
by on 12/27/2010 09:35am

Things-like this makes People go-off-thier-rockers. Next they will make a Law, to kill all Cats that run free.

5
Utah
by on 12/27/2010 10:06am

Has any=one heard they are getting rid of the Wild Horses, on our public land, to let cattlemen run their cows. Sick-huh-check-it-out................what is next ??????????? US

6
Kitty Hunt
by on 12/27/2010 02:23pm

There's been collective paranoia for a long time, and it shows no sign of abating. When I was a kid, we rode bikes and climbed poles sans helmets, didn't use seatbelts, and did all sorts of things that are now considered extremely hazardous to your health. Your article highlights a potential example of this rampant paranoia. Glad someone is speaking up before cats become the latest object of needless witch hunts.

7
toxicara larval migrans
by on 12/27/2010 02:31pm

It is my understanding that zoonotic hookworm infection of humans is one of the reasons that most children's parks ban dogs from the park in many states. However the canine and feline hookworm rarely becomes an adult in the gut of the human.

The serious problem is not even cutaneous larval migrans, it is two other
possibilities that happen in the inappropriate human host, ocular larval
migrans and cerebral larval migrans.

searching pubmed with the keywords "cerebral larval migrans toxicara" will
give a lot of links.

http://www.ncbi.nlm.nih.gov/pubmed

Human hookworm is a different parasite and its control has been one of the major health targets for groups such as the Gates Foundation - especially in tropical climates. Ivermectin and similar drugs have been very useful in controling ascarid infections in humans as well as in animals.

by on 12/28/2010 11:30am

Thanks for mentioning this. One of my brothers actually lost an eye (an entire eye!) due to this parasite. It is for this reason that I am especially peeved when I see dog droppings on the ground. A lot of people just do not get that their dog's poop is not natural or clean - I don't think any kind of poop is - and they (these pet owners) are possibly causing the blindness of my child. (here is a link, btw, for Ocular Larva Migrans)

In the same way that I would not have all dogs euthanized because of their stupid owners who refuse to clean up after them, I think it is pointless to consider euthanizing cats that use public sand. As Dr, Khuly points out - is it really so difficult to use flip-flops and a towel?

Hmmm... but then, who is going to wear flip-flops from the towel to the water? In the end, something is gonna get you. And hookworms are not much worse than "sea lice," also ubiquitous on the beaches here.

by on 12/28/2010 01:00pm

You raise a very important point. Children all over the country are still losing their vision (and sometimes the entire globes of their eyes, as my fellow reply-er attests) as a result of roundworm infection. I should have mentioned this, as well in my post. It's important to put all of this into perspective.

8
Scapecats
by on 12/27/2010 03:26pm

Thanks to Dr Khuly for drawing attention to this spot of mass hysteria.

Perception plays a much bigger role here than rational thinking. If people are determined to hate feral cats, they will not be talked out of it. And worms crawling under the skin, whether confirmed or only hearsay, are outrageous. Cats are strange animals. Time and time again, outside of my job as a cat vet, I am reminded of how strongly some people can hate them. The cats themselves, and the people who sustain feral cats. It is perceived that if someone loves cats, they must be anti-human. It's Us or Them. By comparison, I very rarely hear public outrage over dog poop left in parks and on sidewalks. Any ideas on why there is such a difference in perception?

9
is this really new?
by on 12/27/2010 06:20pm

Having (had) two child nephews diagnosed with "pin worm" & treated, what is new about this, except for a beach outbreak ?

And for a specific reason?

How about whip-worms? I have been told numerous times, they are just about IMPOSSIBLE to eradicate , once contaminated in soil.

True or not?

by on 12/28/2010 01:04pm

It's hard to get rid of whipworms but in my experience it's not much tougher than getting rid of hookworms once they're embedded in the soil. Rotating anthelmintic drugs and being assiduous about the use of parasite preventatives (like Heartgard, Revilution or Interceptor, for example) usually does the trick within a year or so even in severely affected areas.

by on 12/29/2010 06:46pm

Thanks Dr. K, You reminded me, this was before the "heartguard & interseptor, and especially Revolution" days, and I have since moved from that "pre-contaminated" area. (with warnings to the new owner)

10
by on 12/31/2010 02:42pm

"I mean, how hard is it to wear flip-flops and lie on a towel, right?"

This is a beach for crying out loud. Sand gets everywhere.

As for comparing influenza and pneumonia to the hookworm outbreak - how can you? There is a pneumococcal vaccination and one for flu every year. They are available, widespread, promoted, and on the minds of people. And hookworm? What kind of prevention is there for that? And how many people do you think are giving this any thought as they allow their kids to romp on sandy beaches?

Deaths from flu and pneumonia do not change the reality for those who were affected by the hookworm nor the fact that having that many cats regularly defecating on public beaches cannot possibly be good for public health or the environment.

11
Perspective?
by on 12/31/2010 04:23pm

"Deaths from flu and pneumonia do not change the reality for those who were affected by the hookworm"?

True enough, but given this "logic," we would combat every possible cause of death--however unlikely--with equal effort. After all, why concern ourselves with flu and pneumonia when there are people choking on fish bones in upscale restaurants all over this fine country of ours? Where is our compassion?

Again, the point is to have some perspective--a hard sell to TNR opponents, whom I find are typically more interested in fear-mongering than in working toward any kind of productive solution.

Peter J. Wolf
http://www.voxfelina.com

12
by on 01/02/2011 06:50pm

"True enough, but given this "logic," we would combat every possible cause of death--however unlikely--with equal effort. After all, why concern ourselves with flu and pneumonia when there are people choking on fish bones in upscale restaurants all over this fine country of ours? Where is our compassion??

What perspective would you like people to have? That having that many cats pooping on the beach is ok? That if one gets hookworm from that situation, so what?

What you wrote about fish bones is silly - and by being silly, you minimize what happened, and that does not lend itself to 'working toward any kind of productive solution' with TNR advocates. What happened (and is likely happening elsewhere) as a result of having so many cats defecate in one area - no one in his/her right mind will say is good for public health - it is what it is - if that is fear mongering to you, then I'd say we won't get any further than this.

13
Cat-Lovers HATE ALL Other
by on 06/05/2011 04:33pm

This comment has been flagged as inappropriate.

LEAVE COMMENTS

Connect with Facebook or login to leave comments.


About fully vetted

Patty Khuly, VMD, MBA

Photo of Dr Khuly

Dr. Khuly is a former petMD blogger and small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. She authors pet health columns for USA Today, The Miami Herald and Vetstreet. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

Subscribe to Fully Vetted

Most Read Fully Vetted Articles

Check Your Pet Food Bags!
The recall of pet foods manufactured at a Diamond Pet Food plant in Gaston, S.C....
READ MORE
No Excuse for Skipping Rabies Vaccination
The Carlsbad, New Mexico area just suffered through one of the worst rabies outbreaks...
READ MORE
Any Dog Can Bite
May 20-26 is National Dog Bite Prevention Week. Being bitten is just one of the...
READ MORE
A New Link Between Pet and Human Health
A study appearing in the journal Emerging Infectious Diseases points to a new link...
READ MORE

Most Commented Articles

No Excuse for Skipping Rabies Vaccination
The Carlsbad, New Mexico area just suffered through one of the worst rabies outbreaks...
READ MORE
Does Horse Racing Deserve Your Support?
I breathed a big sigh of relief on the evening of Saturday, May 5. The 138th running...
READ MORE
Maggots: Thumbs Up or Down?
The weather is starting to heat up here in Colorado, which means that any day...
READ MORE
Palliative Care ≠ Murder
I talked yesterday about compassion fatigue, which often develops when caregivers...
READ MORE
 
MORE FROM PETMD.COM
©1999-2012 petMD, LLC. All Rights Reserved
x
Stay informed about your pet's health...and more!