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