It’s also a concern from a public health standpoint – people don’t get the intestinal infection, but they can develop a condition called cutaneous larva migrans, in which the parasite larva in the environment penetrate and burrow though the skin, causing an extremely itchy rash that persists until the parasite ultimately dies or is killed. They are voracious feeders and large burdens can cause serious (or even fatal) problems because of the amount of blood that is lost. Adult hookworms live in the small intestine, where they attach to the intestinal wall and suck blood from the host. Resistance poses a particular risk to puppies, since hookworm infestations can kill young dogs. It’s thought to mainly have developed in greyhound breeding and racing kennels, where there’s a lot of dewormer use and a lot of infection pressure, creating a perfect environment for emergence of resistance. The concern is that there is now pretty solid evidence of hookworms that are resistant to most or all approved drugs typically used to treat these parasites. Resistant parasites don’t tend to get as much attention as resistant bacteria, but they can present similar challenges. Ray Kaplan from the University of Georgia gave a somewhat scary talk about the emergence of multidrug-resistance in the hookworm Ancylostoma caninum. In a presentation yesterday at the 2019 ACVIM Forum in Phoenix AZ, Dr.
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