Date amended:
Statements of Principles
Current RMA Instruments
Reasonable Hypothesis SOP
7 of 2017
Balance of Probabilities SOP
8 of 2017
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 126.0, 126.1, 126.9
  • ICD-10-AM Codes: B76.0 – B76.9
Brief description

Hookworm is a parasitic intestinal infection that is very common in impoverished rural areas in warm wet climates, including in remote communities in northern Australia.  Conditions that allow transmission of hookworm infection are: human fecal contamination of soil; favorable soil conditions for larval survival (moisture, warmth, shade); and, contact of human skin with contaminated soil.  Most infections cause no symptoms. The SOP covers symptomatic infection only.

Confirming the diagnosis

The diagnosis is made by examination of stool to identify hookworm eggs. There are no reliable serologic tests.  Polymerase chain reaction testing is possible but not widely available.

The relevant medical specialist is an infectious diseases physician.

Additional diagnoses covered by SOP
  • Ancylostomiasis
  • Infection with Ancylostoma duodenale, A. ceylanicum, A. caninum or Necator americanus.
Clinical onset

Hookworm infection may cause symptoms in the acute phase, including skin itch for a few days (typically of the feet), cutaneous larva migrans, mild cough and gastrointestinal symptoms (nausea, vomiting, diarrhoea).  In endemic areas, chronic infection can cause anaemia, mild eosinophilia and nutritional impairment.  For acute symptoms the clinical onset will be within a short time (up to a few months) after the relevant exposure.  Infection is generally eliminated without treatment in one to two years, but in some cases infection can persist for longer.  Chronic manifestations of hookworm infection generally indicate repeated exposure.

Clinical worsening

Infection from a one-off exposure is generally self-limiting and will resolve in time without treatment.  Infection can be successfully treated with anthelminthic drugs.