Warning: graphic photos of worms in feet ahead.
The hookworms are so tiny that most people don't even notice it when they enter the skin through the bottom of the foot. "You might feel a slight itch or see a rash but most people think it's a mosquito bite or a blister from their shoes at first, so it's easy to miss at first — but in a few days, it can become very painful," Michele S. Green, an NYC-based dermatologist, tells BuzzFeed News.
"The foot will become very itchy and inflamed, but you can actually tell where the larva is migrating through the skin because it creates red, squiggly raised lines in the shape of a serpent," Pritt says. As you can tell by the photos in this post, it looks pretty gross.
The good news? Humans are a dead-end host for these little guys. "The hookworms that cause cutaneous larva migrans can't complete their life cycle in humans, so they will eventually die in a few weeks," Pritt says. But the infection is also very easy to treat, and the right medication will kill the larvae and ease symptoms in a day or two. "Anthelmintics are drugs that rid the body of worms, like ivermectin, and are widely available in most countries," Green says.
"The first precaution you can take is to wear closed-toed shoes on the beach, but that’s obviously not appealing, so you can also try contacting the place you are staying to ask if it is a private beach that is fenced off so dogs can't get in," Pritt says. Hookworm is a relatively common infection, so it's a risk when you travel to any tropical area, but the bottom line is you shouldn't walk barefoot in any area which you think could be contaminated — whether that's a beach or a park or a hiking trail.
"Another great thing people can do is to go to a travel clinic before your trip and they can tell you specifically what to look out for and whether you need certain medications or vaccines beforehand based on where you are going," Pritt says. Besides hookworm, there are other parasitic and bacterial infections and mosquito-borne diseases in tropical areas that can be a lot more serious.