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Parasitic Puppetry: The Relationship Between Hookworms and Laziness

Oakland, CA

What are Hookworms?

Hookworms are parasites generally detected in tropical locations with unsanitary conditions. Necator americanus and Ancylostoma duodenale are the two main species of hookworms causing infections. A human may contract hookworms by touching soil containing the larvae of a hookworm. Larvae enter the soil by passing through the feces of someone infected with hookworms. Thus if human feces is utilized as fertilizer, the ground may be contaminated by hookworm larvae. Once the larvae enter the host through their skin, they travel through blood vessels to the heart and lungs. Coughing extracts larvae from the lungs, but the larvae are swallowed, hence following the digestive tract. They will then ingest the blood from the intestinal wall, develop into adults, and lay eggs in the small intestine. Fertilized eggs exit the host's body by excretion to find another host.

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Image of hookworms with a matchstick

What Are the Symptoms of a Hookworm Infection?

Though most people infected with hookworms do not initially experience symptoms, symptoms grow more apparent as the infection progresses. People who do encounter indications of a hookworm infection will typically note an itchy rash where the larvae went into their skin. Diarrhea will follow. Other possible symptoms are fever, loss of appetite, weight loss, anemia, nausea, abdominal pain, and intestinal cramps. Severe cases of hookworm infection may lead to anemia and ascites.

When Have Hookworms Led to Laziness?

During the early twentieth century, the South fought to eradicate the “germ of laziness.” According to many, the germ was to blame for the South’s ill population, poverty, etc. The “germ of laziness” was later revealed as the hookworm infection. The infection managed to contaminate many North Carolinians due to their lack of toilets in the 1900s. To substitute the toilet, North Carolinians either used a chamber pot (a portable toilet) or the outdoors. Both practices led to the feces being disposed of outside. Since Southerners lacked footwear due to the climate and being impoverished, the probability of them contacting soil contaminated by hookworm larvae through their feet increased exponentially. To Northerners, Southerners looked lazy. In reality, they were not indolent but ill due to the parasites ingesting their blood.

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Old image of people standing with a hookworm related banner

How Are Hookworm Infections Treated?

Hookworm infections are commonly treated by anthelmintic medication. Medicines someone with a hookworm infection may be prescribed are mebendazole (Emverm or Vermox) and albendazole (Albenza). Generally, people will take these medicines for one to seven days. A doctor may also provide iron supplements to those who have anemia. To ward off hookworm infections, it is advised to avoid skin contact with soil contaminated by hookworms.


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Delgado, Amanda. “Hookworm Infections: Causes, Symptoms, and Treatments.” Healthline, 8 Mar. 2019,

Foss, Mandy. “Hookworms.” NCpedia, 1 Jan. 2008,,and%20weakened%20resistance%20to%20germs.

“Hookworm Disease: What Is It, Causes, Symptoms & Treatment.” Cleveland Clinic, 24 June 2021,

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