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Eggs are passed in the
stool
,
and under favorable conditions (moisture, warmth, shade), larvae hatch in 1
to 2 days. The released rhabditiform larvae grow in the feces and/or the
soil ,
and after 5 to 10 days (and two molts) they become become filariform
(third-stage) larvae that are infective
. These
infective larvae can survive 3 to 4 weeks in favorable environmental
conditions. On contact with the human host, the larvae penetrate the skin
and are carried through the veins to the heart and then to the lungs. They
penetrate into the pulmonary alveoli, ascend the bronchial tree to the
pharynx, and are swallowed
. The
larvae reach the small intestine, where they reside and mature into adults.
Adult worms live in the lumen of the small intestine, where they attach to
the intestinal wall with resultant blood loss by the host
.
Most adult worms are eliminated in 1 to 2 years, but longevity records can
reach several years. Some A. duodenale larvae, following penetration of the host skin, can become dormant (in the intestine or muscle). In addition, infection by A. duodenale may probably also occur by the oral and transmammary route. N. americanus, however, requires a transpulmonary migration phase. |