WARNING: This story contains graphic images not suitable for all readers
An Ontario couple is warning Canadians to be careful walking barefoot on the beach after they contracted parasitic foot infections while on vacation.
Katie Stephens and her boyfriend Ed Zytner both picked up larva migrans, or hookworms, during their stay at the IFA Villas Bavaro Resort and Spa in Punta Cana in January.
On Facebook, both Windsor, Ont., residents posted their experiences, as well as graphic photos of their infections, after what they thought were initially just bug bites. Zytener said in the beginning, his feet were very itchy so he went to the hospital.
“At first they thought it was sand fleas, wrapped me up, told me to come back for a check up tomorrow and sent me on my way,” he wrote on the social media site.
He added that when he went back to the hospital in the next few days, things had gotten worse.
Fortunately, there was one doctor who had seen a similar case like this in the ER 10 years ago, after a tourist came back from Thailand.
“I wanted to make this post because most doctors have never seen larva migrans before. Three out of the four doctors we saw have never heard of this hookworm. And if your feet begin to have an itch, swell or blister or look like mine, get those hooves checked out.”
Stephens posted similar photos of her foot, swollen and covered in blisters.
“Also, this injury has nothing to do with coverage or travel insurance. I was back in my home country when I was first treated and don’t need travel coverage for what I have,” she wrote on her Facebook page.
According to CTV, the couples’ doctor sent Health Canada a request for a drug called ivermectin because it is not licensed in Canada.
“We found out that Health Canada had denied our request to receive the medication saying our case wasn’t severe enough. At that point, that’s when we freaked out a little,” she told the new site.
She said Zytner’s mother drove to Detroit to purchase the $88 medication, and Zytner added the couple had began their treatment to recovery.
There is currently no travel health notice specific to cutaneous larva migrans (CLM) in the Dominican Republic, says Anna Maddison, senior media relations advisor of Health Canada and the Public Health Agency of Canada.
“Canadians returning from travel destinations who feel they may have been exposed to CLM or other parasites should consult their medical professional to find out what treatment options are available and how to access them.”
Although the agency could not comment on this specific case due to privacy reasons, Maddison adds oral ivermectin is currently not marketed in Canada, and is only available to practitioners and their patients via Health Canada’s Special Access Programme (SAP). A topical ivermectin is currently marketed in Canada, but it is only approved to treat rosacea.
“SAP permits access to new drugs for patients with serious or life-threatening diseases or conditions who lack therapeutic options and who may benefit from such therapies. The SAP may authorize a drug that is not available on the Canadian market, to treat a patient with a serious or life-threatening condition,” Maddison adds.
Larva migrans is not considered a serious or life-threatening infection, she says.
According to the National Health Service in the U.K., hookworms can infect humans in warm, moist countries with poor sanitation.
“The hookworm larvae are found in soil that’s been contaminated with human feces. The larvae can infect people if their bare skin comes into contact with the soil – for example, if you’re walking barefoot,” the site notes.
Maddison adds human infection can also occur when the worm burrows into the skin, creating a visible serpentine rash.
“The hookworm then becomes trapped, is unable to reproduce, and eventually dies off.”
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And while most people infected with the worm don’t have any symptoms, if the larvae get into the skin, it can cause itching or rashes. More severe symptoms can include diarrhea, weight loss and anameia.
Health Canada adds if you are travelling in regions with hookworms, don’t walk barefoot or touch soil or sand with your bare hands.
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