The eggs optimally hatch in warm, shady, moist, sandy soil found in tropical and subtropical areas. Humans are infected with the larvae by walking barefoot on the sand. The larvae quickly penetrate the skin upon contact. The prohibition of dogs and cats on beaches is a way to limit transmission of the infection. In the US, most cases occur in eastern and southern coastal areas from New Jersey to Texas.
Highest incidence is in Florida.
Cutaneous larva migrans is indigenous to the Caribbean, Central and South America, Africa, and Southeast Asia. Mortality from the infection is not reported. Most incidents of cutaneous larva migrans resolve with or without treatment and with no long-term adverse reactions. Morbidity is associated with an intensely pruritic rash, which leads to secondary impetiginization and cellulitis. In rare incidents of cutaneous larva migrans in which nematodes use man as a definitive host, infection can lead to the completion of the nematode life cycle with adult worms residing in the intestines.