Once in the GI tract, worms attach to the wall of the intestine and begin to feed on the blood of the host. Eggs begin to appear in the stool approximately 4-6 weeks after initial infection. The lifespan of the worm is up to 1 year for A duodenale and up to 5 years for N americanus . The female produces 10,000-25,000 eggs per day during this time. This is because children are more likely than adults to come in direct contact with fecally contaminated soil containing infective larva.
Most infected individuals are asymptomatic.
Infected patients are not directly contagious, as eggs require a brief period outside the body to hatch into their infective larval form. Onset of ground itch occurs. Low-grade fever may occur. Migration of worms through the lungs may produce a mild cough. Pulmonary inflammatory response can lead to wheezing.