WARNING: THIS ARTICLE INCLUDES IMAGES SOME READERS MAY FIND DISTURBING
While taking a leisurely stroll along the beach during a vacation in the Caribbean, a Canadian couple returned home only to experience a painful, itchy post-holiday nightmare.
In January 2018, Eddie Zytner and Katie Stephens, of Windsor, Ontario, flew to Punta Cana, Dominican Republic, to kick back and relax at the IFA Villas Bavaro Resort and Spa.
During their week-long stay at the resort, the couple strolled barefoot along the golden sands, basking under the tropical sun.
Though Stephens and Zytner felt “incredibly itchy” in their feet during their vacation, they dismissed it and considered it to be harmless bug bites.
“For a lot of our trip, we found that we were scratching our feet quite a bit,” Zytner told CTV News in a telephone interview. “Sand fleas we had heard about so we kind of assumed it was that at first.”
The couple didn’t think much about the itchiness until they got back home.
On Friday, Jan. 19, 2018, a day after returning home from the Caribbean, Zytner noticed a swelling in his feet, and by the weekend, it only got worse. There were painful blisters on his toes, and the severe swelling made him unable to put on his shoes or socks. To make matters worse, he needed assistance while walking.
Troubled by this condition, Zytner then sought medical attention from two doctors; however, they were unsure about his condition and sent him home with bandages.
But by the evening of Sunday, Stephens started experiencing the same horrifying symptoms that plagued Zytner.
“I had a lot of itchiness during the trip,” Stephens said. “I think I might have complained about it a little bit more that my feet were really itchy, but mine didn’t start swelling and everything until about the Sunday night.”
On the following Monday, Jan. 22, 2018, Zytner visited the third doctor, but this time with Stephens.
Thankfully, this time around, the doctor knew exactly what they had contracted.
“When I went back to the hospital Monday we were very, very fortunate the doctor in the ER had seen this before – 10 years ago and from a tourist returning from Thailand,” Zytner wrote in a Facebook post.
The doctor said they had hookworms—also called cutaneous larva migrans—burrowing in their feet.
“I have dozens of worms in my feet, and so does Katie,” Zytner told the Windsor Star.
“It’s pretty gross. It’s something living in your body that’s not supposed to be there,” Stephens chimed in.
The couple suspected they had contracted hookworms while walking barefoot on the beach at the resort in the Dominican Republic.
The microscopic cutaneous larva migrans usually infect cats or dogs. These hookworms tend to live on the sand or soil where the infected dog or cat has defecated.
“The hookworm eggs come out of the stool and hatch in the sand or soil, where they live until an unsuspecting human walks on them barefoot,” Bobbi Pritt, M.D., director of the Clinical Parasitology Lab and co-director of Vector-Borne Diseases Lab Services in Mayo Clinic’s Department of Lab Medicine and Pathology, told MedPage Today.
“The foot will become very itchy and inflamed, but you can actually tell where the larva is migrating through the skin because it creates red, squiggly raised lines in the shape of a serpent,” Dr. Pritt added.
To anybody travelling somewhere tropical, please be careful when in the sand and wear shoes! My boyfriend and I recently…
To cure this, the couple had to take a drug called ivermectin. But the drug isn’t licensed for sales in Canada, so their doctor reported their case and sent photos of their feet to Health Canada in order to get medication.
Unfortunately, despite the serious swelling, Health Canada denied their request and stated that their case “wasn’t severe enough.”
“At that point, that’s when we freaked out a little,” Stephens said.
Zytner explained: “I don’t know how much worse it has to be for them to approve it. People have passed away from (parasitic infections).”
To obtain the required medication, Zytner’s mother drove down to Detroit, United States, and paid CA$88 for ivermectin.
Zytner and Stephens took the medication for two days, and eventually, they started to get better, though they still needed a crutch to walk around.
“Our blisters have gone down quite a bit … The worms are dead by now. Or they should be,” Zytner said.
According to Dr. Pritt, “the hookworms that cause cutaneous larva migrans can’t complete their life cycle in a human host, so they will eventually die in a few weeks.”
To create awareness about hookworms among doctors and travelers, the couple shared their unpleasant experience on Facebook.
“To anybody travelling somewhere tropical, please be careful when in the sand and wear shoes!” Stephens wrote, alongside the ghastly images of her feet.
“If your feet become incredibly itchy please get it checked out right away since we simply thought it was just bug bites and it became worse as each day passed,” she added.
Zytner wrote: “I wanted to make this post because most doctors have never seen Larva Migrans before.”
“So, anyone travelling.. check with your resort and see if the beaches around you are cleaned regularly. And it’s best to wear shoes on the beach as much as possible!” Zytner advised.
To all beach lovers out there, please keep this advice in mind in order to avoid a similar fate.