The Frontier

John D. Rockefeller launched a commission in 1908 to investigate Southern economic stagnation, which attributed it to a laziness disease.

Rockefeller's investigators later linked anemia in the South to sandy loam soils and discovered hookworm infections were the cause.

Researchers built a sandbox experiment showing hookworm larvae could crawl four feet from infected stool, leading to the adoption of outhouses dug six feet deep.

Dixon Despommier argues improved sanitation and outhouses eradicated hookworm and also reduced diseases like salmonella, cholera, and giardia.

Jasper Lawrence discovered research showing asthma was 50% less likely in people with hookworm infections, leading him to seek infection in Cameroon.

Lawrence infected himself by walking barefoot in 30-40 village latrines and reported his allergies and asthma disappeared completely afterward.

Lawrence later started a business selling hookworms to about 85 clients, sourcing them from his own stool, despite lacking FDA approval.

David Pritchard's safety study found 10 hookworms were tolerated, but 50 worms caused gut pain and potential anemia from blood loss.

Paul Giacomin's research uses worm farms where volunteers host hookworms to produce eggs for clinical trials, delivered via bandages on skin.

Hookworm larvae enter through skin, travel via lymphatics and bloodstream to the lungs, are coughed up and swallowed, maturing over two to three weeks before settling in the small intestine.

Adult hookworms bite the intestinal wall to feed on blood, initially causing inflammation and diarrhea, then release proteins that promote wound healing and quiet the immune system.

Giacomin's two-year trial on pre-diabetic patients showed hookworm treatment reduced blood glucose and insulin resistance, with some patients no longer pre-diabetic.

Almost all participants in Giacomin's trial opted to keep their worms after the study, and placebo-controlled trials for celiac disease reported improved well-being, mood, and sleep quality.

Research links hookworms to potential benefits for multiple sclerosis, ulcerative colitis, and Crohn's disease, with some patients entering remission.

The hygiene hypothesis posits that eliminating parasites like hookworms through improved sanitation may contribute to increased autoimmune disorders.

Current hurdles for hookworm therapy include sourcing from stool, standardization challenges, and public aversion, leading researchers like Giacomin to pursue developing isolated worm proteins in pill form.