Can resistant Ancylostoma ceylanicum arise and spread between humans and animals?

Ancylostoma ceylanicum, a prevalent zoonotic hookworm in the Asia-Pacific region, poses significant public and animal health risks due to its high infection rates in both humans and animals. Recent research indicates that this hookworm is predominant among approximately 30% to 50% of individuals in Southeast Asia and affects up to 95% of dogs and cats in the region. The transmission dynamics of A. ceylanicum involve three primary pathways: circulation between humans and animals, and persistence in smaller populations within each host. Effective control has relied on Mass Drug Administration (MDA) with benzimidazoles for humans and routine veterinary deworming for animals. However, the emergence of benzimidazole resistance in canine hookworms highlights a growing concern. Resistance is caused by single nucleotide polymorphisms (SNPs) in the β-tubulin isotype 1 gene, impairing drug efficacy. This resistance could lead to the development of drug-resistant A. ceylanicum populations that could spread between humans and animals. To address this potential threat, genetic analysis of hookworm isolates from both hosts is crucial. Employing β-tubulin isotype 1 as a marker, researchers can trace resistance patterns and transmission routes, aiding in the development of more effective control strategies. Given the zoonotic nature of A. ceylanicum and its capacity for resistance development, continuous monitoring and adherence to established guidelines from the World Health Organization and the World Association for the Advancement of Veterinary Parasitology are essential. This approach will help mitigate the risks associated with drug-resistant A. ceylanicum populations, thereby protecting public health and animal welfare.