The China Quarterly



Research Report

China's Hookworms 1


Peter J.  Hotez 

Abstract

Huang zhong bing, the “yellow puffy disease” caused by parasitic hookworms living in the human small intestine, was common throughout pre-liberation China. Hookworms contributed significantly to the nation's reputation as the sick man of Asia. However, even today China has the world's greatest number of cases of human hookworm infection. From estimates based on diagnostic surveys obtained during the early 1990s on over one million patients, there are approximately 194 million Chinese infected with hookworm. Most of these infections occur among the rural poor in the south and south-west. Even more recent data obtained in 1997 and 1998 indicate that hookworm remains a major public health problem in Hainan, Sichuan and Yunnan provinces. Populations of the elderly and middle-aged women are emerging as the groups now at greatest risk for acquiring hookworm. New evidence indicates that in addition to threatening health, hookworms also contribute significantly to economic under-development. Hookworms are a living reminder of China's often-forgotten rural southern poverty and a rapidly growing urban–rural inequality; they are an impediment to China's future economic growth.



Footnotes

1 This article is dedicated to the life and work of Professor Frank F. Richards who retired from the Yale University faculty in 2001. In his position as Director of the MacArthur Center for Molecular Parasitology, Frank pioneered the establishment of numerous joint biomedical research projects between Chinese and American scientists, and helped to found the Morgan-Tan Institute of Molecular Genetics on the campus of Fudan University in Shanghai.Field studies on the epidemiology of hookworm infection are funded by grants from the March of Dimes Birth Defects Foundation and the National Institute of Allergy and Infectious Disease of the National Institutes of Health (NIAID, NIH) (P50 AI-39461). Laboratory and clinical investigations to develop an anti-hookworm vaccine are funded by the NIAID, NIH (AI-32726) and the Bill and Melinda Gates Foundation (through the Sabin Vaccine Institute). Scientific exchange between US and Chinese institutions is funded by a Parasitology Grant from the China Medical Board of New York, Inc.