It started with an itch after a stroll on a Caribbean beach, but in just a few days it had morphed into a gut-churning travel nightmare.
In mid-January Eddie Zytner and Katie Stephens, a couple from Windsor, Ontario, went on a vacation to Punta Cana, a resort town on the eastern coast of the Dominican Republic.
At some point, they assumed they had been bitten by bugs during one of their walks because their feet wouldn't stop itching.
“We were scratching our toes for almost the duration of the trip,” Zynter told CNN.
It kept getting worse. Four days after they got back to Windsor, their feet swelled, then erupted into painful blisters, according to the couple's Facebook posts.
They could no longer wear socks or shoes and had to use crutches to walk.
And they started to see scars, injuries that seemed to be the result of something tunneling through their flesh.
After multiple trips to doctors, one made a correct, if disgusting, diagnosis: cutaneous larva migrans, a medical term translated as “wandering larvae in the skin.”
The parasite species that cause cutaneous larva migrans — commonly known as hookworms or whipworms — mostly live in the small intestine but can be passed in the feces of an infected person or animal, depending on the species, according to the Centers for Disease Control and Prevention. If that person defecates outside, or if the feces is used as fertilizer, as it is in some countries, the eggs can be deposited in the soil. Some species prefer sand. Infections are most common in the Americas.
The eggs hatch and become larvae, which grow into a form that can puncture and penetrate human skin. Once past that first barrier, the parasites travel, eating their way through a person.
According to the CDC, the most common way to be infected is by walking barefoot on contaminated soil.
More than half a billion people across the world are infected with the parasites, which were once widespread in the United States, the CDC says. Parasitic worms “account for a major burden of disease worldwide.”
The Canadian couple became the latest example of travel ailments that have befallen people trying to take a vacation from winter.
In December, more than 300 passengers on a giant Royal Caribbean cruise ship were sickened by norovirus, which ripped through the close quarters of the ship, overwhelming passengers and the ship's medical personnel. At the same time on the other side of the world, 200 people were sick and five had to be hospitalized during an outbreak on a 14-night cruise from Sydney to Singapore.
Norovirus is not deadly, the cruise company told passengers, and they could decrease their chances of infection by repeatedly washing their hands.
Similarly this month, Stephens, now on the mend after taking anti-parasitic drugs, was doling out health advice for travelers wary of following in her swollen footsteps: Wear shoes.
“To anybody traveling somewhere tropical, please be careful when in the sand and wear shoes!” she posted.
“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.”