An emergency medicine doctor has shared a graphic and disturbing video to warn Americans about a parasitic infection that affects up to 4million Americans.
The clip, posted by Florida-based physician Dr Sam Ghali, shows a revolting bundle of worms wriggling out of an intestine on an operating table.
He explained that the parasites are giant roundworms — or Ascaris lumbricoides — which can grow up to 11 inches long and live in the intestines of humans or animals for up to two years.
The worms, which can be contracted via contaminated food and water, generally cause no symptoms. But a large number can trigger gastro-intestinal problems like abdominal pain, diarrhea and nausea.
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Dr Ghali explains that the video, which has received half a million views on X, actually features the intestine of a horse — however he says the worms can also infect humans.
Dr Ghali explains that, just like you see in humans, a build up of the worms can cause a potentially deadly intestinal blockage.
However, veterinarians commenting on the video said a human would not normally have such a severe infection.
Up to a billion people are estimated to have giant roundworms worldwide, or one in eight, including 4million in the US — or one in a hundred people.
Individuals unwittingly become infected by consuming contaminated food or water laced with the worm's microscopic eggs.
This can happen via contamination of hands from pets' feces, with the eggs then passed on to food while a meal is prepared. Water can become contaminated if poor sanitation leads to it being mixed with feces.
Dr Ghali said: 'While these infestations aren't known to really cause bowel obstruction in humans, obviously they will cause GI [gastro-intestinal] symptoms.
'This one is endemic to places like Mexico and South America, Africa and India.
'Even if you're not living there, if you plan to travel to any of those parts of the world, this is definitely something that you should know about.'
In the US, infections can happen in rural areas or those with poor sanitation.
Previously, they have also been linked to close contact with pig farms — which can harbor the worms.
It was not clear when or where the video was filmed, but it is likely from a Spanish-speaking country.
Responding to the clip, a viewer wrote, 'so gross! But important to know', while a second said, 'about to cancel my trip to Brazil'.
Infections with the worms are generally diagnosed via looking for traces of microscopic eggs or any worms in feces.
Doctors may also use a colonoscopy, where a camera is placed into the bowel to check for the presence of worms.
The infection is treated using anti-parasitic drugs to kill the worms.
The CDC says online: 'This infection is generally rare to absent in developed countries, but sporadic cases may occur in rural, impoverished regions of those countries.'
Once someone consumes the eggs of roundworms, these hatch in the intestines before the larvae migrate into the bloodstream and to the lungs.
They grow in these organs before being coughed up and swallowed, allowing the worms to return to the intestines where they live for a year or two.
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