Strongyloidiasis is an infestation caused by a roundworm or a threadworm generally found in tropical and subtropical regions, mainly affecting the small intestine that causes diarrhea and ulceration. Strongyloides stercoralis parasite causes this infection. When an organism lives in the body of another species and depends on this species to obtain nutrients that are essential for its growth is known as a parasite. The infected organism or species is known as the host. These types of parasites live in countries with a warm climate. This infection is commonly found in rural areas and institutional set up like nursing homes. Good personal hygiene practices can prevent infection.
Different Ways of Infestation
Parasites are transmitted through several channels. Water, food, accessibility to other infected people, closeness to standing water, and through the sharing of clothes, bed, comb, etc that are infested are very common ways of transmission to human beings. The parasites get into the host body through different routes.
- Percutaneous route: Some parasites make their entry to the host body through the skin and enter the bloodstream
- Per os route: Some parasites enter through the mouth and transmitted by the ingestion of contaminated food and water.
- Trans-placental route: Some are transmitted through the placenta to the fetus.
- Trans-colostral route: Some newborn gets infestation through the mother’s first milk.
- Inhalation route: Some tiny parasites enter the host body through inhalation.
- Sexual route: Some parasites enter through the sexual route.
- Blood transfusion: Contaminated blood acts as a medium for many parasitic transmission.
- Through vectors: Some parasitic transmission occurs through the bite of infected insects like flies.
- Trans-rectal route: Poor personal hygiene and some sexual practices transmit parasites through this route.
Depending on the parasite and your locality where you live, you tend to swallow some stage of the parasite in the food you eat if it’s inadequately cooked or undercooked. Contact with contaminated soil that contains free-living larvae could be the cause of the primary mode of infection. Head lice, ticks, bed bugs in old mattresses, and ectoparasites like mosquitoes, horseflies, and vampire bats too carry parasites within them and cause infection.
Symptoms of Strongyloidiasis
- Diarrhea alternating with constipation
- Vomiting
- Weight loss
- Red rashes
- Itchy skin near the anus
- Upper abdominal pain
According to the Center for Disease Control and Prevention (CDC), immigrants, refugees, and military veterans mainly spread this type of infection. You are vulnerable to such infection under the following circumstances:
- If you live in or travel to tropical or subtropical countries
- If you live in or travel to rural areas, with unhygienic living conditions
- If you are into a job with constant contact with contaminated soil
- If you practice poor personal hygiene
- If you have a very weak immune system
Diagnosis of Strongyloidiasis
Duodenal aspiration: Duodenal fluid is taken and examined for the presence of S. stercoralis under the microscope by the doctor during this test.
Sputum culture: This method is used to analyze the lung fluid for the presence of S. stercoralis.
Stool sample for ova and parasites: Stool sample is used to check the larvae of S. Stercoralis in the feces.
Complete blood count (CBC) with differential: This test helps to rule out other causes.
Blood antigen test: When duodenal aspiration and stool sample tests are negative and the doctor still suspects to have an infection, a blood antigen test is carried out. This test result will differentiate the past and current infection.
Treatment
The purpose of the treatment for strongyloidiasis is to remove the worms from the host body. The medicine used in treating strongyloidiasis is ivermectin (Stromectol) and a single dose of this drug kills the parasite present in the small intestine. Ivermectin is an antihelminthic drug. It is used both internally and externally. Usually, a single dose of this drug is sufficient to kill the worms inside our body and the topical application of this drug is effective for mites, head lice, scabies, and other conditions and this drug should be taken only by doctor’s advice as it is not recommended for pregnant ladies and lactating mothers.
For enhancing the absorption rate and efficiency of the drug, it is recommended to take them in an empty stomach one hour before having your breakfast. To facilitate drug absorption, drink 240ml of water with the medicine. Post medication the paralyzed worms can cause some side effects like headache, giddiness, swelling of face and eyes, difficulty in breathing or vision in certain patients. Such instances have to be brought into the doctor’s notice if it is severe. To deal with inflammation caused by dead worms, doctors prescribe corticosteroids for several days. If the infection is widespread, you might require a longer or repeated course of medication.
Exposure to parasites cannot be eliminated. However, remember to ensure good personal hygiene, good cooking practices, sterilization of water, and simple precautions and the utmost care is taken by oneself while traveling in the risk-prone areas, etc. All these precautionary measures can reduce the threat to a great extent.
Thank you,
Glenda, Charlie and David Cates
