Strongyloides stercoralis

Strongyloidiasis is primarily an infection of the small bowel by the filarial worm Strongyloides stercoralis (and rarely S. fülleborni) (1).

• it is endemic in the tropics and subtropics but also seen in countries with temperate climates, people who have lived or travelled to these areas are also at risk
• infection can be either acute or chronic in nature (2)

Transmission of the infection may occur through:

• direct penetration of human skin by infective larvae when in contact with soil e.g. - walking barefoot
• oro-anal contact - seen in homosexual men
• solid organ transplants - there have been reports of transmission of the infection derived from the donor organ
• faecal-oral route - may be possible when larvae contaminated water is used to wash vegetables in endemic areas (2)

Most infections are asymptomatic however immunosuppressed individuals may suffer gross infection.

Reference:

• (1) World health Organization (WHO). Strongyloidiasis. Key facts
• (2) Greaves D et al. Strongyloides stercoralis infection. BMJ. 2013;347:f4610