Strongyloidiasis: Symptoms and Treatment

What is Strongyloidiasis?

Strongyloidiasis is a disease caused by a nematode, or a roundworm, in the genus Strongyloides. Strongyloides stercoralis is one of over 40 species within this genus that may cause disease in birds, reptiles, amphibians, livestock, and other primates. The virus sometimes infects primates, dogs, and cats, and some strains infecting dogs and primates can infect humans as well.

Signs and Symptoms?

• Upper abdominal burning or pain
• Alternating diarrhea and constipation
• Rash
• Diarrhea and vomiting
• Weight loss
• Cough
• Intermittent episodes of constipation
• Red hives near the anus

Severe symptoms may include:

• Hoarseness
• Inflammation of the lungs
• Respiratory failure
• Coughing up blood

It can be severe and life-threatening in persons who:

• Are taking corticosteroids for asthma
• Have chronic obstructive pulmonary disease 
• Exacerbations, lupus, and gout
• Have conditions requiring steroids for immunosuppression or symptomatic relief
• Are infected with the virus HTLV-1
• Have leukemia or lymphoma or are transplant recipients.

In case of severe side effects, ensure to seek immediate medical help from the nearest medical facility.

Causes of Strongyloidiasis

It is caused by a nematode, or a roundworm, in the genus Strongyloides. Once they are in your small intestine, they lay their eggs. Adult females can lay up to 40 eggs per day. Either these eggs are passed out in the stool and continue to contaminate the soil, or they remain inside of you and cause autoinfection. When the worms burrow back into your intestines or the skin around your anus, they re-infect you. 

The Risk Factors of Strongyloidiasis

This is often found in wet, moist areas, including South America, Africa, and the Southeastern United States. Your risks increase if you travel in those areas for a longer period. This condition  is found more often in the following people:‌

• Living in institutions
• Who are socioeconomically disadvantaged
• Those living in rural areas
• Those working in agriculture 
• Contact with contaminated soil
• Walking barefoot 
• Contact with sewage or human waste

Diagnosis and Treatment of Strongyloidiasis

‌Strongyloidiasis can be challenging to diagnose because examining the stool under a microscope does not always show the infection. Doctors may recommend stool tests for five sessions to ensure the diagnosis. It can also sometimes be diagnosed with a blood test and some cases may diagnose by testing fluid from your lungs or small intestine.

Treatment is recommended for all persons found to be infected, whether symptomatic or not, due to the risk of developing hyperinfection syndrome. Additionally, it is suggested that patients be considered for testing before being initiated on any immunosuppressive therapy, particularly corticosteroids.

A sputum or stool culture should be negative for 2 weeks for people with a weakened immune system or hyperinfection syndrome. In some cases, antibiotics are required to treat bacterial infections as well.

How Fast Do Symptoms After Exposure?

Most people do not know when their exposure happened. For those who do, a local rash can occur immediately. Coughing usually occurs several days later and the abdominal symptoms typically occur approximately 2 weeks later, and larvae can be found in the stool about 3 to 4 weeks later.

How to Prevent Strongyloidiasis?

In countries where sanitation and human waste disposal have improved, strongyloidiasis has been mostly eliminated. Additional strategies to prevent strongyloidiasis include the following: ‌

• Wearing shoes when you walk on the soil
• Cleaning up after dogs
• Managing sewage and feces properly 
• Avoiding contact with sewage and feces

Medication Used for Strongyloidiasis

Ivermectin is a recommended treatment for this condition. It is a disease caused by a roundworm. This drug is effective in treating this kind of condition. It works by paralyzing and inactivating the gut of parasites in humans. It stops the adult one from producing larvae. It kills the newly developed parasite and works to treat the infection.

What are the Side Effects of Ivermectin?

• Abdominal Pain
• Vomiting
• Fever
• Rashes
• A headache
• Fatigue
• Nausea
• Coughing 
• Dizziness
• Constipation
• Weakness

Inform your doctor right away if you experience this symptom. If you develop other side effects it’s better to visit your doctor. Seek medical attention.