14074 Strongyloidiasis

Overview

Strongyloidiasis is an infection caused by a tiny roundworm called Strongyloides stercoralis. The worm lives in soil and enters the body through the skin, usually when you walk barefoot. It then travels through the body to the intestines, where it can live for a long time.

It is not common in the UK or other areas with cold climates, but it is common in tropical and subtropical regions. Around the world, it is estimated that tens of millions of people are infected.

Anyone living in or traveling to areas where the worm is found can get it. People with weakened immune systems, such as those taking certain medicines or with conditions like HIV, are at higher risk of severe infection.

Symptoms

Common symptoms

• Itching or a snake-like rash where the worm entered the skin
• Stomach pain or cramps
• Diarrhoea
• Nausea
• Dry cough or wheezing

Symptoms in children

• Poor weight gain or growth
• Irritability
• Belly pain
• Itchy skin

Symptoms in older adults

• More severe abdominal symptoms
• Unexplained weight loss
• Weakness or fatigue
• Difficulty breathing if the worm spreads to the lungs

Causes

Main causes

• Contact with soil that contains the worm larvae
• Walking barefoot on contaminated ground
• Touching soil with bare hands

Risk factors

• Living in or traveling to tropical or subtropical regions with poor sanitation
• Having a weakened immune system due to illness or medication
• Being older or having chronic illness

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above
• If you are vomiting and cannot keep fluids down
• If you have signs of severe dehydration

Book a routine appointment if:

• If you have been to an area where strongyloidiasis is found and have ongoing stomach problems, rash, or cough
• If you have a weakened immune system and think you may have been exposed

Diagnosis

Your doctor will ask about your symptoms and travel history. They may ask for a stool sample to look for the worm, or a blood test to check for antibodies.

Tests that may be done

• Stool sample (often several samples over different days)
• Blood test
• Sometimes a mucus sample from your lungs if you have a bad cough

What to expect at your appointment

The tests are simple and painless. You may need to provide more than one sample. Results can take a few days. If tests confirm the infection, your doctor will talk to you about treatment.

Treatment

Strongyloidiasis is treated with a course of medication that kills the worm. This is usually taken by mouth and is very effective.

Self-care at home

• Wash your hands thoroughly with soap and water after using the toilet and before eating
• Do not scratch the rash – it can become infected
• Drink plenty of fluids if you have diarrhoea

Medical treatments

Your doctor will prescribe an antiparasitic medicine for you. The dose and how long you take it depend on your overall health. People with weaker immune systems may need a longer course. Always take the medicine exactly as prescribed.

When is surgery considered?

Surgery is not needed for strongyloidiasis.

Living with this condition

While you are being treated, take your medicine as directed and attend any follow-up appointments. Tell your doctor if your symptoms get worse or do not improve after treatment.

Lifestyle tips

• Keep good hand hygiene
• Wear shoes when walking outdoors, especially in areas where soil may be contaminated
• Wash and cook food properly

Diet and exercise

Eat a balanced diet to keep your body strong while recovering. If you have diarrhoea, make sure to replace fluids by drinking water, clear broth, or an oral rehydration solution recommended by your pharmacist.

Mental health and emotional wellbeing

Having an infection can be stressful, especially if you have had symptoms for a while. It may help to talk to your doctor about any worries you have. Remember that treatment works, and most people feel better after a full course.

Prevention

Yes, the best way to prevent strongyloidiasis is to avoid direct skin contact with soil in areas where the parasite is common. Wear shoes, gloves, and use good hygiene.

Vaccines

There is no vaccine for strongyloidiasis.

Screening programmes

If you are planning to travel to a high-risk area, ask your doctor or travel health clinic about risks. If you have a weakened immune system and have been in these areas, your doctor may recommend a blood test, even if you have no symptoms.

Complications

If left untreated

• The worm can multiply inside the body, especially if the immune system is weak
• Infection can spread to the lungs, liver, or brain
• In very severe cases, it can be life-threatening

Long-term outlook

With early diagnosis and proper treatment, most people make a complete recovery. Even people who have had the infection for years can be cured. The key is to get tested and treated as soon as you suspect you might have it.

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