Are you aware of the worm disease called Strongyloidiasis? Let's talk about it!

You may not have heard of this worm disease before. But it can sneak into our bodies and silently cause a lot of trouble. So, today we're going to talk about a condition called Strongyloidiasis. It's like an uninvited guest taking up residence in your body.

What is Strongyloidiasis?

Simply put, Strongyloidiasis is an infection caused by a parasitic worm called Strongyloides. This worm is very delicate. It enters your body through your skin, travels to your lungs and intestines, where it grows and reproduces. Sometimes this infection can be present for years without any symptoms. However, some people may experience skin problems and stomach upsets that come and go. However, if you have a weak immune system, this can be life-threatening. So it is very important to be aware of this.

Where is the Strongyloides worm most prevalent?

This type of worm is found in many parts of the world. But it is especially common in countries with warm climates (i.e., tropical and subtropical regions), rural areas, and areas with poor sanitation. Countries like Sri Lanka should also be concerned about this worm disease. Even in the United States, this worm has been found in rural areas of the South and Southeast, especially in areas like Appalachia. However, most patients in the United States are infected from other countries.

Who is at higher risk of developing this?

It can actually happen to anyone. But some people are more likely to suffer from it. Let's see who they are:

• People with weakened immune systems : This can be especially serious for those taking medications such as corticosteroids or those infected with HTLV-1 (Human T-cell Lymphotropic Virus-1).
• People who walk on the ground without sandals: Did you know that these worms in the ground can burrow into your skin and enter your body?
• People who work in contact with soil: People who work in agriculture or mining are at greater risk if the soil is contaminated.
• People living in areas with poor sanitation facilities.

How do you know if you have a Strongyloides infection?

This is a bit tricky because the symptoms of strongyloidiasis are often similar to those of other diseases. Some people don't even show any symptoms.So, to know for sure whether you have this infection or not, you need to get tested by a doctor. Experts estimate that between 30 and 100 million people worldwide are infected with these worms. But since many people do not have symptoms, it is difficult to say how many people actually have it.

How does this worm move inside the body?

Imagine, these little worms enter through your skin. They don't even have to be broken. Sometimes they can appear as a red rash with itching. Once inside the body, they travel through the bloodstream to the lungs. That's where they grow. Sometimes they can lay eggs inside the lungs and infect you. Then you may feel a cough and a scratchy throat. Then, you can cough up these big worms. Then they go to the stomach and digestive system (GI tract). There, they lay eggs inside the intestines. Those eggs develop into worms again. This can cause symptoms like nausea, diarrhea, and stomach pain. These worms can come out in your stool and spread the infection to someone else. Also, they can re-infect you internally (this is called autoinfection) or re-enter through the skin.

What is this autoinfection?

This is very special. The Strongyloides worm can complete its entire life cycle (that is, lay eggs and produce new worms that can cause re-infection) inside your body. This means that even if you haven't gotten a new worm from the soil, the worms in your body will keep infecting you. If this cycle continues, it can become chronic strongyloidiasis . This means that it can stay in your body for years if left untreated.

What is Strongyloides hyperinfection? Is it dangerous?

Most people have strong enough immune systems to prevent a severe Strongyloidiasis infection. However, if your immune system is weak, the worms can invade other parts of the body. This is called disseminated strongyloidiasis. This can cause severe swelling of organs and the bacteria to enter the bloodstream. This can lead to life-threatening conditions such as sepsis and pneumonia. You are at higher risk of developing this hyperinfection.

• If you are taking `(corticosteroid)` medicine.
• If you have `(HTLV-1)` infection.
• If you have a disease that affects the blood or bone marrow (such as leukemia or lymphoma).
• If you have had an organ or stem cell transplant.

What are the symptoms of Strongyloidiasis?

These are the most commonly seen symptoms:

• A red, swollen, itchy rash on the skin surface (larva currens): This can often appear between the buttocks, on the thighs, or on the wrists.
• Nausea .
• Stomach upset ( diarrhea ).
• Pain in the upper abdomen: This can be similar to pain from gastritis or a stomach ulcer.
• Filling the stomach .
• Coughing or feeling like your throat is scratchy (this is a little less common).

Remember, many people do not show any symptoms, or the symptoms come and go.

What is the reason for this?

Strongyloidiasis is caused by several types of parasitic worms called Strongyloides that live in the soil. These worms are most common in areas with warm climates and where the soil is more likely to be contaminated with feces. Even if you don't have any wounds on your skin, these worms can enter your body through your skin. They can then travel to your bloodstream, lungs, and intestines. A serious condition called ``hyperinfection'' occurs when your immune system is weakened. You can have strongyloidiasis without any symptoms before, but this ``hyperinfection'' can occur later, even if your immune system is weakened.

Is Strongyloidiasis contagious?

Strongyloidiasis is not usually contagious. Most people get it from contact with contaminated soil. It is very rare for it to be transmitted from another person or from a transplanted organ.

How to diagnose the disease?

To diagnose strongyloidiasis, your doctor will test one or more body fluids for the presence of the Strongyloides worm. They will also look for a rash on your skin, especially on your wrists, thighs, and between your buttocks. The following tests may be done:

• A stool/poop test.
• A sputum test (phlegm from the lungs).
• A blood test.

How is it treated?

Strongyloidiasis is treated with antiparasitic medications. Ivermectin, sometimes with albendazole, is the most effective treatment. The medication usually lasts from two to fourteen days, sometimes longer. If you are taking immunosuppressive therapy, your doctor may temporarily reduce the dose of the medication.

The most important thing is that even if you have no symptoms, you should definitely seek treatment if you have a Strongyloides infection. Only then can you avoid a serious condition called ``hyperinfection.''

How can you survive this?

There are several things you can do to reduce your risk of strongyloidiasis:

• Wear protective clothing when coming into contact with soil in areas where Strongyloides worms may be present. This means shoes, gloves, etc.
• Be especially careful in areas with poor sanitation, as the soil is more likely to become contaminated in such places.
• If you are going to have surgery or start medication that will weaken your immune system, ask your doctor to check for infection. If you are diagnosed with strongyloidiasis at that time, you can treat it while your immune system is still strong. This can help prevent a ``hyperinfection``.

What happens if you get Strongyloidiasis?

If you have a weakened immune system, you should seek treatment for a Strongyloides infection right away. You may need to be hospitalized, or you may need to take several courses of treatment to completely eliminate the infection. If your immune system is healthy, antiparasitic medications can often successfully treat the infection. You should also see your doctor after treatment to make sure all the worms are gone.

Can Strongyloidiasis be completely cured?

Yes, strongyloidiasis can be cured with antiparasitic treatments, especially in people with healthy immune systems. However, if it reaches a state of ``hyperinfection'', it is a little more difficult to cure due to the complications that come with it.

How do I take care of myself?

If your immune system is weak, talk to your doctor about getting tested for infections. Learn how to protect yourself from illness and what to do if you get sick.

When should you see a doctor?

See a doctor in these cases:

• If you have symptoms of strongyloidiasis.
• If your immune system is weak and you are concerned about Strongyloides infections.
• If you are traveling to an area where Strongyloides is common (especially if your immune system is weak), talk to your doctor about ways to prevent infection.
• If you are going to have treatment or surgery that weakens your immune system, your doctor may test you for infections before starting treatment.

When do you need to go to an Emergency Treatment Unit (ETU)?

If you have any of these severe symptoms, go to an emergency room (ETU) immediately:

• High fever (103 degrees Fahrenheit / 39.4 degrees Celsius).
• Confusion or other mental changes.
• Low blood pressure .
• Difficulty breathing or shortness of breath even when standing still.
• New or worsening chest pain.
• No or very little urine output.

What questions should I ask my doctor?

You can ask your doctor these questions:

• How can you avoid infections like Strongyloides?
• Should I get tested for strongyloidiasis?
• Am I at increased risk of becoming seriously ill with strongyloidiasis?
• How should I take my medicine?
• How quickly will I get better?
• When should I come see you again?
• When do I need to go to an Emergency Treatment Unit (ETU) ?

Brief points to remember

Most people who get strongyloidiasis do not get seriously ill. However , if your immune system is weak, it can be life-threatening. If you are about to have an organ transplant, are about to start taking corticosteroids, or if your immune system is weakened for any other reason, ask your doctor about getting tested for strongyloidiasis. Early treatment is the best way to prevent serious illness.