Have you ever thought that walking barefoot on the ground, especially on dirty ground, could introduce a dangerous parasite into your body? You might feel a slight itch, but you probably won't care. Today we're going to talk about a worm disease that can silently enter your body and live inside your body for years without any symptoms, but can sometimes be life-threatening. This is called Strongyloidiasis.
Simply put, what is Strongyloidiasis?
Strongyloidiasis is an infection caused by a parasitic worm called `(Strongyloides)`. This worm enters our body through a skin wound . Imagine, even if there is no wound on your skin, these worms can enter the body through a hole in the skin. After entering the body, they go straight to our lungs and intestines. That's where these worms grow, lay eggs, and reproduce.
The peculiarity of this infection is that some people can go for years without showing any symptoms . Others may experience skin rashes, blisters, or stomach upset that come and go from time to time. However, if a person's immune system is weak , this simple worm infection can become severe and even life-threatening.
Where is this worm most common? Who is most at risk?
Although the Strongyloides worm can be found anywhere in the world, it is most common in countries with warm climates (tropical and subtropical) and in rural areas with poor sanitation.
Anyone can develop this disease, but some people are at higher risk of being exposed to it.
| Risk factor | Description |
|---|---|
| Weakened immunity | The risk is particularly high for those taking steroid medications (corticosteroid therapy), those infected with the HTLV-1 virus, cancer patients (especially leukemia, lymphoma), and those who have received organ transplants. |
| Walking barefoot | Walking barefoot, especially on dirty soil, poses a great risk due to constant contact with the soil. |
| Some jobs | People who farm, mine, or otherwise work in jobs that involve frequent contact with the soil are at higher risk. |
| Areas with poor hygiene | Living in areas where the soil is more likely to be contaminated with human feces increases the risk of contracting the disease. |
What does this worm do once it enters the body?
This is like a movie. Imagine, tiny worms (larvae) in the soil enter your body through your skin.
1. Skin penetration: When these larvae first enter the skin, they can cause red, swollen, and very itchy lesions .
2. Travel to the lungs: Next, they enter the bloodstream and travel with the blood to the lungs. That's where they get a little bigger. During this time, some people may feel a strong cough or a tickle in the throat .
3. Entering the intestines: When we cough up worms from the lungs, they enter the throat and we swallow them without realizing it. Then they pass through the stomach and enter the intestines.
4. Transmission: These tapeworms lay their eggs in the intestines. The eggs hatch into larvae, which are passed out in the feces. When they are passed out, they contaminate the soil and can infect others.
The most dangerous thing about this is that these worms, instead of being passed out in the feces, can re-enter the intestines, re-enter the bloodstream, and start the whole cycle over again. This is called ``autoinfection.'' This is why, if left untreated, the infection can persist for years.
Hyperinfection: A severe, life-threatening condition
Usually, the body of a healthy person with a good immune system can keep these worms under control, so severe symptoms do not occur.
However, if a person with a weakened immune system gets this infection, the worms can no longer control the infection. The worms multiply very quickly, leaving the intestines and spreading to other organs such as the brain, liver, and heart. This is called ``hyperinfection`` or ``disseminated strongyloidiasis``.
At this point, as the worms exit the intestines, they also add bacteria from the intestines to the bloodstream. This can lead to very serious, life-threatening complications such as ``sepsis`` (blood poisoning) and ``pneumonia`` (pneumonia).
Who is at higher risk of severe infection (hyperinfection)?
- For those taking corticosteroids for a long time
- For those infected with HTLV-1
- For people with blood-related cancers such as leukemia or lymphoma
- For those who have had an organ transplant or bone marrow transplant
What are the symptoms of this disease?
Many people may have no symptoms, or they may come and go from time to time. If symptoms do occur, they may include:
- Skin lesions: Red, raised, itchy lesions that appear to move very quickly (larva currens). These are most commonly seen between the buttocks, on the thighs, or in the wrist area.
- Stomach upset: Upper abdominal pain (similar to gastritis), bloating, nausea, and diarrhea.
- Cough: A dry cough or a scratchy throat.
Diagnosis and treatment of the disease
If you have these symptoms or are in a risk group, it is important to see a doctor . The doctor will ask you questions, examine you, and order several tests to confirm the diagnosis.
- Stool test: Check for worms or their larvae.
- Sputum test: To find out if there are worms in the lungs.
- Blood test: Checks for antibodies that the body makes against the worm.
As a treatment, the doctor will prescribe anti-parasitic medications. Ivermectin and Albendazole are the most commonly used drugs for this. The medication usually has to be taken for a few days to two weeks.
The most important thing is that even if you have no symptoms, if you are confirmed to have the infection, you should definitely seek treatment. Because if your immunity weakens in the future, this silent worm can become a ``hyperinfection`` and become life-threatening.
How can you protect yourself from this disease?
Protecting yourself from this disease is actually very simple.
- Always wear shoes: Wear sandals or shoes, especially in the garden, field, or anywhere you come into contact with the soil.
- Take care of your hygiene: Wash your hands thoroughly after using the toilet. Avoid contact with soil in areas with poor sanitation.
- Tell your doctor: If you are taking immunosuppressants for any reason, are undergoing cancer treatment, or are preparing for an organ transplant, tell your doctor. If necessary, they can test you for tapeworm before starting treatment.
When should you see a doctor?
If you are in the following situation, be sure to see your family doctor.
- If you have symptoms of Strongyloidiasis (especially strange skin lesions, stomach upset).
- If your immune system is weak and you are afraid of infections like this.
- If you are traveling to an area where this disease is common.
- Before you start any treatment that weakens your immune system.
When to go to the ETU (Emergency Treatment Unit) immediately
If you suspect you have Strongyloidiasis and develop any of the following severe symptoms, go to the nearest hospital Emergency Department (ETU) immediately.
- High fever (over 39.4 Celsius / 103 Fahrenheit)
- Despair or altered consciousness
- Very low blood pressure
- Difficulty breathing
- Chest pain
- Very little or no urine output
Take-Home Message
- Strongyloidiasis is a disease caused by a parasitic worm found in dirty soil that enters the body through the skin.
- Many people do not show any symptoms for many years.
- For people with weakened immune systems (e.g., those taking steroids, cancer patients), this disease can be very severe and even life-threatening.
- You can easily protect yourself from this disease by wearing shoes and practicing good hygiene.
- Even if there are no symptoms, medical treatment should be sought if infection is detected.
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