INFECTIOUS AGENT

• Strongyloides stercoralis, a nematode

• larvae penetrate skin, enter blood vessels, travel to lungs, migrate up respiratory tree to the pharynx, where they enter the gastrointestinal tract (where the female lays eggs)

MODE OF TRANSMISSION

• penetration of skin or mucous membrane by infective larvae (usually from fecally contaminated soil)

• free-living form of the parasite can be maintained in the environment (soil) for years

• transmission also occurs via oral-anal sexual activities

DISTRIBUTION

• worldwide; most common in tropical and subtropical areas

INCUBATION PERIOD AND COMMUNICABILITY

• larvae can be found in stool 2 to 3 weeks after exposure

• infection is potentially communicable as long as living worms remain in the intestine

TREATMENT

• antiparasitic agents: thiabendazole, albendazole, ivermectin

PREVENTION AND CONTROL

• disposal of feces in a sanitary manner

• avoidance of skin-soil contact in endemic areas

FACTORS FACILITATING EMERGENCE

• international travel

• immunosuppression

DISEASE(S) AND SYMPTOMS

• a systemic protozoan disease, frequently present as an acute mononucleosis-like disease (malaise, myalgias, fever)

• immunocompromised persons tend to have severe primary infection with pneumonitis, myocarditis, meningoencephalitis, hepatitis, chorioretinitis, or some combination of these