Strongyloidiasis — The deadly tropical disease you’ve probably never heard of.


Strongyloides stercoralis is a parasitic worm. It lives in the environment and then it can
get into your gut via your bloodstream by getting in through your skin. If your immune system gets compromised, the
disease can go into a more severe form, that’s where the larvae multiplies enormously and
then it goes from the gut to other organs. It goes into hyperinfection, where you have
huge numbers, and then they can move out of the gut tissue and into your other organs,
and that’s almost invariably fatal. We really need to get an understanding of
how many people are currently infected. But we also currently don’t understand where
it’s living in the environment. What environmental conditions give rise to
its survival. So how it’s actually passed from person to
person. At the moment, we’re relying on one or two
drugs. And unfortunately, we’ve seen a couple of
studies that have shown resistance in animals, and it’s possible we could start to see resistance
in human Strongyloides. One of the challenges with Strongyloides is
that, although it’s readily treatable, we don’t develop immunity. So, potentially, you could be treated, and
then walk back out into the environment and become re-infected. It tends to be more associated with the more
tropical, and it also tends to be associated with areas of disadvantage, and we think this
is probably because places that don’t have appropriate sewage disposal, or rubbish disposal
are more likely to have the worm. We found that Strongyloides is important to
indigenous health, and we need to be trying to close this gap between indigenous and non-indigenous
Australians. There’ve been some individual community studies
where they’ve done either screening for Strongyloides followed by treating, or where they’ve just
screened the entire community. And the estimates sort of range from between
about 20% through to about 80% infection rates. If we had a better understanding of the distribution,
then the likelihood increasing screen-and-treat programs is definitely there. Because I think one of problems is that it’s
underestimate, so it’s not seen as a disease of concern.

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