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Endemic institutional strongyloidiasis in British Columbia
Summary
Strongyloides stercoralis infection can occur in institutions. Consider this parasitic worm in patients with persistent illness or high eosinophil counts, even in temperate regions.
Area of Science:
- Infectious Diseases
- Parasitology
- Public Health
Background:
- Strongyloides stercoralis is a parasitic nematode.
- Infection can be asymptomatic or present with vague symptoms.
- Chronic care institutions may harbor endemic infections.
Purpose of the Study:
- To investigate the potential for endemic Strongyloides stercoralis infection in a chronic care facility.
- To identify additional cases following an incidental finding.
Main Methods:
- Review of residents after an initial case identification.
- Exhaustive laboratory investigations, including fecal examinations.
- Consideration of serologic testing as an adjunct diagnostic tool.
Main Results:
- Five additional cases of Strongyloides stercoralis infection were identified.
- Fecal-oral transmission was identified as the likely route of spread.
- Unexplained persistent illness and high eosinophil counts were key indicators.
Conclusions:
- Endemic strongyloidiasis should be considered in institutional settings, regardless of climate.
- Prompt investigation and diagnosis are crucial for controlling outbreaks.
- Serologic testing complements fecal examinations for improved detection.