Strongyloidiasis in high-income countries: Taiwan's data illuminate a global blind spot

Strongyloidiasis remains neglected despite its lethal potential in immunocompromised hosts. Recent Taiwanese data reveal a prevalence of 1.9-4.8 % among at-risk cohorts, challenging assumptions that strongyloidiasis is rare in high-income countries (HICs). This commentary highlights three key implications: (i) systematic screening for elderly and immunosuppressed patients, (ii) integration into One Health surveillance frameworks recognizing zoonotic cycles, and (iii) economic evaluations to define cost-effective screening strategies. Addressing this silent infection is urgent amid expanding migration and immunosuppressive therapy use. Ignoring strongyloidiasis risks preventable morbidity, mortality, and rising healthcare costs in ageing HIC populations.