Investigation of Donor-Transmitted Strongyloides stercoralis Infections in Solid Organ Transplant Recipients, United...

Strongyloides stercoralis is a parasitic nematode endemic in tropical and subtropical regions, including parts of the southeastern United States, that can be transmitted via organ donation. As of October 2025, the Organ Procurement and Transplant Network implemented new policy for screening in deceased US organ donors to reduce the risk for donor-derived Strongyloides infection. To assess the potential effect of policy changes, we reviewed investigations of suspected transplant-related strongyloidiasis in the United States conducted by the Centers for Disease Control and Prevention and partners for solid organ transplants occurring during 2012-2024. During that period, 21 proven donor-derived strongyloidiasis cases originated from 15 unscreened donors. Of donors who were screened, 31 seropositive donors resulted in ivermectin prophylaxis for 77 recipients, none of whom had disease develop. Our findings support the effectiveness of universal organ donor screening and prophylactic ivermectin treatment of recipients to prevent donor-derived Strongyloides infection.