IN HUMANS continued
Rhabditiform larva of S. stercoralis
Chest radiograph demonstrating typical findings of pulmonary strongyloidiasis. Note ground-glass opacity
unreliable marker of severe disease. Because of the risk of disseminated infection, serological screening for Strongyloides is recommended prior to immunosuppressive treatment, particularly in patients who had lived in ‘high risk’ settings. Serology is also used to demonstrate falling titres, and ensure cure following ivermectin therapy.
or Koga Agar plate culture utilising a lawn of E. coli ). PCR testing is also increasingly used, but serology is the mainstay of diagnosis. • Immunocompetent patients with chronic strongyloidiasis may demonstrate persistent eosinophilia, however eosinophilia may disappear during hyperinfection, and hence can be an
KEY CONSIDERATIONS 1. Strongyloidiasis is considered a neglected tropical disease, endemic to parts of tropical and subtropical Australia. 2. Screening of patients (human and animal) in known endemic areas prior to initiating immunosuppressive therapy is recommended due to the risk of disseminated infection. 3. Due to the ability of S. stercoralis to cause autoinfection, human patients can have a life-long infection unless provided with effective treatment. Infected humans may be a source of infection for dogs.
Minimise contact with potentially contaminated soil through appropriate clothing, footwear, protective equipment and good hand hygiene.
References: 1. Thamsborg, S.M., et al (2017) Strongyloides spp. infections of veterinary importance. Parasitology, 144(3), 274-284. 2. Wulcan, J.M., et al (2019) Strongyloides spp. in cats: a review of the literature and the first report of zoonotic Strongyloides stercoralis in colonic epithelial nodular hyperplasia in cats. Parasit Vectors, 12(1), 349. 3. Wilson, A., et al (2018) Paediatric strongyloidiasis in central Australia. Trop Med Infect Dis, 3(2), 64. 4. Buonfrate, D., et al (2020) The global prevalence of Strongyloides stercoralis infection. Pathogens , 9, 428. 5. Sanpool, O., et al (2020) Dogs are reservoir hosts for possible transmission of human strongyloidiasis in Thailand: molecular identification and genetic diversity of causative parasite species. J Helminthol, 94. 6. Beugnet, F., et al (2018) Textbook of Clinical parasitology in Dogs and Cats. Strongyloidosis. Servet editorial-Grupo Asís Biomedia, SL. 27-29. 7. Graham, J.A., et al (2019) Disseminated Strongyloides stercoralis infection in a dog following long-term treatment with budesonide. J Am Vet Med Assoc, 254(8), 974-978. 8. Kassalik, M., et al (2011) Strongyloides stercoralis hyperinfection syndrome and disseminated disease. Gastroenterol Hepatol, 7(11), 766. 9. Raza, A., et al (2018) Gastrointestinal parasites in shelter dogs: occurrence, pathology, treatment and risk to shelter workers. Animals, 8(7), 108. 10. Dillard, K.J., et al (2007) Strongyloides stercoralis infection in a Finnish kennel. Acta Vet Scand, 49(1), 37.
11. Beknazarova, M., et al (2020) Opportunistic mapping of Strongyloides stercoralis and hookworm in dogs in remote Australian communities. Pathogens, 9(5), 398. 12. Beveridge, I., et al (2015) Australasian Animal Parasites: Inside and Out. Australian Society for Parasitology 186. 13. Dantas-Torres, F., et al (2020) TroCCAP recommendations for the diagnosis, prevention and treatment of parasitic infections in dogs and cats in the tropics. Vet Parasitol, 109167. 14. Ross, K.E., et al (2017) The National Strongyloides Working Group in Australia 10 workshops on: commendations and recommendations. Aust NZ J Publ Heal, 41(3), 221-223. 15. Paradies, P., et al (2019) Efficacy of ivermectin to control Strongyloides stercoralis infection in sheltered dogs. Acta Trop, 190, 204-209. 16. Schär, F., et al (2013) Strongyloides stercoralis: global distribution and risk factors. PLoS Negl Trop Dis, 7(7), e2288. 17. Keiser, P.B., et al (2004) Strongyloides stercoralis in the immunocompromised population. Clin Microbiol Rev, 17(1), 208-217. 18. Krolewiecki, A., et al (2019) Strongyloidiasis: a neglected tropical disease. Infect Dis Clin, 33(1), 135-151. 19. Page, W., et al (2016) Chronic strongyloidiasis-Don’t look and you won’t find. Aust Fam Physician, 45(1/2), 40.
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Companion Animal Zoonoses Guidelines 82
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