High Prevalence of Strongyloidiasis in Spain: A Hospital-Based Study

Ana Requena-Méndez; Joaquin Salas-Coronas; Fernando Salvador; Joan Gomez-Junyent; Judith Villar-Garcia; Miguel Santin; Carme Muñoz; Ana Gonzalez-Cordon; Maria Teresa Cabezas Fernández; Elena Sulleiro; Maria del Mar Arenas; Dolors Somoza; Jose Vazquez-Villegas; Begoña Treviño; Esperanza Rodríguez; Maria Eugenia Valls; Carme Subirá; Jose Muñoz

Unlike other parasitic infections, this helminth has some characteristics that are of particular importance for migrant populations [7] . In the first place, the infection can persist the whole lifetime due to its ability to replicate in the human host [8] . Therefore, people coming from endemic areas may be at risk their whole life irrespective of the moment they arrive to a nonendemic area as long as they are not treated. Second, Strongyloides stercoralis infection is generally asymptomatic or causes unspecific symptoms, being unnoticed for health professionals not looking for it [9] . Third, although the infection is rarely transmitted through person to person, [10] it can be transmitted through organ transplantation, and autochthonous cases have been reported in nonendemic areas [11] . Thus, screening should be considered in potential donors at risk of the infection [12] [13] [14] . Finally, in case of immunosuppression, particularly described with the concomitant use of steroids, transplant recipients or patients with malignancies and Human T-Cell Lymphotropic virus-1 co-infections, the parasite may enter into a high replicating cycle (called hyperinfection) or disseminate to vital organs (disseminated strongyloidiasis), causing a severe disease with high mortality [15] . In this regard, immunosuppression permit larval proliferation (hyperinfection disease) and also dissemination to other organs (disseminated Strongyloides) [15] . The copyright holder for this preprint (which was not peer-reviewed) is the . https://doi.org/10.1101/852558 doi: bioRxiv preprint