Best Evidence Summary for Prevention of Gut Worm – Strongyloidiaisis
Strongyloides stercoralis (strong- gu-loy-dees stir-core-a-lis) is a worm that can burrow into people’s skin and make its way to the gut. It usually lives in the dirt anywhere that human faeces (poo) have been left. If someone stands on or sits on the ground where the worm is living, the young worms (the lavae) will feel the warmth of the person and head for that place. The young worm will enter the body without leaving any sign that this has happened. It then travels through the body to the lung and then to the gut where it lays more eggs, infecting people with the strongyloides worm or gut worm.
This infection is called strongyloidiasis.
Why worry about Strongyloides?
Although most people in Australia will never be at risk of strongyloides, there are groups of people who have high rates of infection. Strongyloides makes people more likely to get sick. It can affect people’s immune system, leaving them weak. The strongyloides worm goes through the lung causing infections and then to the gut. Once someone has strongyloidiasis (gut worm infection), it can stay in the body for years, making them more likely to get other infections and illnesses, such as diarrhoea and. People may also lose their appetite and become malnourished.
Strongyloides or gut worm is also closely linked to one of the autoimmune diseases called HTLV1 which can be passed on to other people through close contact. It is important to check for strongyloides in places where this is a risk or among people who have been exposed to this risk in other places.
Who is at risk for getting Strongyloides?
Aboriginal people, mainly from Central Australia, have the greatest risk of getting infected by strongyloides. Anywhere that there is a lack of basic toileting facilities for the safe disposal of human faeces will create the kind of place that the gut worm can grow in. Anyone living in or travelling to Aboriginal communities can be at risk. Other groups at risk of getting gut worm infections include World War II veterans who might have been exposed to unsafe conditions during their war service, immigrants from SE Asia, Africa and South American tropical and subtropical regions.
What can practitioners do?
- Provide education about the risk factors which include areas where human faeces is not properly taken care of:
- Babies nappies that are dropped on the ground and not safely put in rubbish bins can create an unclean environment.
- People who go to the toilet in outside areas and do not safely dispose of their faeces also create a risk for gut worm to grow.
- Make sure that there are adequate waste disposal (rubbish & toilet) facilities in the community
- Encourage people to wear closed in footwear and cover their legs or place a blanket down when sitting on the ground as a protective barrier between them and the worm.
- Conduct blood tests, skin checks and lung checks for signs of strongyloidiasis.
The key message from the evidence is that Strongyloides can be prevented or delayed by:
Strongyloides is a health problem that can be prevented. Public health measures such as hand washing, toileting hygiene,
safe disposal of human faeces including baby nappies, wearing footwear and other protective clothing and/or blankets when
sitting on the ground, will help prevent strongyloides.
2. Einsiedel, L & Taylor, K 2015 HTLV1 Research story, Poche Centre for Indigenous Health & Wellbeing: Alice Springs