Intestinal parasitosis, anguillulosis is a disease linked to the presence of a roundworm in the intestine, Strongyloid stercoralis and more rarely Strongyloid full bomi. It is common in tropical countries. It is the cause of digestive pain, diarrhea or constipation, and a deterioration of the general condition. 

Anguillulosis is a digestive parasitosis linked to the presence of a roundworm in the small intestine, Strongyloid stercoralis and more rarely Strongyloid full bomi. 

How does the contamination come about?

Contamination occurs from larvae present in soiled water and which will pass through the skin. These larvae will gain the blood or lymphatic circulation (lymphatic vessels) to pass through the heart, lungs, trachea and then be swallowed to reach the first part of the small intestine, the duodenum and the jejunum.

Arrived in this part of the intestine, they will burrow into the intestinal mucosa and turn into an adult worm, the eel. This round worm will lay eggs by parthenogenesis (without the intervention of a male worm) which will in turn become larvae, which will be expelled by the stool to contaminate other people.

This intestinal parasitosis is common in tropical countries such as black Africa, the West Indies, Central America, the Indian Ocean and parts of Southwest Asia. A few cases have been reported in Eastern Europe and France. It affects 30 to 60 million people worldwide.

People are contaminated by water contaminated with faeces, when walking barefoot in mud or by bathing in small ponds or polluted ponds. It is also possible to be contaminated by walking with bare feet on sand by the sea.

This contamination is the result of larvae present in these stagnant waters in tropical countries, which will cross the skin and mucous membranes to migrate inside the body. The presence of these larvae is favored by poor hygienic conditions locally (faecal danger), by humidity and by heat. Sexual contamination (sodomy) is also possible.

The symptoms are of a different nature depending on the phase of maturation from the larva to the adult worm:

Skin disorders

They are made by the penetration of the larvae through the skin, causing a rash of pimples (papules) at the points of penetration of the larvae associated with local allergic reactions (hives, itching).

Respiratory disorders

They can appear as the larvae migrate into the lungs with an irritating cough, shortness of breath that suggests asthma.

Digestive disorders 

By the presence of the adult worm in the beginning of the small intestine (inflammation of the duodenum, abdominal pain, diarrhea, constipation, irritation in the anal region). But at the start of the parasite infestation, there are few or no digestive symptoms in almost half of the cases.

Coping with complications 

Later or in an immunocompromised person (decrease in immunity due to an illness or treatment), the symptoms are more severe and can lead to an alteration of the general condition (AEG) with weight loss, anorexia, severe fatigue (severe asthenia ). 

Other complications are possible, in particular infectious, such as septicemia (a microbe that passes into the blood), lung and brain abscesses, and infections of the lungs (pneumopathy). The microbes found are of digestive origin. These severe infections can lead to death if treatment is not given on time.

Biological signs are found in a blood test with a multiplication of a certain type of white blood cells, eosinophils, which are normally located between 2 and 7% and which can be found in 40 or 60% of all blood cells. white.

Finally, a parasitological examination of the stool as well as a search for anti-Strongyloides antibodies in the blood (Elisa test) may find the presence of eel larvae and be positive for the test (High Authority for Health recommendation 2017).

The starting treatment for Anguillulosis will be an antiparasitic, ivermectin, in a single dose, 83% effective. Other antiparasitic treatments are also offered if necessary. These treatments will be combined with an antibiotic treatment to treat the infectious complications of this parasitosis.

Finally, in severe forms, other treatments will also be implemented depending on the complications present.

Prophylaxis (prevention) is based on the fight against faecal peril by ensuring better hygiene in the countries concerned and better living conditions.