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Microsoft word - 124 strongyloidosis.doc

EAZWV Transmissible Disease Fact Sheet Sheet No. 124
STRONGYLOIDOSIS
CLINICAL
TREATMENT PREVENTION
DISEASE ?
& CONTROL
AFFECTED
Fact sheet compiled by
Last update
Manfred Brack, formerly German Primate Center, Göttingen / Germany.
Susceptible animal groups
Mainly Old World nonhuman primates, man.
Causative organism
Strongyloides stercoralis, S.fülleborni, S.cebus.
Zoonotic potential
Yes.
Distribution
World- wide, preferentially in subtropical and tropical regions.
Transmission
Percutaneously. The adult Strongyloides females live in the large intestines of the host animals (or man!),
produce embryonated eggs, which in S.fülleborni and S.cebus are faecally excreted as such, whereas in
S.stercoralis
the larvae may hatch already in the original hosts large intestine, thus causing autoinfections.
In the other Strongyloides spp. the larvae hatch in the environment, proceed through 2 molts to reach the
infective filariform larval stage or to develop into free-living male and female adults, which start one or more
new external larval cycles. Both the directly and the indirectly generated filariform larvae penetrate the skin,
or at being swallowed, the epithelia of the upper digestive tract. Subsequently they migrate via the circulation
to the lung, burrow through the alveolar capillaries and alveolar walls, migrate actively up to the larynx and
pharynx, are swallowed and ,on reaching the small intestine of the new host become again adult
embryonated eggs producing females. Migrating larvae may cross the placental tissues, thus leading to
infections already od newborn apes. That migration stage, regardless of the Strongyloides- species involved,
applies to only a precentage of infecting larvae. The others convert to a resting stage somewhere in the new
hosts tissues after epithelial penetration, surviving there for decades and eventually becoming reactivated
after stress (pregnancy, social stress etc.).
Incubation period
Prepatent period: 11 – 18 days.
Clinical symptoms
The skin-penetrating larvae cause itching sensations, and eventually urticaria, those burrowing through the
lung dyspnea, cough or even pneumonia. The adults living in the small intestine cause haemorrhagic-mucoid
diarrhea, anorexia, vomitus, depression, weight loss and occasionally paralytic ileus.
Post mortem findings
Multifocal or diffuse pulmonary haemorrhages, catarrhal to haemorrhagic- necrotic enterocolitis. In
hyperinfections subacute eosinophilic interstitial pneumonia, eosinophilic vasculitis and perivasculitis.
Diagnosis
Repeated ovodiagnosis in S. fülleborni/S. cebus infestations, repeated larval demonstrations in S.stercoralis
infestations of great apes and man, using Baerman Wetzel funnels. In necropsies of great apes larval
emigration tests from the duodenal tissues and histological examination of the duodenum are advisable
EAZWV Transmissible Disease Fact Sheet Sheet No. 124

Material required for laboratory analysis
Faecal samples.
Relevant diagnostic laboratories
Local veterinary laboratories.
Treatment
Thiabendazole (50 – 100 mg/kg/day for several days)
Mebendazole (50 mg/Kg)
Albendazole (16 mg/kg/day for 3 days)
combination with Ivermectin (200 mg/kg).
Ivermectin (2 x 100 mg)- in man.
Moxidectin (0.5 mg/kg)
Prevention and control in zoos
Drainage and steam-desinfection of outdoor-housing and floor-beddings .
Suggested disinfectant for housing facilities

Notification

Guarantees required under EU Legislation

Guarantees required by EAZA Zoos

Measures required under the Animal Disease Surveillance Plan

Measures required for introducing animals from non-approved sources

Measures to be taken in case of disease outbreak or positive laboratory findings

Conditions for restoring disease-free status after an outbreak

Experts who may be consulted

References
1. Appleton, C. C., R. C. Krecek, A. Verster, M. R. Bruorton, and M. J. Lawes . 1994. Gastro – intestinal parasites of the Samango monkey, Cercopithecus mitis , in Natal, South Africa. J. Med. Primatol. 23 : 52 – 55. 2. Brack, M. 1987. Agents Transmissible from Simians to Man. Springer, Berlin. 3. Brack, M., und W. Rietschel. 1986. Ivermectin zur Strongyloidose fülleborni – Bekämfung bei Rhesusaffen – Kurzmitteilung. Kleintierpraxis 31 : 29. 4. Dufour, J. P., F. B. Cogswell, K. M. Phillippi-Falkenstein, and R. P. Bohm. 2006 Comparison of efficacy of moxidectin and ivermectin in the treatment of strongyloides fulleborni infection in rhesus macaques. J. Med. Primatol. 35 : 172 – 176. 5. Mojon, M., and P. B. Nielsen. 1987. Treatment of Strongyloides stercoralis with Albendazole. A cure rate of 86 per cent. Zent. bl. Bakteriol. Hyg. A 263 : 619 – 624. 6. Muriuku, S. M: K., R. K. Murugu, E. Munene, G. M. Karere, and D. C. Chai. 1998. Some gastro – intestinal parasites of zoonotic ( public health ) importance commonly observed in Old World non – human primates in Kenya. Acta Trop. 71 : 73 – 82. 7. Naquira, C., G. Jimenez, G. G. Guerra, R. Bernakl, D. R. Nalin, D. Neu, and M. Aziz. 1989. Ivermectin for human strongyloidosis and other intestinal helminths. Am. J. Trop. Med. Hyg. 40 : 304 – 309. 8. Nielsen, P. B., and M. Mojon. 1987. Improved diagnosis of Strongyloides stercoralis by seven consecutive stool specimens. Zent. bl. Bakteriol. Hyg. A 263 : 616 – 618. 9. Rietschel, W. 1991. Zum Einsatz von Ivermectin bei mit Strongyloides spp. befallenen Primaten. Verh. ber. Arb. tag. Zootierärzte Dtsch. sprach. Raum. 11 : 57 – 59. 10. Viney, M. E., R. W. Ashford, and G. Barnish. 1991. A taxonomic study of Strongyloides Grassi, 1879 ( Nematoda ) with special reference to Strongyloides fülleborni von Linstow, 1905 in man in Papua New Guinea and the description of a new subspecies. Syst. Parasitol. 18 : 95 – 109.

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