Disease
Most people infected with Strongyloides do not know they’re infected. If they do feel sick the most common complaints are the following:
Abdominal

• stomachache, bloating, and heartburn
• intermittent episodes of diarrhea and constipation
• nausea and loss of appetite

Respiratory

• dry cough
• throat irritation

Skin

• an itchy, red rash that occurs where the worm entered the skin
• recurrent raised red rash typically along the thighs and buttocks.

Rarely, severe life-threatening forms of the disease called hyperinfection syndrome and disseminated strongyloidiasis can occur. These forms of the disease are more common in people who are on corticosteroids (prednisone for example) or other immunosuppressive therapies or who are infected with HTLV-1. In this situation, people become critically ill, and should be taken to the hospital immediately.
Diagnosis
Strongyloides is usually diagnosed by seeing larvae in stool when examined under the microscope. This may require that you provide multiple stool samples to your doctor or the laboratory. Some laboratories are capable of diagnosing Strongyloides with blood tests.
Treatment
Treatment for strongyloidiasis is recommended for all persons found to be infected, whether symptomatic or not, due to the risk of developing hyperinfection syndrome and/or disseminated strongyloidiasis. Furthermore, it is recommended that patients be considered for testing prior to being initiated on any immunosuppressive therapy, particularly corticosteroids.
Prevention & Control
The best way to prevent Strongyloides infection is to wear shoes when you are walking on soil, and to avoid contact with fecal matter or sewage. Proper sewage disposal and fecal management are keys to prevention.
Furthermore, if you believe that you may be infected, the best way to prevent severe disease is to be tested and, if found to be positive for disease, treated.
You should discuss testing with your doctor if you are

• taking steroids or other immunosuppressive therapies
• about to start taking steroids or other immunosuppressive therapies
• a veteran who served in the South Pacific or southeast Asia
• infected with Human T-cell Lymphotropic Virus-1 (HTLV-1)
• diagnosed with cancer
• going to donate or receive organ transplants.