To the Editor.—
The article by Genta and colleagues1 on the use of an enzyme-linked immunosorbent assay for the diagnosis of strongyloidiasis in an atrisk group emphasizes the need for using multiple diagnostic modalities in the search for this elusive parasite. Our experience in Tasmania, however, contrasts with their observation that patients' clinical manifestations may not be helpful in suggesting the diagnosis.
For the past eight years, we have been investigating Strongyloides stercoralis infestation in World War II veterans who were prisoners of war in the Far East. As Strongyloides is not endemic in Tasmania, the bulk of the cases in this group of veterans were acquired during their time as prisoners working on the Burma-Thai railway, 40 years previously.Of the 150 veterans so far investigated, 29 have had the typical clinical manifestations of episodic diarrhea, vague abdominal discomfort, eosinophilia, and rapidly advancing linear skin eruptions (larva
Byard RW, Oliver NWJ, Rowbottom DJ. Strongyloidiasis in Veterans. JAMA. 1987;258(22):3258-3259. doi:10.1001/jama.1987.03400220058031