Investigation of Strongyloides stercoralis in an intermediate care facility for developmentally disabled individuals, New York, November to December 2023

Kelly A Barrett; Rowena Clavines; Haillie Meek; Wallace Jenkins; Monica Quinn; Ada Huang; Bruce Reidenberg; Karyn Hirsch; Emily Lutterloh; Geetika Sood

doi:10.1016/j.ajic.2025.05.021

Investigation of Strongyloides stercoralis in an intermediate care facility for developmentally disabled individuals, New York, November to December 2023

Am J Infect Control. 2025 Jun 3:S0196-6553(25)00408-0. doi: 10.1016/j.ajic.2025.05.021. Online ahead of print.

Authors

Affiliations

¹ Division of Epidemiology, New York State Department of Health, Albany, New York, United States. Electronic address: Kelly.barrett@health.ny.gov.
² Division of Epidemiology, New York State Department of Health, Albany, New York, United States.
³ Intermediate Care Facility Chief Medical Officer, New York, United States.
⁴ Division of Disease Control, Westchester County Health Department, Hudson Valley Developmental Disabilities Services Office, New Rochelle, New York, United States.
⁵ New York State Office for People with Developmental Disabilities, Theills, New York, United States.
⁶ Division of Epidemiology, New York State Department of Health, Albany, New York, United States; Department of Epidemiology and Biostatistics, College of Integrated Health Sciences, State University of New York at Albany, Albany, New York, United States.

PMID: 40473219
DOI: 10.1016/j.ajic.2025.05.021

Abstract

Background: Strongyloidiasis is a parasitic infection caused by the nematode Strongyloides stercoralis and can often be asymptomatic.

Methods: An investigation was initiated by the local health department following notification of 3 cases of Strongyloides in a facility for individuals with developmental disabilities in November 2023. Residents and staff were tested using immunoglobulin G antibody by a commercial laboratory. A site visit was conducted, and staff were interviewed.

Results: Among 62 residents and 140 staff tested, 11 (17.7%) residents and 6 (4.3%) staff were positive for Strongyloides immunoglobulin G antibodies. Age ranged from 29 to 68 years. Most affected residents were male (72%) and located on the third floor (82%) (odds ratio 2.88 [CI 0.49, 30.23]). Almost all residents were nonambulatory. Infection control practices were assessed; a compliance rate of 4% was observed for staff hand hygiene opportunities and 14% for environmental cleaning in resident rooms. Positive cases were treated, and the last case was reported in December 2023.

Discussion: This was a large outbreak of strongyloidiasis in a long-term care setting in which transmission was likely attributable to workers and/or environmental contamination.

Conclusions: The source of Strongyloides remains unknown; however, adherence to appropriate infection control practices may help to mitigate future outbreaks.

Keywords: Developmentally disabled; Outbreak; Parasitic infection.