Investigation of Donor-Transmitted Strongyloides stercoralis Infections in Solid Organ Transplant Recipients, United States, 2012–2024

Strongyloides stercoralis is a parasitic nematode endemic in tropical and subtropical regions, including parts of the southeastern United States, that can be transmitted through organ transplantation. During the period 2012–2024, 21 cases of donor-derived infection were identified from 15 unscreened donors. In contrast, among 31 seropositive donors who were screened, 77 recipients received prophylactic ivermectin treatment, and none of them developed disease. Ivermectin is an effective treatment with cure rates up to 96 percent. Since October 2025, the Organ Procurement and Transplant Network in the United States has implemented a new policy requiring mandatory testing of all deceased donors for this infection. The research demonstrates the effectiveness of universal donor screening and prophylactic ivermectin treatment of recipients in preventing donor-derived Strongyloides infection.