Intended for healthcare professionals

Student Education


BMJ 2003; 327 doi: (Published 01 August 2003) Cite this as: BMJ 2003;327:0308280
  1. Ellen Welch, intercalating medical student1,
  2. Geoff Gill, consultant physician, diabetes and endocrinology2
  1. 1University of Westminster
  2. 2Aintree Hospital, Liverpool

A funny sounding name, for a funny sort of illness. Ellen Welch and Geoff Gill explain how the consequences of this tropical disease can be far from funny

An example from recent history


Prisoners working on the Kwai bridge

Shortly after the second world war it became obvious that many of the men who had been held captive in the Far East had contracted strongyloidiasis, especially those prisoners who were forced to work on the infamous Thai-Burma “death” railway. This 400 km railway line, engineered by the Japanese in an attempt to win the war, stretched through mountainous jungle in northern Thailand over to Burma (now Myanmar). A year of exhausting work with primitive tools, in areas rife with tropical diseases, led to the deaths of 20 000 Allied prisoners and 100 000 Asian labourers, and a railway that never fulfilled any useful purpose.

Among the host of tropical diseases contracted by the men,3 the tropical jungle environment of the Burma railway provided perfect conditions for development of the filariform Strongyloides larvae, which infected the men through the soles of their poorly shod feet as they worked.

Tropical medicine is a subject that is often neglected from …

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