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SCHISTOSOMIASIS

What is schistosomiasis?
Schistosomiasis, also known as bilharzia, is a disease caused by parasitic worms. Infection with Schistosoma mansoni, S.
haematobium, and S. japonicum causes illness in humans; less commonly, S. mekongi and S. intercalatum can cause disease.
Although the worms that cause schistosomiasis are not found in the United States, more than 200 million people are infected
worldwide.
How can I get schistosomiasis?
Infection occurs when your skin comes in contact with contaminated freshwater in which certain types of snails that carry
schistosomes are living.
Freshwater becomes contaminated by Schistosoma eggs when infected people urinate or defecate in the water. The eggs hatch,
and if certain types of freshwater snails are present in the water, the parasites develop and multiply inside the snails. The parasite
leaves the snail and enters the water where it can survive for about 48 hours. Schistosomaparasites can penetrate the skin of
persons who are wading, swimming, bathing, or washing in contaminated water. Within several weeks, parasite mature into adult
worms, residing in the blood vessels of the body where the females produce eggs. Some of the eggs travel to the bladder or
intestine and are passed into the urine or stool.
What are the signs and symptoms of schistosomiasis?
Within days after becoming infected, you may develop a rash or itchy skin. Fever, chills, cough, and muscle aches can begin
within 1-2 months of infection. Most people have no symptoms at this early phase of infection.
When adult worms are present, the eggs that are produced usually travel to the intestine, liver or bladder, causing inflammation or
scarring. Children who are repeatedly infected can develop anemia, malnutrition, and learning difficulties. After years of
infection, the parasite can also damage the liver, intestine, lungs, and bladder. Rarely, eggs are found in the brain or spinal cord
and can cause seizures, paralysis, or spinal cord inflammation.
Symptoms of schistosomiasis are caused by the body's reaction to the eggs produced by worms, not by the worms themselves.
What should I do if I think I have schistosomiasis?
See your health care provider. If you have traveled to countries where schistosomiasis is found and had contact with freshwater,
describe in detail where and for how long you traveled. Explain that you may have been exposed to contaminated water.
How is schistosomiasis diagnosed?
Your health care provider may ask you to provide stool or urine samples to see if you have the parasite. A blood sample can also
be tested for evidence of infection. For accurate results, you must wait 6-8 weeks after your last exposure to contaminated water
before the blood sample is taken.

Swimming in the ocean and in chlorinated swimming pools is safe. When a mosquito bites a person who has lymphatic filariasis. ponds. rivers. Martinique. See your doctor for appropriate diagnosis and treatment. In the lymph vessels they grow into adults. Lymphatic filariasis affects over 120 million people in 80 countries throughout the tropics and sub-tropics of Asia. Suriname. streams. The lymph system maintains the body's fluid balance and fights infections. Although schistosomiasis is not transmitted by swallowing contaminated water. Vigorous towel drying after an accidental. and travel to the lymph vessels. Boiling water for at least 1 minute will kill any harmful parasites. Saudi Arabia. rivers. Yemen Southern China Parts of Southeast Asia and the Philippines. if your mouth or lips come in contact with water containing the parasites. or lakes. Guadeloupe. Venezuela Caribbean: Dominican Republic. People get lymphatic filariasis from the bite of an infected mosquito.What is the treatment for schistosomiasis? Safe and effective drugs are available for the treatment of schistosomiasis. Saint Lucia (risk in Caribbean is low) The Middle East: Iran. you should either boil water for 1 minute or filter water before drinking it.           In what areas of the world does schistosomiasis occur? Africa: all freshwater in southern and sub-Saharan Africa–including the great lakes and rivers as well as smaller bodies of water–are at risk for schistosomiasis transmission. Iraq. The microscopic worms pass from the mosquito through the skin. Water held in a storage tank for at least 1-2 days should be safe for bathing. thread-like worms. Africa. Transmission also occurs in the Mahgreb region of North Africa and the Nile River valley in Egypt and Sudan. Am I at risk? If you live in or travel to areas where schistosomiasis occurs and your skin comes in contact with freshwater from canals. you are at risk of getting schistosomiasis. Because water coming directly from canals. and parts of the Caribbean and South America. You should NOT rely on vigorous towel drying to prevent schistosomiasis. An adult worm lives for about 5-7 years. the Western Pacific. microscopic worms circulating in the person's blood enter and infect the mosquito. or springs may be contaminated with a variety of infectious organisms. or viruses present. The adult worms only live in the human lymph system. You cannot get infected with the worms in the United States. you could become infected. Laos How can I prevent schistosomiasis? Avoid swimming or wading in freshwater when you are in countries in which schistosomiasis occurs. lakes. South America: Brazil. Bath water should be heated to a rolling boil for at least 1 minute. How is lymphatic filariasis spread? The disease spreads from person to person by mosquito bites. very brief water exposure may help to prevent the Schistosoma parasite from penetrating the skin. Drink safe water. streams. Praziquantel is the recommended treatment drug. The adult worms mate and release millions of . bacteria. FILARIASIS What is lymphatic filariasis? Lymphatic filariasis is a parasitic disease caused by microscopic. Iodine treatment alone WILL NOT GUARANTEE that water is safe and free of all parasites.

This mostly affects the legs. How is lymphatic filariasis diagnosed? The standard method for diagnosing active infection is the identification of microfilariae by microscopic examination. For this reason. Many of these bacterial infections can be prevented with appropriate skin hygiene. lab tests are often negative with these patients. This syndrome is typically found in infected persons in Asia. Men can develop hydrocele or swelling of the scrotum due to infection with one of the parasites that causes LF specifically W. This causes hardening and thickening of the skin.microscopic worms. An infection will show up on a blood test. the blood collection has to be done at night to coincide with the appearance of the microfilariae. called microfilariae. A small percentage of persons will develop lymphedema. and wheezing. People living for a long time in tropical or sub-tropical areas where the disease is common are at the greatest risk for infection. This is not always feasible because in most parts of the world. Short-term tourists have a very low risk. Filarial infection can also cause pulmonary tropical eosinophilia syndrome. which is called elephantiasis. Use mosquito repellent on exposed skin between dusk and dawn . The eosinophilia is often accompanied by high levels of IgE (Immunoglobulin E) and antifilarial antibodies.   Wear long sleeves and trousers. The mosquitoes that carry the microscopic worms usually bite between the hours of dusk and dawn. but can also occur in the arms. If you live in or travel to an area with lymphatic filariasis:  Sleep under a mosquito net. The swelling and the decreased function of the lymph system make it difficult for the body to fight germs and infections. and genitalia. How can I prevent infection? Avoiding mosquito bites is the best form of prevention. This is caused by improper functioning of the lymph system that results in fluid collection and swelling. Serologic techniques provide an alternative to microscopic detection of microfilariae for the diagnosis of lymphatic filariasis. shortness of breath. What are the signs and symptoms of lymphatic filariasis? Most infected people are asymptomatic and will never develop clinical symptoms. People with the worms in their blood can give the infection to others through mosquitoes. breasts. Affected persons will have more bacterial infections in the skin and lymph system. microfilariae are nocturnally periodic. Who is at risk for infection? Repeated mosquito bites over several months to years are needed to get lymphatic filariasis. which means that they only circulate in the blood at night. Most people develop these clinical manifestations years after being infected. Because lymphedema may develop many years after infection. Clinical manifestations of pulmonary tropical eosinophilia syndrome include cough. into the blood. bancrofti. despite the fact that the parasite damages the lymph system.

Even after the adult worms die. Use antibacterial or antifungal cream if necessary. it does prevent infected people from giving the disease to someone else. lymphedema can develop. You can ask your physician for a referral to see a lymphedema therapist for specialized care. Lymphedema and elephantiasis are not indications for DEC treatment because most people with lymphedema are not actively infected with the filarial parasite. called diethylcarbamazine (DEC). Disinfect any wounds. Prevent the lymphedema from getting worse by following several basic principles:  Carefully wash the swollen area with soap and water every day. . that kills the microscopic worms circulating in the blood. Physicians can obtain DEC from CDC after lab results confirm infection. While this drug does not kill all of the adult worms.   Elevate and exercise the swollen arm or leg to move the fluid and improve the lymph flow.What is the treatment for lymphatic filariasis? People infected with adult worms can take a yearly dose of medicine.