ROUTE OF ENTRY

• The skin-infective cerceriae(larvae)from the

infected snail penetrate the skin during
wading or bathing.
 AGENT-HOST INTERACTIONS
A. SNAILS
• Parasite eggs are released into the
environment from infected individuals,
hatching on contact with the fresh water to
release miracidium which infect fresh water
snails by penetrating the snails foot after
infection, it transforms into sporocyst which
divide to produce secondary sporocysts which
migrates to snails hepatopancrease.
• In the hepatopancrease germ cells divides to
produce cerceriae , larvae capable of
infecting mammals. Most common way of
getting schistosomiasis is by wadding or
swimming in lakes, ponds and other water
bodies infested with snails, usually of genre
Biomphalaria or Bilunus that are their natural
reservoirs.
B. HUMANS

Symptoms of schistosomiasis are caused not by the

worms themselves but by the body’s reaction to the
eggs. Eggs shed by the body can be lodged in the
intestines or the bladder causing inflammation or
scarring. After years of infection the parasite can also
damage the liver, intestine, spleen, lungs and bladder.
Rarely eggs are formed in the brain or spinal cord and
can cause seizures, paralysis or spinal cord
inflammation.
Signs and symptoms
Acute phase;
1. Few patients develop skin irritation when
cerceriae penetrates skin.
2. Fever, chills, cough and muscle aches after 2
months of infection.
3. Some patients develop kata Yama fevers
showing- fever, abdominal pain, bloody
diarrhea, headaches and rash.
Schistosomiasis skin irritation and rash
• Eosophageal varices - dilated submucosal
veins in the lower 1/3 of the eososphagus due
to portal hypertension.this can develop into
bleeding.
• Caput medusae - not a common presentation
of schistosomiasis but may arise due to portal
hypertension caused by hepatomegaly.
 Mechanism of Hepatosplenomegaly
• Condition of having a simultaneous enlargement of the
liver and the spleen.It presents as an abdominal mass in a
patient suffering from schistosomiasis.
• Periportal fibrosis may occur.Hepatocellular function is
spared but periportal fibrosis can lead to portal
hypertension that may present as caput medusae.
• Periportal fibrosis is a serious consequence of schistosoma
mansoni infection. It involves remodelling of the
extracellular matrix and excessive deposition of collagen
by hepatic stellate cells along the branches of the portal
tract.
Chronic phase

• Patient shows;
i. Blood in urine and painful urination
ii. Shortness of breath and coughing.
iii. Seizures.
iv. Lesions on the vulva or the perianal area.
Genital schistosomiasis
 PREVENTION AND CONTROL
• At the natural reservoir
The water dwelling snails are the natural
reservoirs. Drugs such as Acrolein, copper
sulphate, and Nidosamide can be used to
eliminate the reservoir.
Measures like increasing Cray fish population
can be taken because they feed on snails.
 At level of the definitive host(humans)

 Drinking clean treated water.

Treatment ;
i. Praziquantel- treats all forms of
schistosomiasis with no side effects.
ii. Oxamniquine- treats intestinal
schistosomiasis i.e. S.Mansoni.
iii. Metrifonate- treats urinary schistosomiasis.
At the route of entry;

 Wearing protective gear such as gum boots

when walking in fresh water ponds.
At the point of exit;

Which is through fecal matter and urination.

Control can be achieved through proper
sanitation.
Thank you
Questions?