Schistosomiasis: symptoms, causes and treatment

What is schistosomiasis?

Schistosomiasis is an acute or chronic disease caused by parasitic worms that live in water in subtropical and tropical areas. Schistosomiasis is also known as bilharzia or "snail fever".

This disease attacks the intestines and urinary system first. However, because the worms stay in the blood, schistosomiasis can invade other systems.

The part of the body affected by this disease will depend on the parasite species. Several species can affect the lungs and spinal cord, brain, and central nervous system.

Often times you won't feel any symptoms the first time you become infected with schistosomiasis. However, these parasites can stay in the body for years and cause damage to organs, such as the urine, kidneys and liver.

Schistosomiasis is often not immediately fatal, but chronic (chronic) which can seriously damage internal organs. This condition can even lead to reduced growth and cognitive development in children.

How common is schistosomiasis?

According to WHO, there are about 90% of schistosomiasis cases requiring treatment in Africa.

This parasite is most commonly found in Africa. However, this parasite is also found in parts of South America, the Caribbean, the Middle East and Southeast Asia.

In Indonesia, this disease is also found in the province of Central Sulawesi, to be precise in the highlands of Lindu, Napu, and Bada.

This condition is very common and can occur in patients of any age. Schistosomiasis can be treated by reducing risk factors. Talk to your doctor for more information.

Symptoms of schistosomiasis

Symptoms vary with the worm species and phase of infection. The characteristics and symptoms of schistosomiasis are:

• Many parasites can cause fever, chills, swollen lymph glands, and swelling of the liver and lymph.
• When the worms first get into the skin, they can cause itching and a rash (swimmer's itch). In this condition, worms Schistosoma crushed into the skin.
• Intestinal symptoms include abdominal pain and diarrhea (there may be blood).
• Symptoms of urination include frequent urination, pain, and blood.

These symptoms, known as acute schistosomiasis, often get better on their own within a few weeks. However, it is still important to get treatment because parasites can stay in the body and cause long-term problems.

Some people with schistosomiasis, whether symptomatic early or not, will experience more serious problems in the parts of the body where these worm eggs are found. This condition is called chronic schistosomiasis.

Chronic schistosomiasis can include a variety of symptoms and problems, depending on which area is infected.

The following are some of the symptoms that appear based on the infected area:

• Digestive system: causes anemia, pain and swelling in the stomach, diarrhea and blood in the stool
• Urination system (urinary): can cause infection of the bladder (cystitis), painful urination, frequent urge to urinate, and blood in the urine
• Heart and lungs: causes a persistent cough, wheezing, shortness of breath, and coughing up blood
• Nervous system or brain: causes seizures, headaches, weakness and numbness in the legs, and dizziness.

Without treatment, the affected organs can be permanently damaged.

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

When should I see a doctor?

Immediately consult a doctor if you experience any of the following:

• Experiencing signs or symptoms of parasite infection as above
• Travel to tropical or subtropical areas with a high incidence of schistosomiasis
• Drinking or being exposed to water that is contaminated with parasites

Causes of schistosomiasis

The cause of schistosomiasis is a parasitic infection, aka worms. These worms live in fresh water, such as:

• Pool
• Lake
• River
• Reservoir
• Canal

Water for bathing that comes from sources that are not filtered directly from lakes or rivers can also spread infection. These worms do not live in seawater, chlorinated ponds, or other well-managed water sources.

You can become infected if you come in contact with a water source contaminated with parasites, while rowing a boat, swimming or washing, and small worms enter your skin.

Once in the body, the worms travel through the blood to areas, such as the liver and intestines. After a few weeks, the worms start to hatch eggs.

Some eggs stay in the body and are destroyed by the immune system. Some others pass through the urine or feces. Without treatment, the worms can keep hatching eggs for years.

When the eggs leave the body into the water, they produce tiny larvae which need to grow in freshwater snails for several weeks before they can infect other people.

This means that schistosomiasis transmission cannot occur between humans.

Risk factors for schistosomiasis

Anyone can get schistosomiasis. However, there are many factors that can increase a person's risk of developing this disease, namely:

• Living or traveling to areas where schistosomiasis has occurred
• Your skin is in contact with fresh water from canals, rivers or lakes
• Age of children

Diagnosis and treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What tests are done to diagnose this condition?

If you have recently returned from an area with schistosomiasis and are experiencing symptoms, you should see a doctor.

The doctor will ask you where you have been traveling, how long you have been there, and if there has been any contact with contaminated water.

Next, the doctor will perform a physical examination and perform various tests:

• Antibody test to look for signs of infection
• Tissue biopsy
• Complete blood count test
• Kidney function tests
• Liver function tests
• Stool examination for parasite eggs
• Urinanalysis to look for parasite eggs in the urine

You are advised to do a checkup 3 weeks after returning even if there are no symptoms, because it is possible that symptoms will not appear until some time later.

What are the treatments for schistosomiasis?

Praziquantel is a medication that can be given in the short term to treat an infection. This medicine can help even though the patient has reached an advanced stage of the disease.

The praziquantel-type deworming is usually effective, as long as damage or complications have not occurred. However, these drugs do not prevent the infection from coming back at a later time.

Steroid medications can also be used to relieve symptoms of acute schistosomiasis, or symptoms caused by damage to the brain or nervous system.

Prevention of schistosomiasis

Here are lifestyle and home remedies that can help you avoid schistosomiasis infection, especially if you are traveling to an area with a high incidence of disease:

• Avoid rowing, swimming or washing in fresh water (make sure you swim only in the ocean or pool with chlorine)
• Bring pants and shoes boot waterproof when there is a possibility that you have to pass through a stream or river
• Boil or filter the water before drinking
• Apply insect repellent on your skin or dry your skin immediately with a towel after getting out of the water that may be contaminated
• Use a single dose of oral praziquantel annually, to reduce the chance of infection and complications.

If you have any questions, consult your doctor for the best solution to your problem.