Have you ever bathed or played in a lake, river, or small pond with dirty water? Today we are going to talk about a dangerous parasite that can sometimes enter our bodies through such water. This is called Schistosomiasis. Although it is a bit of a long name, it is very important to know about it, especially if you are traveling to foreign countries.
What exactly is Schistosomiasis?
Simply put, schistosomiasis is an infection caused by a type of parasitic worm. These worms are called trematodes, or flatworms. It is specifically caused by worms belonging to the genus Schistosoma. These parasites live inside or on the body of another organism (the host) and feed on it. So, if this happens to the host organism, it is not good.
What happens in schistosomiasis is that these worms live in certain types of snails. Then, these parasites are released into the water from those snails. Imagine, if your skin comes into contact with this kind of dirty, parasite-infested water, they can pierce your skin and enter your body, where they can live for years. When these parasites develop in the snails and enter the water, they have a bifurcated head. That's how they pierce our skin and enter.
There are three main types of schistosomiasis parasites that cause the two main forms of this disease: Urogenital Schistosomiasis and Intestinal Schistosomiasis.
There are other names for this disease, some call it Bilharzia , others call it Snail Fever .
Who is most likely to get this disease?
In fact, anyone who bathes or swims in contaminated water that contains this parasite can get the infection. This parasite is most commonly found in freshwater lakes, rivers, and ponds. Especially in the following areas:
- Many parts of Africa: including Sub-Saharan Africa and South Africa. The parasite is also found in the Maghreb region of North Africa and the Nile Valley of Egypt and Sudan.
- In South America: countries like Brazil, Suriname, and Venezuela.
- Caribbean Islands: There are also islands like the Dominican Republic, Guadeloupe, and Martinique. However, the risk in the Caribbean region is a little lower.
- Southern regions of China.
- This risk also exists in countries like Southeast Asia: the Philippines, Laos, and Cambodia.
- In Europe: This has also been reported on the island of Corsica.
This is not very common for us in Sri Lanka. However, if you are traveling to these countries, you need to be very careful.
How common is schistosomiasis?
It is estimated that over 230 million people worldwide are infected with this parasite. Even though this parasite is not present in countries like the United States, people in those countries can still contract the disease when they travel to other countries. So, it is very important for us to be aware of this when we travel abroad.
What are the symptoms of schistosomiasis?
Most people infected with schistosomiasis do not show any symptoms at first . However, within a few days of infection, some people may develop itching and small blisters or a rash . This is a reaction to the parasite penetrating the skin.
Then, between 30 and 60 days after infection, which is about a month or two, other symptoms may appear. These include:
- Fever
- Chills
- Cough
- Muscle pain and soreness
Although these symptoms may seem like a sudden cold or flu, if you have recently come into contact with dirty water, you should be suspicious.
What happens if left untreated?
If you don't treat it properly, these parasites can live inside your body for years. The symptoms that appear are a bit more serious:
- Stomach pain.
- Enlarged liver (Hepatomegaly).
- Blood in the urine (Hematuria). Some people also call this "blood in the urine."
- Difficulty or pain when urinating (Dysuria).
- Blood in the stool (Hematochezia).
- Women can also have miscarriages .
If this condition continues, that is, if you develop chronic schistosomiasis , you are more likely to develop liver scarring or cirrhosis and bladder cancer.
Very rarely, the eggs of these parasites can travel to the brain or spinal cord. If this happens, seizures, paralysis, or an inflamed spinal cord can occur. This is a very dangerous condition.
What causes this disease?
The main cause of schistosomiasis is a parasite that lives in the bodies of certain types of snails found in freshwater reservoirs. After this parasite is released from the snails into the water, it penetrates the human skin and enters the body. When infected people urinate and defecate, the parasite eggs in them are released back into the water. When these eggs reach a snail colony, they enter the snails' bodies, starting the cycle again. In this way, children and adults are frequently infected.
However, this disease is not transmitted directly from one person to another. Even if you have schistosomiasis, you cannot pass it on to another person. It is only transmitted through contaminated water.
Researchers are still looking for ways to control this disease. Some are trying to develop a vaccine, while others are looking for ways to control these snails.
How is schistosomiasis diagnosed?
Doctors mainly perform several tests to diagnose this disease.
- Sometimes, parasite eggs can be found in urine or stool samples. These are examined under a microscope.
- But it may not always be possible to find the eggs this way. In that case , a blood test will be needed. This will check for antibodies produced in the body against the parasite.
All of these tests are done in a laboratory, under a microscope.
What are the treatments for this?
The main drug used to treat schistosomiasis is praziquantel . Its brand name is Biltricide®. It is given as a pill. This drug belongs to a group of drugs called anthelmintics. Simply put, these drugs kill worms.
When you take Praziquantel, you should take it with water and food. It is usually given once a day. Either as one large dose, or as three small doses throughout the day.
It is important to tell your doctor about any other medications, supplements, and allergies you are currently taking before taking this medication. Also, ask your doctor if you can eat grapefruit or drink grapefruit juice while taking this medication, as grapefruit may not be compatible with some medications.
Are there any complications or side effects of the treatment?
Yes, sometimes side effects can occur. These can be caused by the infection itself, or by a reaction to the medication and the worms being killed. Or they can be both. You can expect things like:
- Headache
- Fever
- Stomach pain or nausea
- Dizziness
- Itching
- Malaise (feeling unwell)
If you develop hives, see a doctor immediately. Also, if you have any other symptoms that you notice or that seem to be getting worse, tell your doctor about them as well.
How can I reduce this risk?
There are a few things you should not do near freshwater ponds, lakes, or rivers in areas known to have schistosomiasis:
- Don't assume that the water is clean and there is no problem just because someone says so. If you are in an area where the parasite is known to be present, don't take any risks.
- Don't drink water from these types of reservoirs. Drinking the water won't directly introduce the parasite, but it can enter through the skin around your mouth.
- Do not bathe or swim in this water.
- Do not wash clothes with this water.
- Don't even go fishing in reservoirs like this.
If you accidentally get wet in this kind of water, wipe it off vigorously with a towel. It might help, but it's not completely reliable. The best thing to do is to stay out of that kind of water.
What happens if I have this condition?
If you have schistosomiasis and you get the right treatment, you can make a full recovery. However, if you live in an area where these parasites are active, you should always be careful and stay away from freshwater sources where you may be infected. This is because it can recur. There is no vaccine yet.
If you don't get treatment, you will remain infected. This can cause serious damage to your liver, intestines, and bladder. In women, if you develop Urogenital Schistosomiasis, which affects the urinary and reproductive systems, you may be at increased risk of contracting HIV because of the tissue damage. The disease has also been linked to bladder cancer.
Children who are frequently infected with this parasite may develop anemia and may not grow properly . If left untreated, schistosomiasis can be fatal.
When should I see a doctor?
If you live, work, or travel in an area known to have schistosomiasis, and you have a rash, fever, or urinary symptoms (e.g., blood in your urine, pain when urinating), be sure to see a doctor. Also, tell your doctor if you have come into contact with water that you suspect is contaminated.
Although this disease is not very common in Sri Lanka, if you have been exposed to such contaminated water abroad, even if you do not have symptoms, it is wise to get a medical examination after returning to Sri Lanka. Because many people do not show symptoms initially. If you are infected with this parasite, you should definitely seek treatment.
Summary (Take-Home Message)
Okay, so let's recap some of the things we talked about:
- Schistosomiasis is a disease caused by a parasite found in dirty water. It is also called bilharzia .
- This parasite comes from snails and enters the water, entering our bodies through our skin.
- There may be no symptoms at first, but later things like fever, body aches, and itching may occur.
- If left untreated , it can damage organs such as the liver, intestines, and bladder, and can even lead to cancer.
- When traveling to countries where this disease is prevalent, do not go swimming, bathing, or drinking water in unfamiliar places.
- This can be cured with a drug called Praziquantel .
- If you have any doubts, definitely seek medical advice.
Remember, awareness is the best defense. When we know about these diseases, it is easier for us to stay safe from them. Wishing you and your family good health!
` Schistosomiasis, parasitic diseases, bilharzia, snail fever, dirty water, skin infections, travel health
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