DEFINITION ETILOGIC AGENT INCUBATION MODE OF SIGNS AND SYMPTOMS

PERIOD TRANSMISSION
Schistosomiasis, caused by blood flukes 4-6 WEEKS Early stage - Initial penetration of skin by cercariae results in
People become
(trematode worms) of the hypersensitivity and transient pruritic., papular skin rash (swimmer's itch).
also known as infected when larval
bilharzia, is a disease genus Schistosoma. 
forms of the parasite Intermediate stage 
caused by parasitic -After penetration, the organism enters the bloodstream and migrates
worms.  S. haematobium causes – released by through the lungs. 
urinary tract disease; the freshwater snails – - fever, malaise, cough, rash, abdominal pain, diarrhea, nausea,
The infectious form of lymphadenopathy, and eosinophilia (Katayama fever). 
other Schistosoma species penetrate the skin - a mucoid bloody diarrhea accompanied by tender hepatomegaly occurs. 
the parasite, known as cause intestinal disease.
cercariae, emerge from during contact with
Geographic distribution differs Chronic schistosomiasis - retained eggs induce the formation of
the snail into the water. infested water. eosinophilic granulomas, fibrosis and scarring, probably  mediated by
You can become by species:
cytokines and involves T helper lymphocytes.
infected when your Transmission occurs
skin comes in contact -S. haematobium: Widely when people Bladder:
with contaminated distributed over the African suffering from -The bladder becomes inflamed and fibrotic
freshwater continent with smaller foci in schistosomiasis -Symptoms and signs include dysuria, urgency, terminal microscopic and
contaminate gross hematuria, secondary urinary tract infections, and nonspecific pelvic
the Middle East, Turkey, and pain.
freshwater sources
India -Chronic urinary carriage and bacteremia with salmonella can occur
with their excreta .
-S. mansoni: Widespread in containing parasite Bowel. S. mansoni and japonicum produce congestion and ulceration of
Africa, foci in Middle East, and eggs, which hatch in the bowel wall.
the only species in the water. -Long-term involvement of the colon produces abdominal pain and
Western Hemisphere in parts bloody diarrhea.  
-Recurrent Salmonella bacteremia is related to parasitization of the
of South America and some schistosome gut by Salmonella.
Caribbean islands
Liver
Portal hypertension can develop and cause hepatosplenomegaly, ascites,
-S. japonicum: Asia, mainly in and esophageal varices.
China, the Philippines, Swimmer's itch (cercarial dermatitis) is caused by the larvae of other avian
Thailand, and Indonesia and mammalian schistosome species that penetrate human skin but do not
complete the life cycle and do not cause chronic fibrotic disease. 
-Manifestations include mild to moderate pruritus at the penetration site a
-S. mekongi: Southeast Asia few hours after exposure, followed in 5 to 14 days by an intermittent
pruritic, sometimes papular, eruption. 
-In previously sensitized persons, more intense papular eruptions may
-S. intercalatum: Central and occur for 7 to 10 days after exposure.
West Africa
DIAGNOSTIC PROCEDURES TREATMENT MODALITIES NURSING MANAGEMENT/PREVENTION
-Infection with S mansoni and other species (except S - Avoid swimming or wading in freshwater when
haematobium) is determined by microscopic  Praziquantel you are in countries in which schistosomiasis
examination of concentrated stool specimens to detect Single-day oral treatment with praziquantel (20 mg/kg occurs. 
characteristic eggs.  - Drink safe water. Although schistosomiasis is not
twice a day for S. haematobium, S. mansoni, and S.
transmitted by swallowing contaminated water, if
o In light infections, several specimens may have intercalatum; 20 mg/kg 3 times a day for S. your mouth or lips come in contact with water
to be examined before eggs are found japonicum and S. mekongi) containing the parasites, you could become
o A biopsy of the rectal mucosa may be -Praziquantel is effective against adult schistosomes, infected. 
necessary.  but not developing schistosomula, which are present - Water used for bathing should be brought to a
o The fresh tissue obtained should be early in infection. rolling boil for 1 minute to kill any cercariae, and
compressed between 2 glass slides and then cooled before bathing to avoid scalding. 
- For asymptomatic travelers who have had exposure
examined under low power (unstained) for - Vigorous towel drying after an accidental, very
in potentially contaminated fresh water, treatment is brief water exposure may help to prevent
eggs. 
delayed for 6 to 8 weeks after the last exposure. parasites from penetrating the skin. 
-Schistosoma haematobium is diagnosed by - Adverse effects of praziquantel are generally mild - Chemicals used to eliminate snails in freshwater
 and include abdominal pain, diarrhea, headache, and sources may harm other species of animals in the
examining filtered urine for eggs.  dizziness.  water 
-Corticosteroids are often used to reduce the symptoms -The sanitary disposal of urine and feces reduces
o Egg excretion often peaks between noon and 3 of this reaction.  the likelihood of infection.
PM -Mass community-based or school-based
There is no specific therapy for dermatitis or Katayama treatment with praziquantel, education
-Biopsy of the bladder mucosa may be necessary.  syndrome.  programs, and molluscicides to reduce snail
-Swimmer's itch is a self-limited disease that requires populations are used to control schistosomiasis
-Serologic tests may be particularly helpful for only symptomatic treatment of the urticarial rash in endemic areas.
detecting light infections or before eggs appear in the
stool or urine.
-Metrifonate may be used for S. hematobium and
-Swimmer's itch can be difficult to differentiate from oxamniquine for S. mansoni as alternative drugs
other causes of dermatitis. A skin biopsy may
demonstrate larvae, but their absence does not -No satisfactory alternative drug for S japonicum is
exclude the diagnosis. available.