Parasitology Research

, 101:91 | Cite as

Cream formulations protecting against cercarial dermatitis by Trichobilharzia

  • C. Wulff
  • S. Haeberlein
  • W. HaasEmail author
Original Paper


Dermatitis caused by penetrating bird schistosome cercariae is an emerging global public health problem. Infections may be prevented by the use of topical formulations that inhibit cercarial skin penetration. We evaluated nine water resistant formulations by exposing treated arms of volunteers to Trichobilharzia szidati cercariae. Six formulations protected from cercarial invasion. However, after immersion of the treated skin in water (2 × 20 min), only two formulations offered full protection: (1) Safe Sea™, a cream protecting against jelly fish, (2) niclosamide in water resistant sun protecting cream formulations at concentrations as low as 0.05%. In an in vitro system Safe Sea™ and a 0.1% niclosamide formulation caused a high damage rate in T. szidati (92% and 99% after 5 min; only niclosamide with lethal effect) but not in Schistosoma mansoni (1% and 72%; both formulations with lethal effect). However, a 1% niclosamide formulation damaged S. mansoni sufficiently (100% after 5 min) and might offer full penetration protection.


Dodecanoic Acid Deet Schistosoma Mansoni Penetration Rate Niclosamide 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors would like to thank Bayer chemicals and Wacker chemicals, Germany, and Dr. G. Steidl for kindly providing us with the agents, the parasitology group of the University of Erlangen-Nuremberg for participating as volunteers and Korinna Kedves for the advice. This work was supported by the Baden-Württembergisches Sozialministerium, by the Deutsche Forschungsgemeinschaft and communities at lake Bodensee, Germany. The experiments comply with the current laws of Germany.


  1. Abu-Elyazeed RR, Podgore JK, Mansour NS, Kilpatrick ME (1993) Field trial of 1% niclosamide as a topical antipenetrant to Schistosoma mansoni cercariae. Am J Trop Med Hyg 49:403–409PubMedGoogle Scholar
  2. Allerberger F, Wötzer G, Dierich MP, Moritz C, Fritsch P, Haas W (1994) Auftreten von Badedermatitis in Tirol. Immun Infect 22:30–32Google Scholar
  3. Andrews P, Thyssen J, Lorke D (1982) The biology and toxicology of molluscicides, Bayluscide. Pharmacol Ther 19:245–295PubMedCrossRefGoogle Scholar
  4. Appelton CC, Brock K (1986) The penetration of mammalian skin by cercariae of Trichobilharzia sp. (Trematoda: Schistosomatidae) from South Africa. Onderstepoort J Vet Res 53:209–211Google Scholar
  5. Bayssade-Dufour C, Martins C, Vuong PN (2001) Histopathologie pulmonaire d’un modèle mammifère et dermatite cercarienne humaine. Med Mal Infect 31:713–722CrossRefGoogle Scholar
  6. Bruce JI, Miller R, Lightner L, Yoganathan S (1992) Efficacy of Niclosamide as a potential topical antipenetrant (TAP) against cercariae of Schistosoma mansoni in monkeys. Mem Inst Oswaldo Cruz 87:281–289PubMedCrossRefGoogle Scholar
  7. Caumes E, Felder-Moinet S, Couzigou C, Darras-Joly C, Latour P, Léger N (2003) Failure of an ointment based on IR3535 (ethylbutylacetylaminopropionate) to prevent an outbreak of cercarial dermatitis during swimming races across Lake Annecy, France. Ann Trop Med Parasitol 97:157–163PubMedCrossRefGoogle Scholar
  8. Chamot E, Toscani L, Rougemont A (1998) Public health importance and risk factors for cercarial dermatitis associated with swimming in Lake Leman at Geneva, Switzerland. Epidemiol Infect 120:305–314PubMedCrossRefGoogle Scholar
  9. Cherfas J (1989) New weapon in the war against schistosomiasis. Science 246:1242–1243PubMedCrossRefGoogle Scholar
  10. Cohen FE, Gregoret LM, Amiri P, Aldape K, Railey J, McKerrow JH (1991) Arresting tissue invasion of a parasite by protease inhibitors chosen with the aid of computer modelling. Biochemistry 30:11221–11229PubMedCrossRefGoogle Scholar
  11. de Gentile L, Picot H, Bourdeau P, Bardet R, Kerjan A, Piriou M, Le Guennic A, Bayssade-Dufour C, Chabasse D, Mott KE (1996) Cercarial dermatitis in Europe: a new public health problem? Bull World Health Organ 74:159–163PubMedGoogle Scholar
  12. Ercoli N, Payares G, Nuñez D (1985) Schistosoma mansoni: neurotransmitters and the mobility of cercariae and schistosomules. Exp Parasitol 59:204–216PubMedCrossRefGoogle Scholar
  13. Fischer H, Reimann H (2006) Rezeptur gegen Badedermatitis. Cited 26/2006
  14. Fradin MS, Day JF (2002) Comparative efficacy of insect repellents against mosquito bites. N Engl J Med 347:13–18PubMedCrossRefGoogle Scholar
  15. Haas W, Pietsch U (1991) Migration of Trichobilharzia ocellata schistosomula in the duck and in the abnormal murine host. Parasitol Res 77:642–644PubMedCrossRefGoogle Scholar
  16. Haas W, van de Roemer A (1998) Invasion of the vertebrate skin by cercariae of Trichobilharzia ocellata: penetration processes and stimulating cues. Parasitol Res 84:787–795PubMedCrossRefGoogle Scholar
  17. Hoeffler DF (1974) Cercarial dermatitis. Arch Environ Health 29:225–229PubMedGoogle Scholar
  18. Horák P, Kolářová L (2000) Survival of bird schistosomes in mammalian lungs. Int J Parasitol 30:65–68PubMedCrossRefGoogle Scholar
  19. Horák P, Dvořák J, Kolářová L, Trefil L (1999) Trichobilharzia regenti, a pathogen of the avian and mammalian central nervous systems. Parasitology 119:577–581PubMedCrossRefGoogle Scholar
  20. Horák P, Kolářová L, Adema CM (2002) Biology of the schistosome genus Trichobilharzia. Adv Parasitol 52:155–233PubMedCrossRefGoogle Scholar
  21. Hrádková K, Horák P (2002) Neurotropic behaviour of Trichobilharzia regenti in ducks and mice. J Helminthol 76:137–141PubMedCrossRefGoogle Scholar
  22. Ingram RJ, Bartlett A, Brown MB, Marriott C, Whitfield RJ (2002) Dimethicone barrier cream prevents infection of human skin by schistosome cercariae: evidence from Franz cell studies. J Parasitol 88:399–402PubMedGoogle Scholar
  23. Kock S (2001) Investigations on intermediate host specificity help to elucidate the taxonomic status of Trichobilharzia ocellata (Digenea: Schistosomatidae). Parasitology 123:67–70PubMedCrossRefGoogle Scholar
  24. Kolářová L, Horák P, Sitko J (1997) Cercarial dermatitis in focus: schistosomes in the Czech Republic. Helminthologia 34:127–139Google Scholar
  25. Lim KC, Sun E, Bahgat M, Bucks D, Guy R, Hinz RS, Cullander C, McKerrow JH (1999) Blockage of skin invasion by schistosome cercariae by serine protease inhibitors. Am J Trop Med Hyg 60:487–492PubMedGoogle Scholar
  26. MacFarlane WV (1949) Schistosome dermatitis in New Zealand. II. Pathology and immunology of cercarial lesions. Am J Hyg 50:152–167PubMedGoogle Scholar
  27. Neuhaus W (1952) Biologie und Entwicklung von Trichobilharzia szidati n. sp. (Trematoda, Schistosomatidae), einem Erreger von Dermatitis beim Menschen. Z Parasitenkd 15:203–266PubMedCrossRefGoogle Scholar
  28. Odening K (1996) What Cercaria ocellata actually is. Acta Parasitologica Turcica 20:387–397Google Scholar
  29. Olivier L (1953) Observations on the migrations of avian schistosomes in mammals previously unexposed to cercariae. J Parasitol 39:237–243PubMedCrossRefGoogle Scholar
  30. Pellegrino J (1967) Protection against human schistosome cercariae. Exp Parasitol 21:112–131PubMedCrossRefGoogle Scholar
  31. Ramaswamy K, He YX, Salafsky B, Shibuya T (2003) Topical application of DEET for schistosomiasis. Trends Parasitol 19:551–555PubMedCrossRefGoogle Scholar
  32. Rudolfová J, Hampl V, Bayssade-Dufour C, Lockyer AE, Littlewood DTJ, Horák P (2005) Validity reassessment of Trichobilharzia species using Lymnaea stagnalis as the intermediate host. Parasitol Res 95:79–89PubMedCrossRefGoogle Scholar
  33. Salafsky B, Ramaswamy K, He YX, Li J, Shibuya T (1999) Development and evaluation of LIPODEET, a new long-acting formulation of N,N-diethyl-m-toluamide (DEET) for the prevention of schistosomiasis. Am J Trop Med Hyg 61:743–750PubMedGoogle Scholar
  34. Werner S, Fiedler W, Güde H, Haas W, Hertel J, Ostendorp W, Kimmig P, Kirch A, Rothhaupt K-O, Sproll A, Winterer H, Wulff C (2005) Badedermatitis: Ökologie und Auftreten des Auslösers Trichobilharzia franki am Bodensee und Entwicklung von Maßnahmen zur Verminderung des Befalls. Schrift Verein Gesch Bodensee Umgeb 123:257–274Google Scholar
  35. Yang KL, Tchou TK, T’ang CC, Ho TK, Luo HC (1965) A study on dermatitis in rice farmers. Chin Med J 84:143–159PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Institute for Zoology IUniversity of Erlangen-NuernbergErlangenGermany

Personalised recommendations