Current Infectious Disease Reports

, Volume 15, Issue 3, pp 211–215 | Cite as

Schistosomiasis: Current Epidemiology and Management in Travelers

Tropical, Travel and Emerging Infections (L Chen, Section Editor)
First Online:

Abstract

Schistosomiasis is increasingly encountered among travelers returning from the tropics, mainly from Africa. Schistosoma-infected travelers have served as sentinels for the existence of unknown foci of transmission even outside Africa. Acute schistosomiasis (also termed Katayama syndrome) is the common manifestation among travelers and may follow exposure to any of the Schistosoma species. Neuroschistosomiasis is a rare complication but may result in severe disability. Diagnosis in travelers is hampered by the poor sensitivity of microscopy in urine and stool, especially during acute infections, while seroconversion may be delayed for a period of weeks. During acute schistosomiasis, symptomatic treatment is the only available therapy, while for chronic schistosomiasis, praziquantel is the only drug available, despite reports of emerging resistance to it. Since the potential for exposure to Schistosoma through travel will probably continue to increase, it is clear that new, sensitive diagnostic methods and drugs affecting the parasite in all its stages are needed.

Keywords

Schistosomiasis/epidemiology Schistosomiasis/diagnosis Schistosomiasis/therapy Neuroschistosomiasis Praziquantel Travel 
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Notes

Conflict of Interest

Eyal Meltzer declares that he has no conflict of interest.

Eli Schwartz declares that he has no conflict of interest.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Renoult A J. Notice sur l’hématurie qu'éprouvent les Européens dans ta haute Egypte et la Nubie. Journal général de Médecine et de Chirurgie 1803; 17:366–9. Available at: accessed via Google Books at: http://books.google.co.il/books?id=lS3A0_HxzF8C&pgRA1-PA366&dq=Notice+sur+l%E2%80%99h%C3%A9maturie+dans+la+haute+Egypte+et+la+Nubie&hl=iw&sa=X&ei=eLziULvRGqKw0AX29YE4&ved=0CGQQuwUwCA#v=snippet&q=notice%20sur%20l'hematurie&f=false sur l’hématurie dans la haute Egypte et la Nubie&f=false.Google Scholar
  2. 2.
    World Health Organization. The global burden of disease 2004. 2008; Available at: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf.
  3. 3.
    Zhou Y-B, Liang S, Jiang Q-W. Factors impacting on progress towards elimination of transmission of schistosomiasis japonica in China. Parasites Vectors. 2012;5:275.PubMedCrossRefGoogle Scholar
  4. 4.
    Schneider MC, Aguilera XP, Barbosa da Silva Junior J, et al. Elimination of neglected diseases in latin america and the Caribbean: a mapping of selected diseases. PLoS Negl Trop Dis. 2011;5:e964.PubMedCrossRefGoogle Scholar
  5. 5.
    Leder, K , Torresi, J , Libman MD et al. for the GeoSentinel Surveillance Network. Longitudinal trends in ill-returned travelers, 2000–2010. Annals Int. Med. 2013; in press.Google Scholar
  6. 6.
    Nicolls DJ, Weld LH, Schwartz E, et al. Characteristics of schistosomiasis in travelers reported to the GeoSentinel Surveillance Network 1997–2008. AmJTrop Med Hyg. 2008;79:729–34. 7.Google Scholar
  7. 7.
    Lim P-L, Han P, Chen LH, et al. Expatriates ill after travel:results from the Geosentinel Surveillance Network. BMC Infect Dis. 2012;12:386.PubMedCrossRefGoogle Scholar
  8. 8.
    •• Barnett ED, Weld L, McCarthy A, et al. Spectrum of Illness in International Migrants seen at GeoSentinel Clinics 1997–2009, Part 1: US Bound Migrants Evaluated by Comprehensive Protocol-Based Health Assessment. Clinical infectious diseases 2012. doi: 10.1093/cid/cis1015. An analysis of the extensive GeoSentinel USA database providing insight into current epidemiology of schistosomiasis in migrants.
  9. 9.
    •• McCarthy AE, Weld L, Barnett ED, et al. Spectrum of Illness in International Migrants seen at GeoSentinel Clinics 1997–2009, Part 2: Migrants Resettled Internationally and Evaluated for Specific Health Concerns. Clinical infectious diseases 2012 doi: 10.1093/cid/cis1016. An analysis of the non-USA (mostly European and Australasian) GeoSentinel sites–important because of different immigration patterns than for the USA.
  10. 10.
    Hagmann S, Neugebauer R, Schwartz E, et al. Illness in children after international travel: analysis from the GeoSentinel Surveillance Network. Pediatrics. 2010;125:e1072–80.PubMedCrossRefGoogle Scholar
  11. 11.
    Team EC for DP and C (ECDC)-HCU-E editorial. Infectious diseases among travellers and migrants in Europe, EuroTravNet 2010. 2012; Available at: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20205. Accessed 2 January 2013.
  12. 12.
    Herbinger K-H, Drerup L, Alberer M, Nothdurft H-D, Sonnenburg F, Löscher T. Spectrum of imported infectious diseases among children and adolescents returning from the tropics and subtropics. J Travel Med. 2012;19:150–7. Available at: http://www.ncbi.nlm.nih.gov/pubmed/22530821. Accessed 20 November 2012.PubMedCrossRefGoogle Scholar
  13. 13.
    Leshem E, Meltzer E, Marva E, Schwartz E. Travel-related schistosomiasis acquired in Laos. Emerg Infect Dis. 2009;15:1823–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Pavlin BI, Kozarsky P, Cetron MS. Acute pulmonary schistosomiasis in travelers: Case report and review of the literature. Travel Med Infect Dis. 2012;10:209–19.PubMedCrossRefGoogle Scholar
  15. 15.
    Gautret P, Gaudart J, Leder K, et al. Travel-associated illness in older adults (>60 y). J Travel Med. 2012;19:169–77.PubMedCrossRefGoogle Scholar
  16. 16.
    Leshem E, Maor Y, Meltzer E, Assous M, Schwartz E. Acute schistosomiasis outbreak: clinical features and economic impact. Clin Infect Dis: Off Publ Infe Dis Soc Am. 2008;47:1499–506.CrossRefGoogle Scholar
  17. 17.
    Wyler N, Green S, Boddington N, Davies C, Friedli K, Lankester T. Travel related illness in short-term volunteers from the UK to developing countries. Travel Med Infect Dis. 2012;10:172–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Sharafeldin E, Soonawala D, Vandenbroucke JP, Hack E, Visser LG. Health risks encountered by Dutch medical students during an elective in the tropics and the quality and comprehensiveness of pre-and post-travel care. BMC Med Educ. 2010;10:89.PubMedCrossRefGoogle Scholar
  19. 19.
    Guiguet Leal DA, Franco RMB, Neves MF, et al. Acute schistosomiasis in brazilian traveler: the importance of tourism in the epidemiology of neglected parasitic diseases. Case Rep Infect Dis. 2012;2012:650929.PubMedGoogle Scholar
  20. 20.
    Enk MJ, Amaral GL, Costa e Silva MF. Rural tourism: a risk factor for schistosomiasis transmission in Brazil. Memórias do Instituto Oswaldo Cruz. 2010;105:537–40.PubMedCrossRefGoogle Scholar
  21. 21.
    Chunge CN, Chunge RN, Masinde MS, Atinga JN. An outbreak of acute schistosomiasis following a church retreat to Mwanza, Tanzania, 2008. J Travel Med. 2011;18:408–10.PubMedCrossRefGoogle Scholar
  22. 22.
    Chunge CN, Chunge RN, Masinde MS, Atinga JN. An outbreak of acute schistosomiasis following a church retreat to Mwanza, Tanzania, 2008. J Travel Med. 2011;18:408–10.PubMedCrossRefGoogle Scholar
  23. 23.
    Clerinx J, Bottieau E, Wichmann D, Tannich E, Van Esbroeck M. Acute schistosomiasis in a cluster of travelers from Rwanda: diagnostic contribution of schistosome DNA detection in serum compared to parasitology and serology. J Travel Med. 2011;18:367–72.PubMedCrossRefGoogle Scholar
  24. 24.
    Meltzer E, Artom G, Marva E, Assous MV, Rahav G, Schwartzt E. Schistosomiasis among travelers: new aspects of an old disease. Emerg Infect Dis. 2006;12:1696–700.PubMedCrossRefGoogle Scholar
  25. 25.
    Aerssens C, De Vos D, Pirnay J-P, et al. Schistosomiasis in Belgian military personnel returning from the Democratic Republic of Congo. Mil Med. 2011;176:1341–6.PubMedGoogle Scholar
  26. 26.
    Epelboin L, Jauréguiberry S, Estève J-B, et al. Myocarditis during acute schistosomiasis in two travelers. AmJTrop Med Hyg. 2010;82:365–7.CrossRefGoogle Scholar
  27. 27.
    Manzella A, Borba-Filho P, Brandt CT, Oliveira K. Brain magnetic resonance imaging findings in young patients with hepatosplenic schistosomiasis mansoni without overt symptoms. AmJTrop Med Hyg. 2012;86:982–7.CrossRefGoogle Scholar
  28. 28.
    Houdon L, Flodrops H, Rocaboy M, et al. Two patients with imported acute neuroschistosomiasis due to Schistosoma mansoni. J Travel Med. 2010;17:274–7.PubMedCrossRefGoogle Scholar
  29. 29.
    • Lou BS, Price J, Llewelyn M. Fluke infertility: the late cost of a quick swim. J Travel Med. 2011;18:61–2. Female genital schistosomiasis is an underappreciated manifestation of late/chronic schistosomiasis.CrossRefGoogle Scholar
  30. 30.
    Kinkel H-F, Dittrich S, Bäumer B, Weitzel T. Evaluation of eight serological tests for diagnosis of imported schistosomiasis. Clin Vaccine immunol: CVI. 2012;19:948–53.PubMedCrossRefGoogle Scholar
  31. 31.
    Baaten GG, Sonder GJ, Van Gool T, Kint JA, Van den Hoek A. Travel-related schistosomiasis, strongyloidiasis, filariasis, and toxocariasis: the risk of infection and the diagnostic relevance of blood eosinophilia. BMC Infect Dis. 2011;11:84.PubMedCrossRefGoogle Scholar
  32. 32.
    Leshem E, Keller N, Guthman D, et al. False-positive Plasmodium falciparum histidine-rich protein 2 immunocapture assay results for acute schistosomiasis caused by Schistosoma mekongi. J Clin Microbiol. 2011;49:2331–2.PubMedCrossRefGoogle Scholar
  33. 33.
    Cnops L, Tannich E, Polman K, Clerinx J, Van Esbroeck M. Schistosoma real-time PCR as diagnostic tool for international travellers and migrants. Tropical medicine & international health: TM & IH 2012Google Scholar
  34. 34.
    Pérez Del Villar L, Burguillo FJ, López-Abán J, Muro A. Systematic review and meta-analysis of artemisinin based therapies for the treatment and prevention of schistosomiasis. PLoS One. 2012;7:e45867.PubMedCrossRefGoogle Scholar
  35. 35.
    Helleberg M, Thybo S. High rate of failure in treatment of imported schistosomiasis. J Travel Med. 2010;17:94–9.PubMedCrossRefGoogle Scholar
  36. 36.
    Neumayr ALC, Tschirky B, Warren A, Hatz CFR, Blum JA. Acute febrile respiratory reaction after praziquantel treatment during asymptomatic late form of acute schistosomiasis. J Travel Med. 2012;19:264–7.PubMedCrossRefGoogle Scholar
  37. 37.
    • Ross AG, McManus DP, Farrar J, Hunstman RJ, Gray DJ, Li Y-S. Neuroschistosomiasis. J Neurol. 2012;259:22–32. A good review of current diagnostic and therapeutic considerations in neuroschistosomiasis.PubMedCrossRefGoogle Scholar
  38. 38.
    Ferrari TCA, Moreira PRR. Neuroschistosomiasis: clinical symptoms and pathogenesis. Lancet Neurol. 2011;10:853–64.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Center for Geographic Medicine and Department of Medicine C, Sheba Medical Center, Tel Hashomer and the Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
  2. 2.The Center for Geographic Medicine and Department of Medicine CThe Chaim Sheba Medical CenterTel HashomerIsrael

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