| Disease/Syndrome |
Schistosomiasis, hepatic and intestinal |
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| Category |
Infection, Travel |
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| Acute/Chronic |
Subacute |
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| Synonyms |
Bilharziasis; Snail fever; Schistosoma mansoni infection; S. japonicum infection |
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| Biomedical References |
Search PubMed |
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| Comments |
FINDINGS: Acute schistosomiasis (Katayama fever) is flu-like illness that may occur 2-8 weeks after the first exposure in an endemic area, i.e., an illness of previously unexposed visitors. Findings in Katayama fever include urticaria, eosinophilia, hepatosplenomegaly, lymphadenopathy, fever and sweats, cough, dyspnea, and diffuse pulmonary infiltrates or nodules. Late in the illness, eggs appear in the stool. Intestinal infections can cause fatigue, diarrhea, and colicky abdominal pain, and may lead to anemia, strictures, and obstruction. Eggs deposited in the eye can cause choroiditis and optic neuritis. [Guerrant, p. 1593, 1342-5; PPID, p. 3278] Intestinal infection causes blood in the stools. Chronically infected and untreated patients die from bleeding or hepatic failure. [ID, p. 2378] Marked eosinophilia is present early. Eosinophilia may or may not be present during chronic infection. [Guerrant, p. 1482] S. japonicum causes mass lesions of the CNS, and 1%-2% of infected patients have epilepsy. [Guerrant, p. 1603, 1342-5] Hepatic cirrhosis is a complication of infection by S. mansoni and S. japonicum. [Merck Manual, p. 1559] EPIDEMIOLOGY: Humans, dogs, cats, pigs, cattle, water buffalo, horses, and rodents are reservoirs for S. japonicum. Snails are intermediate hosts for these trematode infections. [CCDM, p. 448] "Control programs have eliminated or greatly reduced transmission of schistosomiasis in most countries in Asia and the Americas. . . . the risk is believed to be extremely low or nonexistent in the shaded countries indicated on the map. [See map.] In Brazil, China, Egypt, Philippines, Iran, Morocco, Venezuela, and elsewhere national control programs have reduced morbidity due to schistosomiasis." [CDC Travel, p. 267] |
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| Latency/Incubation |
2 weeks to 1.5 months for Katayama fever; longer for chronic symptoms; |
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| Diagnostic |
Eggs identified in stool or biopsy; Serology; Detection of antigens in serum; |
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| ICD-9 Code |
120 |
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| Effective Antimicrobics |
Yes |
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| Scope |
S. mansoni in Africa, Arabian Peninsula, Brazil, Suriname, Venezuela, and some Caribbean islands; S. japonicum in China, Taiwan, the Philippines, and Sulawesia in Indonesia; [CCDM, p. 476-80] |
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| Reference Link |
CDC - Schistosomiasis |
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| Related Information in Haz-Map |
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| Symptoms/Findings |
Symptoms/Findings associated with this disease:
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| Job Tasks |
High risk job tasks associated with this disease:
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