Schistosomiasis or schistosomiasis ( bilharzia ) is an infection caused by the schistosoma worm. Schistosomiasis is also often referred to as snail fever.

Schistosoma worms live in fresh water, such as lakes, reservoirs or rivers. These worms can live and develop in the body for weeks, or even years.

A person can become infected with schistosomiasis if they have direct contact with water contaminated with schistosoma worms, for example when swimming or bathing in the water.

Causes of Schistosomiasis

Schistosomiasis is caused by infection with parasitic worms that live in water. Some of the worms that cause schistosomiasis include:

  • Schistosoma guineensis
  • Schistosoma haematobium
  • Schistosoma intercalatum
  • Schistosoma japonicum
  • Schistosoma mansoni
  • Schistosoma mekongi

These worms can enter the body when someone is bathing, swimming, washing clothes, or doing other activities in water that has been contaminated with schistosoma worms.

Schistosoma worms can enter the human body through the surface of the skin and spread to other organs through the blood vessels. After a few weeks, the worms will develop into adults and start moving to other organs, such as the lungs and liver.

Schistosomiasis cannot be transmitted between humans through direct physical contact. In addition, worms that cause schistosomiasis cannot be found in swimming pools that have been given chlorine, sea water, and sterile water.

There are several factors that can increase a person's risk of developing schistosomiasis, including:

  • Living in or traveling to an area where there is an outbreak of schistosomiasis
  • Direct contact with fresh water, such as a river, lake or reservoir
  • Weak immune system, for example due to suffering from HIV/AIDS or taking drugs that suppress the immune system (immunosuppressants)

Schistosomiasis Symptoms

Symptoms  of schistosomiasis  are often not visible at first. Usually, a rash or itching on the new skin appears a few days after infection.

In the acute phase (acute schistosomiasis), complaints or symptoms that will appear are:

  • Itchy skin
  • Skin rash
  • Fever
  • Cough
  • Dizzy
  • Stomach ache
  • Diarrhea
  • Muscle and joint pain
  • Feeling tired and weak ( malaise )

If the infection persists, symptoms of chronic schistosomiasis will appear. Symptoms that appear in the chronic stage depend on the organ where the schistosomal worms reproduce, including:

  • Anemia
  • Abdominal pain
  • Difficulty urinating
  • Bloody urine
  • Diarrhea and  bloody bowel movements
  • A continuous cough accompanied by  coughing up blood
  • Fluid buildup in the abdomen ( ascites )
  • Chest pain and palpitations
  • Hard to breathe
  • Headache
  • Paralysis of the limbs
  • seizures

When to see a doctor

Check with  your doctor  if you experience any of the above symptoms, especially if you have recently been swimming, bathing or other activities in a river, lake or reservoir. To determine the cause of these symptoms, the doctor will carry out a number of examinations.

If you are diagnosed with schistosomiasis, carry out routine controls to the doctor to prevent the spread of infection and complications.

Diagnosis Skistosomiasis

To diagnose schistosomiasis, the doctor will conduct questions and answers regarding complaints, personal and environmental hygiene, work, and a history of direct contact with fresh water. Next, the doctor will carry out a thorough physical examination.

After that, the doctor will carry out the following investigations to confirm the diagnosis:

  • Blood tests , to detect anemia and increased  levels of eosinophils
  • Urine  test and stool test , to detect schistosomal worm eggs in the urine or feces
  • Kidney and liver function tests, to ensure there is no interference with these organs
  • Scanning with a CT scan  MRI , X-ray, echocardiography , or ultrasound, to detect the spread of schistosomal infection
  • Biopsy , to detect abnormal cells present in a tissue sample

Schistosomiasis Treatment

Schistosomiasis can be treated with medication. The doctor will give an anti-worm drug, namely praziquantel , as the main choice for treating schistosomiasis.

Corticosteroid class drugs can also be given by doctors to relieve complaints in acute schistosomiasis, or to relieve symptoms caused by damage to the nervous system and brain.

In addition to administering medication, the doctor will suggest surgery to remove lumps of worms, ligation (ligation) of esophageal varices if there is dilation of the veins in the esophagus, removal of granulomas, or installation of  a shunt .

Schistosomiasis complications

There are several complications that can occur due to schistosomiasis, including:

  • Gastrointestinal bleeding
  • Blockage in the stomach or intestines
  • Malnutrition
  • Kidney infection
  • Sepsis
  • Paralysis
  • Barren (infertility)
  • Severe anemia
  • Chronic kidney failure
  • Chronic liver damage
  • Liver and bladder blockage
  • Colitis
  • Pulmonary hypertension
  • Heart failure

Prevention of Schistosomiasis

Schistosomiasis can be prevented by avoiding contact with fresh water that has the potential to be contaminated with schistosoma worms. If you are visiting an area suspected of being contaminated with schistosoma worms, take the following precautions:

  • Wear waterproof pants and boots when working in fresh water areas.
  • Take care of personal hygiene and  wash your hands regularly with soap and running water.
  • Consume boiled water or mineral water that is guaranteed to be clean.
  • Avoid bathing or bathing in river or lake water.
  • Use clean water for bathing and washing.

If you are not sure about the cleanliness of the water to be used, it is recommended to boil the water until it boils, then let the water simmer for 1 minute, then turn off the stove or fire.

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