Schistosomiasis

Overview

Schistosomiasis is a parasitic infection caused by blood flukes (trematodes) of the genus Schistosoma. It is endemic in Africa, the Middle East, South America, and parts of Asia.

Screening

Schistosoma serology is recommended for all refugees from endemic areas.

• Serology should not be performed in infants <6 months old
• A positive serology indicates exposure but does not distinguish active from past infection

Clinical Manifestations

Acute (Katayama Fever)

• Fever, urticaria, eosinophilia
• Occurs 2-8 weeks after exposure

Chronic

• S. haematobium: Urinary symptoms, hematuria
• S. mansoni/japonicum: GI symptoms, hepatosplenomegaly, portal hypertension

Treatment

Praziquantel is the treatment of choice:

• 40 mg/kg in 2 divided doses (S. mansoni, S. haematobium)
• 60 mg/kg in 3 divided doses (S. japonicum)

Consider repeating treatment in 4-6 weeks for heavy infections.