Schistosomiasis

Schistosomiasis is an infection with the parasitic worm Schistosoma. The worm enters your body through your skin and can spread through your blood to other parts of your body. If you don’t treat the infection, it can damage your organs. You get it from contact with freshwater — like rivers, lakes and creeks — that contain the snails that carry it. Schistosomiasis is also called bilharzia.

Symptoms of schistosomiasis

It takes a while for symptoms of schistosomiasis to show up. The only symptom you might notice right away is itching or a rash where the worm entered your skin. You might have flu-like symptoms a few weeks or months after getting infected. These include:

• Fever
• Chills
• Muscle aches
• Cough
• Stomach pain

These symptoms often go away on their own. If the worms spread to your organs, you might develop additional symptoms months later. These include:

• Digestive symptoms (loss of appetite, diarrhea, abdominal pain, vomiting blood, black stool)
• Urinary symptoms (difficulty peeing, blood in your pee, leaking pee)
• Painful intercourse
• Abnormal vaginal discharge
• Painful or bloody ejaculation
• Lower back pain
• Shortness of breath

Rarely, some people develop neurological symptoms. These include seizures, severe headaches, vision problems and difficulty walking.

Schistosomiasis causes

Schistosoma, a type of parasitic worm, causes schistosomiasis. There are many species of Schistosoma that can infect humans. When someone with a Schistosoma infection poops or pees in water, the parasite eggs are released.

The eggs hatch, and the larvae infect freshwater snails to reproduce. Then, they’re released from the snails into the water. From there, they enter your body through your skin.

You can get infected when you’re exposed to contaminated water, like:

• Swimming or bathing in it
• Drinking it
• Washing your clothes in it
• Fishing in it

People without access to clean, running water and toilet facilities are at the highest risk.

Is schistosomiasis contagious?

No, it’s not contagious. The Schistosoma larvae need snails to continue their life cycle. They can’t spread from person to person.

Where is Schistosoma found?

The parasites that cause schistosomiasis are found in many areas of the world, including parts of:

• Africa
• Asia
• France (Corsica)
• South America
• The Caribbean
• The Middle East

Complications

If left untreated, schistosomiasis can spread from your blood to other parts of your body, causing:

• Enlarged liver and spleen
• Intestinal infection
• Infection and scarring of your bladder and urinary tract
• Scarring and granulomas in your genitals
• Changes in how your brain and spinal cord work (encephalopathy)

Repeated infections can cause anemia, malnutrition and developmental issues. Scarring and inflammation of your bladder can eventually lead to bladder cancer.

How doctors diagnose schistosomiasis

Healthcare providers diagnose schistosomiasis by looking for parasite eggs in your pee or poop. They might also do blood tests. Make sure you let your provider know if you’ve traveled anywhere or think you could’ve been exposed to Schistosoma. It takes a few weeks after exposure to Schistosoma to test positive for infection.

Can schistosomiasis be cured completely?

Yes, schistosomiasis can completely go away with treatment. Healthcare providers treat it with the antibiotic praziquantel. You take two to three doses for a day or two. You may have to take additional doses a few weeks after the first treatment to get rid of it entirely.

When should I see my healthcare provider?

Talk to a healthcare provider if you’ve been exposed to water that could have Schistosoma in it, especially if you develop flu-like symptoms weeks later. They can test you for an infection a few weeks after exposure. Early treatment can kill the infection before it spreads.

What can I expect if I have schistosomiasis?

Schistosomiasis is treatable. But it’s best to catch and treat it early, before it spreads. Even with treatment, organ damage can be permanent.

What is the life expectancy of someone with schistosomiasis?

One recent study suggests that the life expectancy of someone with advanced schistosomiasis is around 50 years. The study was done in an area where schistosomiasis is common.

Can schistosomiasis be prevented?

You can reduce your risk of schistosomiasis by:

• Not swimming in freshwater in areas where Schistosoma live
• Boiling bath water (and letting it cool) if it comes from a source where Schistosoma live
• Toweling off right away after swimming and bathing
• Drinking bottled water if you’re unsure whether the water where you are is safe

Access to clean water and antiparasitic medications can help prevent schistosomiasis in areas where it commonly spreads.