SCHISTO

Stephen A. Berger, M.D. mberger at post.tau.ac.il
Thu Feb 28 12:17:27 EST 2002


GIDEON http://www.GideonOnline.com notes that the only form of
schistosomiasis endemic to the United States mainland is cercarial
dermatitis [swimmer's itch].  Periodic importations are listed,
including:
"11 American tourists were infected while rafting on the Omo River
(Ethiopia) in 1981; 7 in 1982; 17 in 1993.
     15 American students acquired infection in Kenya in 1984 -
complicated by transverse myelitis in 2 cases.
     16 American tourists were infected in the Okavango Delta (Botswana)
in 1988.
     Seven American tourists were infected in western Ivory Coast in
1989."

The status of schistosomiasis in Puerto Rico is summarized as follows:
"Schistosomiasis was first reported in Puerto Rico in 1904. Overall
prevalence was estimated at 13.5% in 1945. The disease was formerly
widespread; however, all endemic foci have been virtually eradicated
since the 1980's.
     An outbreak of 28 cases was reported in the Caguas area in 1982.
     0.6% were infested in previously endemic areas as of 1995, all over
age 35. There is evidence of ongoing transmission as of 1995 in Jayuya,
Utuado and Naguabo, including a 36% to 39% seroprevalence rate among
adults under age 25 in these areas (male/female ratio = 2/1).  Rates
diminish with patient age, suggesting decreasing transmission since 1995.

     The intermediate snail host, Biomphalaria glabrata, was eliminated
by a predator species (Marisa comuarietis) and a competing snail species
(Thiara granifera).

and swimmer's itch...
"An outbreak (16 cases) was reported in California in 1981.
     An outbreak (details not given) was reported on the southwestern
shore of Connecticut in 1983.
     An outbreak (30 cases) was reported from a state park in Delaware in
1991 - the infecting pathogen was identified as Microbilharzia
variglandis.
     30 outbreaks were reported during 1991 to 1992.
     Two outbreaks (121 cases) were reported in Oregon during 1995 to
1996 - both associated with lake beaches."

Steve Berger
Geographic Medicine
Tel Aviv Medical Center
mberger at post.tau.ac.il




James wrote:

>  Where might I find case reports of Schistomiasis occuring in the US?
> Please advise.
>
>  Many thanks,
>  Kelli Rowe

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