SCHISTOSOMIASIS

Disease and Terminology

• Schistosomiasis: a blood fluke infection.
• Also known as:
  • Bilharzia
  • “Snail fever” — named for the snail host involved in transmission.

Causative Agents (by Region)

• Schistosoma japonicum: endemic in Philippines and China
• Schistosoma mansoni: in South America, Caribbean, and Africa
• Schistosoma haematobium: endemic in Africa and the Middle East

Incubation Period

• At least 2 months.

Mode of Transmission

• Contact with contaminated water containing the infective larval stage.

Life Cycle / Cycle of Infection

1. Egg release into the environment

   • An infected person urinates or defecates, releasing eggs into urine and feces.

2. Hatching into miracidium

   • Eggs hatch into miracidium (“miracidia/miracidium”).
   • These forms are not yet harmful to humans.

3. Snail intermediate host infection

   • Miracidium infects the snail Oncomelania quadrasi (spelled variants appear in the subtitles).

4. Development inside the snail

   • Miracidium multiplies and matures within the snail.

5. Release of cercaria

   • Mature forms are released as cercaria.

6. Human infection

   • Cercaria infect humans upon contact with contaminated water.
   • Outcome: infected individuals develop schistosomiasis.

Clinical Signs and Symptoms

• Pruritic rash / itchy rash (at the site where cercaria entered)
• Bloody stool and/or diarrhea
• Katayama fever
• Fever and headache
• Cough
• Chills and sweating
• Splenomegaly (enlarged spleen)
• Hepatomegaly (enlarged liver)
• Possible anemia (implied due to bloody stool)

Control Measures

• Case finding
• Health education
  • Avoid wading in potentially infected water
• If accidentally exposed
  • Wash the exposed area with 70% alcohol
  • Alternatives mentioned: Betadine or chlorine
• If household water is from an infected source
  • Allow water to stand for 72 hours
  • Rationale stated: cercaria die if they have no host within 48 hours; an extra 24 hours is used as precaution

Diagnostic Procedures / Tests

• Fecal analysis
• Liver and rectal biopsy
• Circumoval precipitin test
  • Detects antibodies in blood indicating infection

Nursing Management

• Hydration to prevent hypovolemia (due to diarrhea/bloody stool)
• Antipyretic / fever care
  • Paracetamol
  • Mentions “TSB/TP sponge” (temperature-sponging method)
• If anemia is suspected/possible
  • Diet high in iron
• Bed rest (noted as “complete beddress,” i.e., bedridden)

Drugs Mentioned

• Drug of choice: Praziquantel (spelled variably in subtitles)
  • Duration: 6 months
  • Dosing schedule:
    • First 3 months: two tablets per day
    • Next 3 months: one tablet per day
• If praziquantel is not available:
  • Oxamniquine
    • For Schistosoma mansoni
  • Metrifonate
    • For Schistosoma haematobium

Endemic Regions Mentioned (Philippines, per subtitles)

• Region 5: Bicol region
• Region 8: Eastern Visayas (Samar and Leyte)
• Region 11: Davao region

Researchers or Sources Featured

• No specific researchers or external scientific sources are named in the provided subtitles.