SCHISTOSOMIASIS

(Bilharziasis/Snail Fever)
By: Nelhbenson Laurente
BSN III-A, Group 2
 Definition
This is a slowly progressive disease
caused by blood flukes of class trematoda.
It is a chronic wasting disease common
among farmers and their families in certain
parts of the Philippines.
This is not only a public health concern but
also a socio-economic problem because
by causing ill-health, it reduces agricultural
productivity (DOH, 1988).
 Etiologic Agent
The cause of the disease is a parasitic
worm, Schistosoma japonicum.
 Incubation Period
The incubation period is at
least 2 months.
 Three major types of the
organism
1. Schistosoma japonicum
This agent infects the intestinal
tract (Katayama Disease)
It is found to be the only type that is
endemic in the Philippines.
This is also known as “Oriental
schistosomiasis”
2. Schistosoma mansoni
It also affects the intestinal tract
It is common in some parts of
Africa
3. Schistosoma haematobium
It affects the urinary tract
It can be found in some parts of
the Middle East, like Iraq and iran
 Sources of Infection
1. Feces of infected persons
2. Dogs, pigs, carabaos, cows,
monkeys, and wild rats have
been found to be infected and
therefore, they also serve as
host
 Mode of Transmission
1. The disease is transmitted through
ingestion of contaminated water.
2. The disease is transmitted through
the skin pores.
3. The disease is transmitted through
an intermediary host, a tiny snail
called Oncomelania Quadrasi.
Oncomelania Quadrasi
 Characteristics of
Oncomelania Quadrasi
1. The snail thrives best along the
river banks, fresh water streams,
creeks, canals, and swamps.
2. it ca be found clinging to water
hyacinths, grasses, and decaying
leaves, pieces of rotting woods,
bamboos, and coconut husks.
3.It also loves to stay in areas
with sandy-loam soil.
4.The adult snail is greenish-
brown in color and is just as
big as the smallest grain in
palay.
Pathogenesis/Pathology
Larvae (Cercaria)
penetrate

Skin or Mucous membrane

Liver’s venous portal

circulation

Portal Vessels They mature in 1-3 months

Vessels in the large

Intestine or bladder
 Female Cercaria lay eggs

Ulceration in the mucosa

Eggs
Escape into the lumen Portal circulation
Of the intestine filtered

Liver
Excreted with the
Feces
Likewise Small lesions
(Granulomas)
Ulceration healed resolved and replaced

Fibrous Tissue
Scar formation
 Increase Fibrosis

Liver enlarges

Interrupted blood flow

Fluid accumulates
Portal Hypertension

Patient’s belly

DEATH Bulging
 Clinical Manifestations
 The signs and symptoms of the disease
depend on the site of infection, however,
the following can be observed:
 Swimmer’s itch(pathognomonic sign)
 Low grade fever, myalgia, & cough
 Abdominal discomfort due to
hepatomegally, spleenomegally, and
lymphadenopathy.
 Bloody-mucoid stool
 Icteric and jaundice
 Belly becomes big
 Weak, pale, and there is marked
muscle wasting
 Severe headache, dizziness,
and convulsion
Swimmer’s Itch

Bloody
mucoid
Stool
 Complications
1. Liver cirrhosis, portal hypertension
2. Cor pulmonale, pulmonary hypertension
3. Heart failure
4. Ascites
5. Hematemesis as a result from rupture
of esophageal varices
6. Renal failure
 Diagnosis Procedures
1. Fecalysis or direct stool exam
2. Kato Katz technique
3. Liver and rectal biopsy
4. Enzyme Link Immunusorbent Assay
(ELISA)
5. Cercum Ova Precipitin Test (COPT)
- confirmatory diagnostic test
 Modalities of Treatment
1. Praziquantel tablet for 6 months; 1 tab
BID for 3 months, then 1 tab OD for
another 3 months
2. Fuadin injection given either IM or IV.
The patient should consume 360 mg
for the entire treatment
3. If the patinient continues to live in the
endemic area, he frequently gets
reinfected and has to be retreated
 Prevent & Control
Basic principle: to interrupt the life
cycle of the worm and protect
people from infection.
1.Have a stool examination.
2.Reduce snail density by:
Clearing vegetation thus exposing
the snail to sunshine.
Constructing drainage (canals)
Improve farming by proper irrigation
and drainage, crop rotation and
removal of weeds, thus, disturbing the
living condition of the snail.
3. Diminish infection rate by:
Proper waste disposal
Control to stray animals
Preventing people, especially children
from bathing in infested streams
 TNX……… 0(^_^)0
Ibig sabihin.,salamat