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Schistosomiasis

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Schistosomiasis, also known as bilharzia, snail fever, and Katayama fever, is a disease caused by parasitic worms of the Schistosoma type. Species of Schistosoma that can infect humans include:

  • Schistosoma mansoni (ICD-10 B65.1) and Schistosoma intercalatum (B65.8) cause intestinal schistosomiasis
  • Schistosoma haematobium (B65.0) causes urinary schistosomiasis
  • Schistosoma japonicum (B65.2) and Schistosoma mekongi (B65.8) cause Asian intestinal schistosomiasis

The disease is spread by contact with water contaminated with the parasites. These parasites are released from infected freshwater snails. The disease is especially common among children in developing countries as they are more likely to play in contaminated water. Other high risk groups include farmers, fishermen, and people using unclean water for their daily chores.

The disease is found in tropical countries in Africa, the Caribbean, eastern South America, Southeast Asia and in the Middle East. Schistosoma mansoni is found in parts of South America and the Caribbean, Africa, and the Middle East; Schistosoma haematobium in Africa and the Middle East; and Schistosoma japonicum in the Far East. Schistosoma mekongi and Schistosoma intercalatum are found in Southeast Asia and central West Africa, respectively.

The disease is common in about 75 developing countries and mainly affects people living in rural agricultural and semi-urban areas.  Around 700 million people  live in areas where the disease is common.

In 2010, approximately 238 million people were infected with schistosomiasis, 85% of whom live in Africa.  An earlier estimate from 2006 had put the figure at 200 million people infected. In many of the affected areas, schistosomiasis infects a large proportion of children under 14 years of age.

In 2012, 249 million people were in need of treatment to prevent the disease. This likely makes it the most common parasitic infection with malaria second and causing about 207 million cases in 2013.

Schistosoma haematobium, the infectious agent responsible for urogenital schistosomiasis, infects over 112 million people annually in Sub-Saharan Africa alone. It is responsible for 32 million cases of dysuria, 10 million cases of hydronephrosis, and 150,000 deaths from renal failure annually, making Schistosoma haematobium the world’s deadliest schistosome.

Estimates regarding the overall number of deaths vary. The World Health Organization (WHO) estimates more than 200,000 people die from schistosomiasis yearly.

It is thus the most deadly of the so called ‘neglected tropical diseases’.

Symptoms

 

It may infect the urinary tract or the intestines.

Signs and symptoms may include abdominal pain, cough, diarrhoea, bloody stool, or blood in the urine.

Some people develop fevers and fatigue.  In those who have been infected for a long time, liver damage, kidney failure, infertility, or bladder cancer may occur.

One visible symptom is Hepatosplenomegaly — the enlargement of both the liver and the spleen.

There may be Genital sores — lesions that increase vulnerability to HIV infection. Lesions caused by schistosomiasis may continue to be a problem after control of the schistosomiasis infection itself.

Perhaps the worst symptom is that it can cause brain damage and blindness if the parasite manages to reach the brain. 

Wikipedia
cerebral granulomatous disease may be caused by ectopic S. japonicum eggs in the brain, and granulomatous lesions around ectopic eggs in the spinal cord from S. mansoni and S. haematobium infections may result in a transverse myelitis with flaccid paraplegia

 

Diagnosis is by finding the eggs of the parasite in a person's urine or stool.

It can also be confirmed by finding antibodies against the disease in the blood.  

Many with the disease have extremely high ‘eosinophil granulocyte’ counts - white blood cell count.

Wikipedia
Contemporary diagnosis involves detection of parasitic antigens by ELISA; all that is required from the patient is a blood sample. This screening method is highly effective. Microscopic identification of eggs in stool or, less commonly, the urine is another way of arriving at a positive diagnosis. …Stool examination should be performed when infection with S. mansoni or S. japonicum is suspected, and urine examination should be performed if S. haematobium is suspected.

 

Eggs can be present in the stool in infections with all Schistosoma species.
The examination can be performed on a simple smear (1 to 2 mg of fecal material).

Since eggs may be passed intermittently or in small amounts, their detection will be enhanced by repeated examinations and/or concentration procedures (such as the formalin-ethyl acetate technique).

In addition, for field surveys and investigational purposes, the egg output can be quantified by using the Kato technique (20 to 50 mg of fecal material) or the Ritchie technique.

Above all, schistosomiasis is a chronic disease. Many infections are subclinically symptomatic, with mild anaemia and malnutrition being common in endemic areas. Acute schistosomiasis (Katayama's fever) may occur weeks after the initial infection, especially by S. mansoni and S. japonicum.

Causes

 

The cause is clearly the snail, but in recent years the disease has been on the rise. 

Why?

For many years from the 1950s onwards, vast dams and irrigation schemes were constructed,  thereby producing still or stagnant water.

Overall these schemes have caused a massive rise in many water-borne infections including those from schistosomiasis.

Schistosomiasis is endemic in Egypt, for example, exacerbated by the country's dam and irrigation projects along the Nile. From the late 1950s through the early 1980s, infected villagers were treated with repeated injections of tartar emetic. Epidemiological evidence suggests that this campaign unintentionally contributed to the spread of hepatitis C via unclean needles.

 

Egypt has the world's highest hepatitis C infection rate, and the infection rates in various regions of the country closely track the timing and intensity of the anti-schistosomiasis campaign.

The detailed specifications laid out in various UN documents since the 1950s could have minimized this problem. Irrigation schemes can be designed to make it hard for the snails to colonize the water, and to reduce the contact with the local population.

The problem with Bilharzia simply reinforces the evidence that science is not being scientific in its application of technology.  It is a widescale problem that new technologies, new schemes and new pharmaceuticals are released and applied with no proper analysis of the consequences or the long term impact on the environment or the populations it affects.  We will soon be talking about nanoparticles, for example, in much the same way we are talking about Bilharzia.

There is already some gradual realisation of the impact vaccines are having - with their aluminium adjuvants, their excipients that cause allergies and worse, so called autoimmune diseases such as Ehlers Danloss; and their latent viruses.  

Science shows all the signs of being a belief system - a belief in the infallibility of science and the cleverness of man.  Billions are suffering as a result.

Treatment and prevention

Methods to prevent the disease include improving access to clean water and improving access to sanitation or at least improving sanitation.  [McGarvey, ST; Grimes, JET; Croll, D; et al. (2014). "The Relationship between Water, Sanitation and Schistosomiasis: A Systematic Review and Meta-analysis". PLoS Neglected Tropical Diseases 8 (12): e3296. doi:10.1371/journal.pntd.0003296. ISSN 1935-2735]

There is a pharmaceutical.  “In areas where the disease is common entire groups may be treated all at once and yearly with the medication praziquantel. This is done to decrease the number of people infected and therefore decrease the spread of the disease. Praziquantel is also the treatment recommended by the World Health Organization for those who are known to be infected”.

We have also provided observations related to plants from Dr Duke’s research.

Prevention is best accomplished by eliminating the water-dwelling snails that are the natural reservoir of the disease.   Recent studies have suggested that snail populations can be controlled by augmentation of existing, ‘indigenous’ crayfish populations.

 

 

 

References and further reading

  • The IRG Solution — hierarchical incompetence and how to overcome it. London: Souvenir Press. 1984. p.88.
  • Charnock, Anne (7 August 1980). "Taking Bilharziasis out of the irrigation equation". New Civil Engineer. Bilharzia caused by poor civil engineering design due to ignorance of cause and prevention

Related observations