TABLE OF CONTENTS

1. What Is Schistosomiasis?
2. Causes and Risk Factors
3. Recognizing the Symptoms
4. How Schistosomiasis is Diagnosed
5. Treatment Options
6. Preventing Schistosomiasis
7. When to See a Doctor

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Schistosomiasis, also known as bilharzia, is a parasitic disease that affects millions of people in tropical and subtropical regions. 

Caused by waterborne parasitic worms, this illness may not be immediately life-threatening, but can lead to serious long-term organ damage if left untreated. 

Understanding how the disease spreads, its symptoms, and how to protect yourself is essential especially when traveling to or living in endemic areas.

What Is Schistosomiasis?

Schistosomiasis is a parasitic infection caused by flatworms that live in freshwater in tropical and subtropical regions. 

The disease is most commonly found in Africa, but cases are also reported in the Middle East, South America, and Southeast Asia. In Indonesia, schistosomiasis is endemic to parts of Central Sulawesi.

The infection is transmitted through contact with contaminated water that contains larval parasites released by freshwater snails. Once inside the human body, these parasites can cause both acute and chronic illness. 

While not immediately life-threatening, untreated chronic schistosomiasis may lead to severe organ damage and long-term complications.

Causes and Risk Factors

Schistosomiasis is caused by three main species of parasitic worms: Schistosoma haematobium, S. japonicum, and S. mansoni. 

Infection occurs when larvae in contaminated water penetrate the skin during activities like swimming, bathing, or paddling.

After entering the body, the parasites mature and begin laying eggs, which are either excreted through urine or feces or become trapped in body tissues, triggering immune responses. 

People living in or traveling to endemic areas are at higher risk, especially if they have frequent contact with freshwater sources. Weakened immune systems may further increase vulnerability.

Recognizing the Symptoms

Symptoms vary depending on the stage of infection and affected organs. In the acute phase (14–84 days after exposure), symptoms include skin rash, itching, fever, headache, muscle and joint pain, and sometimes shortness of breath.

In chronic infections, symptoms depend on the target organs:

• Digestive system involvement: diarrhea, constipation, blood in stool, ulcers, liver fibrosis, and portal hypertension.
• Urinary tract involvement: painful urination, blood in urine, and increased risk of bladder cancer.
• Long-term infection may also cause anemia and, in rare cases, neurological symptoms if the central nervous system is affected.
• In children, chronic schistosomiasis may delay growth and cognitive development, according to WHO.

How Schistosomiasis is Diagnosed

Doctors typically begin with a detailed medical history, especially recent travel to endemic areas. A physical examination will follow, along with blood tests (e.g., eosinophil count, antibody tests) and stool or urine analysis to detect parasite eggs.

Because the parasites take around 40 days to mature, tests done within 6–8 weeks of exposure may yield false negatives. 

If symptoms involve the digestive or urinary tract, tissue biopsies from the rectum or bladder may be required. 

If no symptoms are present but exposure is suspected, follow-up testing after 3 months is recommended.

Treatment Options

The main treatment for schistosomiasis is praziquantel, an antiparasitic medication that effectively kills adult worms. 

Early treatment can prevent complications, though the drug does not prevent reinfection. 

In cases involving the central nervous system, corticosteroids may be prescribed to reduce inflammation.

Preventing Schistosomiasis

There is currently no vaccine for schistosomiasis. Prevention involves avoiding contact with potentially contaminated freshwater in endemic areas. 

Travelers should refrain from swimming, washing, or paddling in untreated water sources.

If contact with freshwater is unavoidable, wearing waterproof boots and protective clothing can reduce risk. 

Drinking water should be boiled or filtered if its safety is uncertain.

When to See a Doctor

Seek medical attention if you experience fever, rash, muscle aches, or other systemic symptoms after visiting an area where schistosomiasis is common. 

Early diagnosis and treatment can prevent long-term damage.

Even in the absence of symptoms, anyone with recent freshwater exposure in an endemic region should consider getting tested. 

You can consult a nearby healthcare provider or book an appointment with a doctor at a hospital near you through Halodoc.

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References:

World Health Organization. Accessed in 2025. Schistosomiasis.

Cleveland Clinic. Accessed in 2025. Schistosomiasis.

Medical News Today. Accessed in 2025. What is bilharzia, snail fever, or schistosomiasis?.

NHS UK. Accessed in 2025. Schistosomiasis (bilharzia).