South Africa: Schistosomiasis outbreak reported Limpopo province, 140 primary school students affected
In Limpopo province, in northernmost South Africa, officials are reported an outbreak of of the waterborne parasitic disease, schistosomiasis (Bilharzia).
The outbreak has affected several areas within the Greater Tzaneen Local Municipality, located in the Mopani District including Nkowankowa, Khujwane, and Dan villages.
Alarmingly, officials report over 140 students from Malwandla Primary School have been diagnosed and are currently receiving treatment with anti-parasitic medication. The rapid spread of this infection has raised serious concerns about health and safety in the affected communities.
In response to this outbreak, the Limpopo Provincial Government has swiftly established a provincial task team. The task team’s mandate is to coordinate efforts to contain the outbreak, provide medical care to affected individuals, and prevent further spread of the disease.
The Limpopo Provincial Government strongly advises residents in the affected areas to refrain from swimming in rivers, streams, or any other potentially contaminated water sources, ensure that any water used for drinking is boiled or properly treated before use, and that parents and guardians are urged to closely monitor their children for any symptoms of schistosomiasis and seek immediate medical attention if symptoms arise.
Schistosomiasis, also referred to as Bilharzia and Katayama fever, is an infection with a type of Schistosoma parasite.
The schistosomes or blood flukes are parasites that have been around since antiquity. It was described in writings in the Gynacological Papyrus of Kahun from 1900 BC. Calcified ova have been found in Egyptian mummies from 1250 BC. In other words, schistosomes can be associated with great civilizations of the past.
Schistosomiasis is second only to malaria in terms of socioeconomic and public health importance, with 200 million people infected in approximately 75 countries.
Blood flukes in Black and White
Schistosomiasis is an acute or chronic disease; it is not a single disease, but a disease complex initiated by several different species of schistosomes. The three most important human species are Schistosoma mansoni, S. haematobium and S. japonicum.
It is also considered a “man-made” disease, frequently associated with the development of irrigation and hydroelectric projects in developing countries.
Geographically, the three species are found in Africa (S.mansoni and S. haemotobium), the Middle East (S. haemotobium), the Arabian Peninsula, Brazil, Suriname, Venezuela and the Caribbean (S. mansoni) and China, the Philippines and parts of Indonesia (S. japonicum).
The schistosomes are found in fresh water. This water gets contaminated by infected people working in the rice field, fisherman in the lake or children playing who indiscriminately defecate or urinate in the water.
Schistosomes have a very complicated life cycle. The eggs in the feces or urine hatch and the ciliated miracidia swim to the specific snail species where it penetrates and goes through a couple of stages in the snail. After a period, thousands of the infective stage are released and swim around looking for a human to infect.
The free-swimming cercariae are capable of penetrating the unbroken skin of the human host.
In the human, the adult schistosomes eventually end up in the blood vessels of the intestines (S. mansoni and S. japonicum) or bladder (S. haemotobium). Here they produce eggs, which are the cause of the disease.
The pathology of S. mansoni and S. japonicum may include Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fibrosis, portal hypertension, and occasional embolic egg granulomas in brain or spinal cord. People, especially children are characterized with a large distended abdomen due to enlarged liver and spleen.
Pathology of S. haematobium schistosomiasis includes hematuria (blood in the urine), scarring, calcification, squamous cell carcinoma, and occasional embolic egg granulomas in brain or spinal cord.
Schistosomiasis can be diagnosed by identifying the characteristic eggs in stool samples, biopsy of tissue, rectal (all) or bladder (S. haemotobium only). If eggs cannot be found in stool samples, antibody detection tests are available.
The drug of choice is praziquantel for infections caused by all Schistosoma species.
There is not a vaccine or any other prophylaxis available for prevention of schistosomiasis.
Schistosomiasis is discussed in this “worms and germs” educational video: