Characteristics of Schistosomiasis in Travelers Reported to the GeoSentinel Surveillance Network 1997–2008

Deborah J. Nicolls Emory University, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Sheba Medical Center, Tel-Hashomer, Israel; University of Munich, Munich, Germany; University of Alabama at Birmingham, Birmingham, Alabama

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Leisa H. Weld Emory University, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Sheba Medical Center, Tel-Hashomer, Israel; University of Munich, Munich, Germany; University of Alabama at Birmingham, Birmingham, Alabama

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Eli Schwartz Emory University, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Sheba Medical Center, Tel-Hashomer, Israel; University of Munich, Munich, Germany; University of Alabama at Birmingham, Birmingham, Alabama

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Christie Reed Emory University, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Sheba Medical Center, Tel-Hashomer, Israel; University of Munich, Munich, Germany; University of Alabama at Birmingham, Birmingham, Alabama

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Frank von Sonnenburg Emory University, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Sheba Medical Center, Tel-Hashomer, Israel; University of Munich, Munich, Germany; University of Alabama at Birmingham, Birmingham, Alabama

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David O. Freedman Emory University, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Sheba Medical Center, Tel-Hashomer, Israel; University of Munich, Munich, Germany; University of Alabama at Birmingham, Birmingham, Alabama

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Phyllis E. Kozarsky Emory University, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Sheba Medical Center, Tel-Hashomer, Israel; University of Munich, Munich, Germany; University of Alabama at Birmingham, Birmingham, Alabama

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Among ill returned travelers to Schistosoma-endemic areas reported to the GeoSentinel Surveillance Network over a decade 410 schistosomiasis diagnoses were identified: 102 Schistosoma mansoni, 88 S. haematobium, 7 S. japonicum, and 213 Schistosoma unknown human species. A total of 83% were acquired in Africa. Unlike previous large case series, individuals born in endemic areas were excluded. Controlling for age and sex, those traveling for missionary or volunteer work, or as expatriates were more likely to be diagnosed with schistosomiasis. Sixty-three percent of those with schistosomiasis presented within six months of travel. Those seen early more often presented with fever and respiratory symptoms compared with those who presented later. One-third of patients with schistosomiasis were asymptomatic at diagnosis. Half of those examined for schistosomiasis were diagnosed with infection. Screening for schistosomiasis should be encouraged for all potentially exposed travelers and especially for missionaries, volunteers, and expatriates.

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  • 1

    Steinmann P, Keiser J, Bos R, Tanner M, Utzinger J, 2006. Schistosomiasis and water resources development: systematic review, meta-analysis, and estimates of people at risk. Lancet Infect Dis 6 :411–425.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Chitsulo L, Engels D, Montresor A, Savioli L, 2000. The global burden of schistosomiasis and its control. Acta Trop 77 :41–51.

  • 3

    Engels D, Chitsulo L, Montresor A, Savioli L, 2002. The global epidemiological situation of schistosomiasis and new approaches to control and research. Acta Trop 82 :139–146.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Strickland GT, Ramirez BL, 2000. Schistosomiasis. Strickland GT, ed. Hunter’s Tropical Medicine. Eighth edition. Philadelphia, PA: W.B. Saunders Company, 804–832.

    • PubMed
    • Export Citation
  • 5

    Zuidema PJ, 1981. The Katayama syndrome; an outbreak in Dutch tourists to the Omo National Park, Ethiopia. Trop Geogr Med 33 :30–35.

  • 6

    Centers for Disease Control and Prevention, 1982. Cercarial dermatitis among bathers in California; Katayama syndrome among travelers to Ethiopia. Morbid Mortal Wkly Rep 31 :435–438.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Centers for Disease Control and Prevention, 1984. Acute schistosomiasis with transverse myelitis in American students returning from Kenya. Morbid Mortal Wkly Rep 33 :445–447.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Centers for Disease Control and Prevention, 1990. Acute schistosomiasis in U.S. travelers returning from Africa. Morbid Mortal Wkly Rep 39 :141–142, 147–148.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Colebunders R, Verstraeten T, Van Gompel A, Van den Ende J, De Roo A, Polderman A, Visser L, 1995. Acute schistosomiasis in travelers returning from Mali. J Travel Med 2 :235–238.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Schwartz E, Kozarsky P, Wilson M, Cetron M, 2005. Schistosome infection among river rafters on Omo River, Ethiopia. J Travel Med 12 :3–8.

  • 11

    Bierman W, Wetsteyn J, van Gool T, 2005. Presentation and diagnosis of imported schistosomiasis: relevance of eosinophilia, microscopy for ova, and serology. J Trav Med 12 :9–13.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Cetron MS, Chitsulo L, Sullivan JJ, Pilcher J, Wilson M, Noh J, Tsang V, Hightower A, Addiss D, 1996. Schistosomiasis in Lake Malawi. Lancet 348 :1274–1278.

  • 13

    Jelinek T, Nothdurft HD, Loscher T, 1996. Schistosomiasis in travelers and expatriates. J Travel Med 3 :160–164.

  • 14

    Day J, Grant AD, Doherty JF, Chiodini PL, Wright SG, 1996. Schistosomiasis in travelers returning from sub-Saharan Africa. BMJ 313 :268–269.

  • 15

    Doherty JF, Moody AH, Wright SG, 1996. Katayama fever: an acute manifestation of schistosomiasis. BMJ 313 :1071–1072.

  • 16

    Witty CJM, Mabey DC, Armstrong M, Wright SG, Chiodini PL, 2000. Presentation and outcome of 1107 cases of schistosomiasis from Africa diagnosed in a non-endemic country. Trans R Soc Trop Med Hyg 94 :531–534.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Meltzer E, Artom G, Marva E, Assous MV, Rahav G, Schwartz E, 2006. Schistosomiasis among travelers: new aspects of an old disease. Emerg Infect Dis 12 :1696–1700.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Bottieau E, Clerinx J, de Vega MR, Van den Enden E, Colebunders R, Van Esbroeck M, Vervoort T, Van Gompel A, Van den Ende J, 2006. Imported Katayama fever: clinical and biological features at presentation and during treatment. J Infect 52 :339–345.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Thors C, Holmblad P, Maleki M, Carlson J, Linder E, 2006. Schistosomiasis in Swedish travelers to sub-Saharan Africa: can we rely on serology? Scand J Infect Dis 38 :794–799.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Grobusch MP, Muhlberger N, Jelinek T, Bisoffi Z, Corachan M, Harms G, Matteelli A, Fry G, Hatz C, Gjorup I, Schmid ML, Knobloch J, Puente S, Bronner U, Kapaun A, Clerinx J, Nielsen LN, Fleischer K, Beran J, 2003. Imported schistosomiasis in Europe: sentinel surveillance data from TropNet Europe. J Travel Med 10 :164–167.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Bottieau E, Clerinx J, Van den Enden E, Van Esbroeck M, Colebunders R, Van Gompel A, Van den Ende J, 2006. Fever after a stay in the tropics, diagnostic predictors of the leading tropical conditions. Medicine 86 :18–25.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Freedman DO, Kozarsky PE, Weld LH, Cetron MS, 1999. Geo-Sentinel: the global emerging infections sentinel network of the International Society of Travel Medicine. J Travel Med 6 :94–98.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Freedman DO, Weld L, Kozarsky P, Fisk T, Robins R, von Sonnenburg F, Keystone J, Pandey P, Cetron M, 2006. Spectrum of disease and relation to place of exposure among ill returned travelers. N Engl J Med 354 :119–130.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24

    Montgomery S, 2007. Schistosomiasis. In Centers for Disease Control and Prevention. Health Information for International Travel 2008. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service; 2007, 297–301.

    • PubMed
    • Export Citation
  • 25

    Tsang V, Wilkins PP, 1997. Immunodiagnosis of schistosomiasis. Immunol Invest 26 :175–188.

  • 26

    United Nations Statistics Division, Composition of macro geographical (continental) regions, geographical sub-regions, and selected economic and other groupings. Available at: http://unstats.un.org/unsd/methods/m49/m49regin.htm. Accessed June 9, 2008.

    • PubMed
    • Export Citation
  • 27

    Witty C, Carroll B, Armstrong M, Dow C, Snashall D, Marshall T, Chiodini P, 2000. Utility of history, examination and laboratory test in screening those returning to Europe from the tropics for parasitic infection. Trop Med Int Health 5 :818–823.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28

    Outwater A, Mpangala E, 2005. Schistosomiasis in US Peace Corps volunteers in Tanzania. J Travel Med 12 :265–269.

  • 29

    Rocha M, Rocha RL, Pedroso E, Greco D, Ferreira C, Lambertucci J, Katz N, Rocha RS, Rezende D, Neves J, 1995. Pulmonary manifestations in the initial phase of Schistosomiasis mansoni.Rev Inst Med Trop Sao Paulo 37 :311–318.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Cooke GS, Lalvani A, Gleeson FV, Conlon CP, 1999. Acute pulmonary schistosomiasis in travelers returning from Lake Malawi, sub-Saharan Africa. Clin Infect Dis 29 :836–839.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    Schwartz E, Rozenman J, Perelman M, 2000. Pulmonary manifestations of early schistosome infection among non-immune travelers. Am J Med 109 :718–722.

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