Acute schistosomiasis in paediatric travellers and comparison with their companion adults

Shira Rabinowicz*, Eyal Leshem, Eli Schwartz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Schistosomiasis in non-immune travellers can cause acute schistosomiasis, a multi-systemic hypersensitivity reaction. Little is known regarding acute schistosomiasis in children. We describe acute schistosomiasis in paediatric travellers and compare them with adult travellers. Methods: A retrospective study of paediatric travellers (0–18 years old) diagnosed with schistosomiasis at Sheba Medical Center. Patients’ findings are compared with those of adult travellers from the same travel groups. Results: in total, 18 children and 24 adults from five different trips to Tanzania, Uganda, Nigeria and Laos were infected (90% of the exposed travellers). The median bathing time of the infected children was 30 min (interquartile range (IQR) 15–30 min). The most common presentations were respiratory symptoms in 13 (72%), eosinophilia in 13 (72%) and fever in 11 (61%). Acute illness included a median of 2.5 symptoms. Three children required hospitalization and three were asymptomatic. Fatigue was significantly less common in children compared with similarly exposed adults (33% vs 71%, P = 0.03). Rates of hospitalization and steroid treatment were similar. The median eosinophil count in children was 1045 cells/μl (IQR 625–2575), lower than adults [2900 cells/μl (IQR 1170–4584)], P = 0.02. Conclusions: Children may develop acute schistosomiasis following short exposure to contaminated freshwater, demonstrating a high infection rate. Severity seems to be similar to adults, although children report fatigue less commonly and show lower eosinophil counts. The disease should be suspected in children with multi-systemic illness and in asymptomatic children with relevant travel history.

Original languageEnglish
Article numbertaaa238
JournalJournal of Travel Medicine
Volume28
Issue number6
DOIs
StatePublished - 2021

Keywords

  • Acute schistosomiasis
  • Children
  • Katayama syndrome
  • Travel
  • Tropical disease

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