Avoiding and treating the summer disease’
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million people infected with the disease, which is endemic in five out South Africa’s nine provinces. At that time, the article said, 10.8 percent of the South African population was infected.
Can you prevent schistosomiasis?
• Don’t swim (or even stand in) any other body of water known to be infected with schistosomiasis. That’s an impossible ask for many active people. So... • If you are a paddler or other recreational user of water known to be infected with schistosomiasis, have yourself tested and, if necessary, get treated. The blood test measures immunoglobulins (recent exposure, and past infection – ie resistance). According to Pietermaritzburg GP, Richard Anderson, who this year is completed his 20th Dusi Canoe Marathon, the general rule is to wait about two months after exposure to infected water.
For canoeists, this is the end of the canoeing season, ie April/May. In an interview published on the Dusi Umgeni Conservation Trust website, Anderson said he saw about 30 cases of schistosomiasis a year in his private practice. Over 90 percent are paddlers, and most are between October and April. • Minimise the risk by avoiding water that may be infected between 10am and 3pm. Schistosomiasis is known as a “summer disease” because the cercaria - the life stage of the parasite that burrows into human skin - is most active in summer heat. Its ideal temperature is 19C-29C and the cercaria are most active in the summer months, late December to March.
How do you know if you have schistosomiasis?
• You shouldn’t assume you have schistosomiasis if you have any of the following symptoms, but they could be an indication that you should get yourself examined by a doctor and tested: In the first stage of infection, your skin may itch in the places where the cercaria entered, and you may have small itchy bumps. Abdominal pain, coughing, diarrhoea, a fever and fatigue that affects your ability to function effectively may set in within a period of two to six weeks. Blood in the urine occurs in more severe cases which definitely require treatment.
How do doctors treat schistosomiasis?
• According to the WHO, for more than 30 years Praziquan- tel has been the treatment of choice. But WHO emphasises that environment and behaviour need addressing, because the rate of re-infection is high. A 1994 WHO report estimated worldwide infection by schistosomiasis at 200 million.
A 2011 article in the South African Journal of Epidemoiological Infection estimated that 4.5 million South Africans, mostly rural poor, required treatment for urogenital schistosomiasis.
Pointing out that WHO recommends regular mass treatment of all school-aged children, the article notes that preventing and/or treating schistosomiasis may prevent death from the advanced version of the disease, reduce its negative socio-economic impact and even reduce HIV infection.
The latter is because the parasite can cause genital lesions, making a person more susceptible to infection. In 2009 WHO identified urogenital schistosomiasis as a risk for secondary HIV infection. • The article says that although South Africa had implemented a mass treatment pilot programme in KZN in the late 90s, there had been no mass treatment interventions since. Comparing the cost of treatment with Bayer Pharmaceutical’s Bitricide version of Praziquantel to generics, the article shows it was around 60 times cheaper to treat the disease with a generic.
“In South Africa, however, currently the Medicines Control Council and the National Department of Health only have Bayer’s Bitricide for the treatment of schistosomiasis, making treatment unaffordable in afflicted districts…”.