Schistosomiasis and international travel

Infection with Schistosoma species is acquired by exposure to fresh water that harbors cercariae released by infected snails. Although the route of infection is clear, clinical presentation of the established infection in the nonimmune tourist typically differs from that in the local population of areas of endemicity. For the health care practitioner, the traveler's syndrome presents distinctive management problems: water-transmitted bacterial and viral infections may coexist, and identification of the stage of disease at presentation, along with identification of the causative species, will maximize treatment options. Travel medicine clinics serve as epidemiological antennae, helping to identify the dynamics of species transmission in geographically distinct areas. Education of persons traveling to areas of endemicity and the development of mechanical protection against exposure are needed.