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Persistent Schistosoma mansoni infection in Yemeni immigrants to Israel
L Hornstein1, G Lederer, J Schechter
1Immunology Laboratory, Lady Davis Carmel Hospital, Haifa, Israel.
Abstract:
Following sporadic reports on persistent Schistosoma mansoni (S.m) infections in Israelis of Yemeni origin, we systematically surveyed a group of 129 individuals who immigrated to Israel 38 years ago. Physical examination was uneventful in all members of the study group. A single stool examination revealed S.m eggs in 15 of 129 subjects (12%). Specific anti-S.m. IgE was detected in the sera of 48 individuals (37%). Among the 15 egg-positives, 14 had specific IgE (sensitivity 93.3%), but only 80 of the 114 egg-negatives were also negative for specific IgE (specificity 70%). This specific IgE positivity among egg-negatives in the study group (34/114) and its complete absence from two control groups, one of them comprising Yemenites born in Israel, suggest either an S.m infection with low egg output stemming from a low worm burden or low fecundity of senescent worms, or occult infections. Since the S.m infections could not have been contracted in Israel, our findings point to inordinately persistent infections in the members of our study group, and incidentally also to the diagnostic usefulness of specific IgE testing in such cases.
Insights
Persistent Schistosoma mansoni (S.m) infections were found in Israelis of Yemeni origin, even decades after immigration. Specific IgE testing showed promise for diagnosing these long-term S.m infections.
Area of Science:
- Infectious Diseases
- Parasitology
- Immunology
Background:
- Sporadic reports suggested persistent Schistosoma mansoni (S.m) infections in Israelis of Yemeni origin.
- Schistosomiasis remains a significant global health concern, particularly in endemic regions.
Purpose of the Study:
- To systematically investigate the prevalence and diagnostic markers of persistent Schistosoma mansoni infections in a cohort of Yemeni immigrants to Israel.
- To evaluate the utility of specific anti-S.m. IgE as a diagnostic tool for detecting S.m infections, especially in cases with low or no egg excretion.
Main Methods:
- A cohort of 129 individuals, who immigrated from Yemen to Israel 38 years prior, underwent systematic screening.
- Stool examinations were performed to detect S.m eggs, and serum samples were tested for specific anti-S.m. IgE antibodies.
- Control groups, including Yemenites born in Israel, were used for comparison.
Main Results:
- Schistosoma mansoni (S.m) eggs were detected in 12% of the study group.
- Specific anti-S.m. IgE was found in 37% of individuals, with high sensitivity (93.3%) in egg-positive cases.
- A significant proportion of egg-negative individuals (30%) showed specific IgE positivity, suggesting occult or low-output infections.
Conclusions:
- The findings indicate inordinately persistent Schistosoma mansoni infections in the study group, likely acquired decades prior.
- Specific IgE testing demonstrates diagnostic utility for detecting S.m infections, particularly in individuals with low worm burden or senescent infections.
- These persistent infections highlight the long-term impact of schistosomiasis and the need for effective diagnostic strategies.