Imported schistosomiasis in travelers: Experience from a referral tropical medicine unit in Barcelona, Spain

• Published in: Travel Medicine and Infectious Disease
• Main Authors: Fernando Salvador, Cristina Bocanegra, Begoña Treviño, Elena Sulleiro, Adrián Sánchez-Montalvá, Núria Serre-Delcor, Pau Bosch-Nicolau, Ma Luisa Aznar, Lidia Goterris, Diana Pou, María Espiau, Joan Martínez-Campreciós, Juan Espinosa-Pereiro, Inés Oliveira, Francesc Zarzuela, Patricia Martínez-Vallejo, Israel Molina
• Format: Article in Journal/Newspaper
• Language: English
• Published: Elsevier 2024
• Subjects: schistosomiasis; Travelers; Katayama; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1016/j.tmaid.2024.102742; https://doaj.org/article/ed99ec495cbb4b6fbf326fd76a6439cc

Background: Acute schistosomiasis occurs most often in travelers to endemic regions. The aim of the study is to describe the epidemiological, clinical and parasitological characteristics of patients with schistosomiasis acquired during an international travel. Methods: Observational retrospective study including all travel-related schistosomiasis cases seen at the International Health Unit Vall d’Hebron-Drassanes (Barcelona, Spain) from 2009 to 2022. Diagnosis of schistosomiasis was defined by the presence of Schistosoma eggs in stools or urine or the positivity of a serological test. We collected demographic, epidemiological, clinical, parasitological, and therapeutic information. Results: 917 cases of schistosomiasis were diagnosed, from whom 96 (10.5 %) were travel-related. Mean age of the patients was 34.9 years, and 53.1 % were women. Median duration of the travel was 72 days, and geographical areas where travelers had contact with fresh water were Africa (82.3 %), Asia (12.5 %), and South America (5.2 %). Twenty (20.8 %) patients reported having had some clinical symptom, being gastrointestinal symptoms the most frequent. Two patients developed the classical Katayama syndrome. In eleven (11.5 %) cases eggs were observed in urine or feces samples, and 85 (88.5 %) cases were diagnosed by a positive serology. Ninety-one (94.8 %) patients received treatment with praziquantel with different therapeutic schemes. The two patients with Katayama syndrome received concomitant treatment with corticosteroids. Conclusions: Schistosomiasis in travelers represented 10 % of the overall schistosomiasis cases in our center. Increasing the awareness in the pre-travel advice and implementing specific screening in those travelers at risk (long travelers, contact with fresh water) could reduce the incidence and associated morbidity in this group.