University of Perpetual Help System DALTA – Molino Campus

COLLEGE OF NURSING
Molino 3, Bacoor, Cavite
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SCHISTOSOMIASIS
(Bilharziasis; Snail fever)
Definition
Schistosomiasis is a slowly progressive disease caused by blood flukes of class
trematoda. It is chronic wasting disease common among farmers and their families in
certain parts of the Philippines.
Schistosomiasis is not only a public health but also a socio-economic problem because
by causing ill-health, it also reduces agricultural activity, (DOH, 1988).
Etiologic Agent
The cause of the disease is a parasitic worm called Schistosoma japonicum.
Types of the organism:
1. Schistosoma japonica
 Also known as the “Oriental Schistosomiasis.”
 The only type that is endemic in the Philippines.
 It infects the intestinal tract
2. Schistosoma mansoni
 Common in some parts of Africa.
 It also infects the intestinal tract.
3. Schistosomia haematobium
 Can be found in some parts of the Middle East like Iraq, and Iran.
 Infects the urinary tract.
Incubation Period
The incubation period is at least two to three months.
Sources of Infection
• Feces of infected person, and other animals like dogs, carabaos, cows, pigs, wild
rats, and monkeys.
• Contaminated water
Mode of Transmission
• Through ingestion of contaminated water
• Through skin pores
• The disease is transmitted through an intermediary host, a tiny snail called
Oncomelania Quadrasi.
What is Oncomelania Quadrasi?
• The adult snail is greenish-brown in color, usually just as big as the smallest size
of palay.
• Usually thrives in small bodies of water like, river banks, swamps, canals,
streams, and creeks.
• They can also be found on rotting branches of trees, grasses, and decaying
leaves.
• They love to stay in areas with sandy-loam soil.

Signs and Symptoms

Initial signs and symptoms of schistosomiasis depend on the site of infection and the
stage of the disease. However, the following signs may be observed:
• Initially, a transient, pruritic rash develops at the site of cercariae
penetration,

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Mia Dominique V. Sandoval Group 24 BSN 4E
 University of Perpetual Help System DALTA – Molino Campus
COLLEGE OF NURSING
Molino 3, Bacoor, Cavite
_____________________________________________________________________________
_

• Fever, myalgia, and cough.

• Diarrhea, dysentery, and blood in the stool.
• Recurrent infection in children may cause anemia, malnutrition, and
learning difficulties.
• Later signs and symptoms may include abdominal pain due to
hepatomegaly, splenomegaly, and lymphadenopathy.
• Worm migration and egg deposition in the Central Nervous System, which
rarely happens, may cause such complications such as flaccid paralysis,
seizures, spinal cord inflammation, and convulsion.

Swimmer’s itch
Diagnostics
• Fecalysis or direct stool exam
• Kato Katz technique
• Anemia (low number of RBC)
• Antibody test (checjs for schistosome antigens)
• Biopsy of the tissue suspected of being infected
• Enzyme Link Immunosorbent Assay
• Cerum Ova Precipitin Test
- The confirmatory test
Complications
• Bladder cancer
• Chronic kidney failure
• Chronic liver damage and an enlarged spleen
• Colon (large intestine) inflammation with bloody diarrhea
• Kidney and bladder obstruction
• Pulmonary hypertension
• Repeated blood infections can occur, because bacteria can enter the
bloodstream through an irritated colon
• Right-sided heart failure
• Seizures

Treatment
The treatment is effective only when given early in the course of the disease.
• Praziquantel (tablets for 6 months)
- 1 tab twice a day for 3 months
- 1 tab a day for the following 3 months
• Fuadin (IM or IV)
- Should be given 360mg for the entire treatment
• Corticosteroids may be given if the infection is severe or has infected the
brain.

_____________________________________________________________________________
_
Mia Dominique V. Sandoval Group 24 BSN 4E
 University of Perpetual Help System DALTA – Molino Campus
COLLEGE OF NURSING
Molino 3, Bacoor, Cavite
_____________________________________________________________________________
_

Pathophysiology

Nursing Management
• Regularly monitor patient’s temperature.
• Increase fluid and nutritional intake
• Promote comfort by maintaining a stable room temperature.
• Prepare patient for the laboratories that need to be done.
• Provide emotional support for both the patient and the family.

Prevention
Theoretically, the disease can be prevented by avoiding all human skin contact with
freshwater sources where schistosomiasis and the snails that complete their life cycle
are endemic.
Others include:
• Improve farming through proper irrigation and drainage, removal of weeds,
and rotation of crops. Thus, disturbing the living condition of the snail.
• Proper waste disposal.
• Control stray animals.
• Providing safe water for drinking, and for other needs.
• Reporting of cases immediately.
• Health teaching.

_____________________________________________________________________________
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Mia Dominique V. Sandoval Group 24 BSN 4E