Schistosomiasis (bilharzia)

For a lay person:

Schistosomiasis, or bilharzia, is a parasitic worm infection caught when skin touches fresh water containing the larvae, in parts of Africa, Asia, South America and the Middle East. Long-term infection can damage the liver, bowel, bladder and kidneys.

For a trained medical person:

Caused by Schistosoma species released from freshwater snails; acute infection may cause Katayama fever, while chronic egg-induced granulomatous inflammation causes periportal fibrosis and portal hypertension (S. mansoni, S. japonicum) or urogenital disease and bladder cancer risk (S. haematobium). Diagnosis is by stool or urine microscopy for eggs and serology, with imaging for complications. Treatment is praziquantel, often repeated, and management of complications.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Acute Stage; Chronic Stage. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: See a doctor after freshwater exposure in an affected area, even without symptoms; get urgent care for vomiting blood, black stools or a swollen abdomen. It needs antiparasitic treatment and Chinese medicine is adjunctive at most; take care with herbs that may stress the liver if there is liver damage.