Schistosomiasis

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What causes schistosomiasis?

Parasites of the genus Schistosoma (S. mansoni, S. mekongi, S. intercalatum, S. hematobium, and S. japonicum) cause the disease. The disease in humans is part of the complicated life cycle of the parasites that is illustrated in the figure below. Humans enter freshwater areas that contain snails that grow Schistosoma sporocysts that develop into free-swimming cercariae. The cercariae can attach to and penetrate the human skin, migrate to blood vessels, and through lung blood capillaries reach the portal blood or vesicular (bladder) blood systems. During this migration, the cercariae change and develop from schistosomula into male and female adult parasitic worms. The worms incorporate human proteins into their surface structures, so most humans produce little or no immune response to the parasites. After parasite mating occurs in the portal or vesicular blood system, egg production occurs. In contrast to the adult parasites, the parasite's eggs stimulate a strong immune response by most humans. Some eggs migrate through the bowel or bladder tissue and are shed in feces or urine, while other eggs are swept into the portal blood and lodge in other tissue sites. Eggs shed into urine or feces may reach maturity in freshwater and complete their life cycle by infecting susceptible snails. In addition, some adult worms may migrate to other organs (for example, eyes or liver). This life cycle is further complicated by S. japonicum species that may also infect domesticated and wild animals, which can then serve as another host system. S. hematobium is the species that usually infects the human bladder tissue, while the other species usually infect the bowel tissue.

The acute and chronic symptoms of schistosomiasis are thought to be mainly due to the egg migration through tissue and the human immune response to the eggs. Chronic symptoms are mainly due to eggs that are not shed from the body. Complications (for example, hepatomegaly or enlarged liver and bladder cancer) related to the disease are thought to occur due to long-term exposure to the highly antigenic eggs.

Life cycle of schistosomiasis
Life cycle of schistosomiasis
Medically Reviewed by a Doctor on 11/23/2015

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