“Come on In” I hear them shout… The water looks cool and inviting, the surface twinkling under the sun. I’m hot and sweaty and in desperate need to feel cold water on my skin. I hear them all splashing in the water, laughing calling me in to join them… Beads of sweat have formed on my forehead, I wipe them away- my T-shirt has stuck to my back where I was carrying my daypack.
I do so want to run in, or at least take my sandals off and feel the coolness on my hot feet- but something in my head tells me no… Why? I retrace my thoughts and vaguely remember something the nurse said in the travel clinic something about snails and freshwater…? and that Lake Malawi was high risk… ?
I can’t see anything in the water- I’m getting hotter and everyone is now in the water- calling me in to join them… What harm can it do?
I take off my sandals and join in the fun- such a relief from the heat of the sun….
I think nothing more of it… and 4 months later I am back in Bristol uploading my travel photos onto facebook. I find a selection of leaflets amongst my travel documents that I must have collected from the nurse in the travel clinic- one of them mentions something called ‘Schistosomiasis’ (Bilharzia).
Ahhhh this is the disease that I recalled at Lake Malawi- but I feel totally ok, not unwell at all- so I don’t think I have to worry about this. I start reading the information and it states:
‘The majority of people who contract Schistosomiasis have no symptoms’!
But fortunately I can have a screening test 12 weeks after possible exposure which I can have done at my GP practice.
I ring up Students’ Health Service and book a nurse appointment.
Better to check after my quick dip…
Schistosomiasis is one of the most widespread of all parasitic infections of humans. It is the most common parasite transmitted through contact, by either swimming or wading in fresh water in parts of Africa, for example Lake Malawi. South America and the Middle and Far East are also affected.
Initial contact with cercariae can cause an itchy rash, known as “swimmers itch.” Once infection has been established, clinical manifestations/ symptoms can occur within 2-3 weeks of exposure, but many infections cause no symptoms.
Advice for Travellers
Avoid skin contact with fresh water in endemic areas e.g. ponds, lakes and rivers. Swim only in protected swimming pools or safe sea water. Avoid drinking infected water. Wear protective footwear when walking in soil, especially if it is damp or water logged. Those who have been knowingly exposed can be screened after return but if there are no symptoms this should be delayed for 12 weeks after the last possible exposure so as to allow the time for the development of antibodies.
Students’ Health Service ‘Travel Guidelines’ patient information leaflet- available at the practice