Patient : I am a medical student and I wish urgent help>>>>I have travelled to endemic area of Bilharziasis(schistosomiasis) and I swam in fresh water(Nile river) then I saw snails in the water and after I came out I found red spots on the dorsum of my foot(resembling swimmers itch) I fear that I become infected with schistosomiasis as it is endemic in this region This was on 16/4/2010 (from 4 days) so I ask if there is any laboratory tests to determine whether i infected or no in the early infection before egg deposition from worm(so not stool or urine analysis)like ELISA in blood? is it reveal the early infection? what should I do to eradicate the infection in this stage if it occurred? there is any drug i can take as prophylaxis to eliminate the worriness(I am very worry)?
Doctor :   I understand your concern about probable Schistosomiasis. As you already know the transmission is through the skin when larval forms of the parasite released by freshwater snails penetrate.According to your description of the events, I agree with you that there is certainly a possibility that you might have been in contact with it. This parasite starts a process and would need some time to be detected but the clinical diagnosis would be the best choice to detect it or suspect at early as possible. Within days after becoming infected, you may develop a rash or itchy skin, Fever, chills and coughs however most people have no symptoms at this early phase of infection. These symptoms are caused by the bodys reaction to the worms eggs not the worms themselves. The definitive test to confirm this disease is based on the detection of specific Schistosome eggs excreted in stool and urine. This occurs from 5-13 weeks after infection and is determined by worm burden. You might want to take a CBC to look for changes such as Eosinophilia which are one of the first to be noticed. Praziquantel is the only available treatment against all forms of schistosomiasis; it is also used as prophylaxis in endemic areas. I wish you the best.

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