OUTBREAK OF SCHISTOSOMIASIS AMONG TRAVELERS RETURNING FROM MALI, WEST-AFRICA

Schistosomiasis in travelers often remains unrecognized because doctor s are unfamiliar with the clinical presentation and diagnosis of this imported disease. We describe the epidemiological, clinical, and labor atory characteristics associated with an outbreak of schistosomiasis a mong nonimmune travelers. Of 30 travelers in two consecutive groups, 2 9 who had swum in freshwater pools in the Dogon area of Mall, West Afr ica, were followed for 12 months. Twenty-eight (97%) of those 29 becam e infected; 10 (36%) of the 28 had cercarial dermatitis, and in 15 (54 %), Katayama fever developed. Eggs were found in 22 (79%) of the infec ted travelers: eggs of Schistosoma mansoni or terminally spined eggs ( probably of Schistosoma intercalatum) were in the stools of 19 and 10 patients, respectively, and eggs of Schistosoma haematobium were in th e urine of 7 patients. The eggs of 2 of these Schistosoma species were present in 6 cases, and in 4 cases eggs of all 3 species were found. The limited exposure of this group of travelers resulted in a high rat e of infection with all three of the Schistosoma species that are prev alent in Africa. A diagnosis of schistosomiasis should be considered f or any traveler with a history of exposure to fresh water in an area o f endemicity. The only effective method of prevention is avoiding all contact with fresh water in these areas.