SCHISTOSOMIASIS:AN UNFAMILIAR INFECTIOUS DISEASE

Tiffany Jackson, Ph.D. student (Public Health: Epidemiology)Walden University

PUBH 8165-1 (Environmental Health)Instructor: Dr. Shana Morrell

Spring, 2009

Objectives

Educate the general public about Schistosomiasis

Enlighten the public about a potential global impact

Convince professionals of the need for public health interventions

Why Is It Important? Emerging Infectious Disease ???

Socioeconomic Impact

Health Conditions

* Directors of Health Promotion & Education. (2005). Schistosomiasis. Retrieved April 5, 2009 from http://www.dhpe.org/infect/schisto.html.

Schistosomiasis What Is It?

An infection caused by blood flukes

How Do People Get It?Contact with contaminated water

Where Is It Found?Tropical Climates

•Centers for Disease Control & Prevention (CDC). (2008, February). Schistosomiasis: Fact Sheet. Retrieved April 3, 2009 from http://www.cdc.gov/ncidod/dpd/parasites/ schistosomiasis/factsht_schistosomiasis.htm.

* Directors of Health Promotion & Education. (2005). Schistosomiasis. Retrieved April 5, 2009 from http://www.dhpe.org/infect/schisto.html.

Types of Schistosoma Schistosoma mansoni

www.tcd.ie

Schistosoma japonicum

lifesciencedb.jp

Schistosoma haematobium

www.ym.edu.tw

* Johnson, A.G.; Ziegler, R.J.; Lukasewycz, O. A and Hawley, L. B. (2002). BRS: Microbiology and Immunology (4th Ed). Baltimore, MD and Philadelphia, PA: Lippincott, Williams and Wilkins.

* Hawley, L. B. (2000). High Yield Microbiology and Infectious Diseases. Baltimore, MD and Philadelphia, PA: Lippincott, Williams and Wilkins.

Life Cycle

http://creationwiki.org/File: Schistosomiasis_Life_Cycle.jpg

* Directors of Health Promotion & Education. (2005). Schistosomiasis. Retrieved April 5, 2009 from http://www.dhpe.org/infect/schisto.html.* Hawley, L. B. (2000). High Yield Microbiology and Infectious Diseases. Baltimore, MD and Philadelphia, PA: Lippincott, Williams and Wilkins.

* Wilson, W. R. and Sande, M. A. (2001). Current Diagnosis & Treatment in Infectious Diseases. United States: McGraw-Hill

Disease Syndromes Swimmer’s Itch (Dermatitis) Katayama Fever Chronic Fibro – Obstructive Disease

Bladder Carcinoma

http://www.e-radiography.net/radpath/s/ schistosomiasis1.jpgwww.gnntdc.org

* Wilson, W. R. and Sande, M. A. (2001). Current Diagnosis & Treatment in Infectious Diseases. United States: McGraw-Hill.

path.upmc.edu roboticoncology.com

* Kumar, V; Abbas, A. and Fausto, N. (Eds.).(2007). Robbins and Cotran: Pathologic Basis of Disease. Philadelphia, PA: Elsevier Saunders.

Signs / Symptoms

1. Dermatitis Itchy Papular Rash

2. Katayama Fever Fever Chills Headache Cough Lymphadenopathy Hepatosplenomegaly

3. Chronic Fibro-Obstruc. Chronic Granulomatous Disease Fibrosis

4. Bladder Carcinoma Painless Hematuria Frequency Urgency Dysuria

* Wilson, W. R. and Sande, M. A. (2001). Current Diagnosis & Treatment in Infectious Diseases. United States: McGraw-Hill.

* Kumar, V; Abbas, A. and Fausto, N. (Eds.).(2007). Robbins and Cotran: Pathologic Basis of Disease. Philadelphia, PA: Elsevier Saunders.

* Directors of Health Promotion & Education. (2005). Schistosomiasis. Retrieved April 5, 2009 from http://www.dhpe.org/infect/schisto.html.

Laboratory Findings

Parasite Eggs in Feces / Urine Eosinophilia Hematuria Anemia Abnormal LFT’s Increased Creatinine Uremia

(Wilson and Sande, 2001 p.872-874)Wilson, W. R. and Sande, M. A. (2001). Current Diagnosis & Treatment in Infectious Diseases. United States: McGraw-Hill.

Global Impact ???

Increase Incidence / Prevalence

Increase Morbidity / Mortality

Increase in Use of Public Health Resources

* Directors of Health Promotion & Education. (2005). Schistosomiasis. Retrieved April 5, 2009 from http://www.dhpe. org/infect/schisto.html.

* MicrobiologyBytes (Micro). (2007, January). Schistosomiasis. Retrieved May 1, 2009 from http://www.microbiologybytes.com/introduction/Schisto.html

Epidemiological Data Effects about

500,000 in the U.S. Occurs in > 200

million worldwide

http://www.the-travel-doctor.com/schistosomiasis_files/image006.jpg

S. mansoni: : Estimated Morbidity and Mortality

At risk of infection 393       Infected 54 Diarrhoea during previous 2 weeks 0.78 (0.0-7.8) Blood in stool during previous 2 weeks 4.4 (3.0-8.3) Hepatomegaly (mid-sternal line) 8.5 Splenomegaly [6.3] Ascites [0.29] Haematemesis (ever) [0.93] Haematemesis (deaths/year) [0.13]

* World Health Organization (WHO). (2009). Schistosomiasis: Epidemiology. Retrieved May 1, 2009 from http://www.who. int/schistosomiasis/ epidemiology/ table/ en/ index.html

S. haematobium: Estimated Morbidity and Mortality

At risk of infection 436       Infected 112 Haematuria during previous 2 weeks 71 (52-89) Dysuria during previous 2 weeks 32 (17-55) Minor bladder morbidity (detected by ultrasound) 76 (67-92) Major bladder morbidity (detected by ultrasound) 24 (15-31) Moderate hydronephrosis 9.6 Major hydronephrosis 9.6 Non-functioning kidney [1.7] Non-functioning kidney (deaths/year) [0.15] Bladder cancer (deaths/year) Males [0.011]   Females [0.0023]

* World Health Organization (WHO). (2009). Schistosomiasis: Epidemiology. Retrieved May 1, 2009 from http://www.who. int/schistosomiasis/ epidemiology/ table/ en/ index.html

What’s Being Done Now

Prevention Methods

Treatments

Environmental Regulations

*Wilson, W. R. and Sande, M. A. (2001). Current Diagnosis & Treatment in Infectious Diseases. United States: McGraw-Hill

* Directors of Health Promotion & Education. (2005). Schistosomiasis. Retrieved April 5, 2009 from http://www.dhpe. org/infect/schisto.html.

* Madramootoo, C. A.; Johnston, W. R. and Willardson, L.S. (Ed.) (1997). Management of Agricultural Drainage Water Quality. Rome: Food and Agricultural Organization (FAO).

* Trevor, A. J.; Katzung, B. G. and Masters, S. B. (Ed. 7th). (2005). Pharmacology: Examination and Board Review. New York: Lange Medical Books / McGraw-Hill.

What Needs to Be Done

Increase Public Education / Awareness

Better Water Treatment

More Collaborative Efforts

* Directors of Health Promotion & Education. (2005). Schistosomiasis. Retrieved April 5, 2009 from http://www.dhpe. org/infect/schisto.html.

BibliographyFor more information on Schistosomiasis

refer to the following resources:

Centers for Disease Control and Prevention: Division of Parasitic Diseases

(www.cdc.gov/ncidod/dpd/parasites/Schistosomiasis/) Directors of Health Promotion and Education

(www.dhpe.org/infect/schisto.html) Global Health Council (http://www.globalhealth.org/news/article/2086) U.S. National Library of Medicine and the National Institutes of Health:

Medline Plus (www.nlm.nih.gov/medlineplus/ency/article/001321.htm) World Health Organization (www.who.int/topics/schistosomiasis/en/)

References Centers for Disease Control & Prevention (CDC). (2008, February).

Schistosomiasis: Fact Sheet. Retrieved April 3, 2009 from http://www.cdc.gov/ncidod/dpd/parasites/ schistosomiasis/ factsht_schistosomiasis.htm.

Directors of Health Promotion & Education. (2005). Schistosomiasis. Retrieved April 5, 2009 from http://www.dhpe. org/infect/schisto.html.

Hawley, L. B. (2000). High Yield Microbiology and Infectious Diseases. Baltimore, MD and Philadelphia, PA: Lippincott, Williams and Wilkins.

Johnson, A.G.; Ziegler, R.J.; Lukasewycz, O. A and Hawley, L. B. (2002). BRS: Microbiology and Immunology (4th Ed). Baltimore, MD and Philadelphia, PA: Lippincott, Williams and Wilkins.

Kumar, V; Abbas, A. and Fausto, N. (Eds.).(2007). Robbins and Cotran: Pathologic Basis of Disease. Philadelphia, PA: Elsevier Saunders.

MicrobiologyBytes (Micro). (2007, January). Schistosomiasis. Retrieved May 1, 2009 from http://www.microbiologybytes.com/introduction/Schisto.html

References Cont. Moeller, D. W. (2005). Environmental Health (3rd ed.). Boston:

Harvard University Press. Madramootoo, C. A.; Johnston, W. R. and Willardson, L.S. (Ed.)

(1997). Management of Agricultural Drainage Water Quality. Rome: Food and Agricultural Organization (FAO).

Trevor, A. J.; Katzung, B. G. and Masters, S. B. (Ed. 7th). (2005). Pharmacology: Examination and Board Review. New York: Lange Medical Books / McGraw-Hill.

Wilson, W. R. and Sande, M. A. (2001). Current Diagnosis & Treatment in Infectious Diseases. United States: McGraw-Hill.

World Health Organization (WHO). (2009). Schistosomiasis: Epidemiology. Retrieved May 1, 2009 from http://www.who. int/schistosomiasis/epidemiology/table/en/index.html