1887

Abstract

Introduction. Schistosomiasis, a travel-related trematode infection, can cause a range of symptoms with potentially life-threatening complications. In this report, we describe an outbreak of schistosomiasis in a Scottish school group that had travelled to Uganda. We discuss the requirement for robust and accurate pre-travel advice, and the importance of raising awareness in travellers, particularly due to the asymptomatic nature of the disease. In addition, we highlight the need to submit a serum sample for laboratory testing on return from endemic regions where freshwater exposure has occurred.

Case presentation. A Scottish school group consisting of 19 individuals visited Uganda during July 2016 with one positive symptomatic case identified on return to the UK. As three of the individuals were not Scottish residents, their data were excluded from this report. Freshwater exposure was noted from taking part in activities which included swimming in the Nile. The Scottish Parasite Diagnostic and Reference Laboratory performed serology testing using sera from 16 Scottish residents to detect IgG towards Schistosoma egg antigens. Thirteen were positive despite only one case being symptomatic.

Conclusion. The high positivity rate raised several issues. These included the lack of a robust risk assessment by the travel company organizing the trip, the lack of awareness of schistosomiasis by some individuals, the lack of appropriate and accurate pre-travel advice, and the asymptomatic nature of the infection. This report provides supportive evidence to strengthen the need for improvements to prevent largely asymptomatic cases being missed in future.

  • This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Loading

Article metrics loading...

/content/journal/jmmcr/10.1099/jmmcr.0.005166
2018-09-25
2024-03-29
Loading full text...

Full text loading...

/deliver/fulltext/jmmcr/5/10/jmmcr005166.html?itemId=/content/journal/jmmcr/10.1099/jmmcr.0.005166&mimeType=html&fmt=ahah

References

  1. World Health Organisation Neglected Tropical Diseases. World Health Organisation Programmes; 2017 Available from www.who.int/neglected_diseases/diseases/en/ [accessed 29 November 2017]
  2. Meltzer E, Schwartz E. Schistosomiasis: current epidemiology and management in travelers. Curr Infect Dis Rep 2013; 15:211–215 [View Article][PubMed]
    [Google Scholar]
  3. World Health Organisation Schistosomiasis Factsheet [Internet]. World Health Organisation Media Centre; 2017 Available from www.who.int/mediacentre/factsheets/fs115/en/ [accessed 4 January 2018]
  4. World Bank Group Economic and Statistical Analysis of Tourism in Uganda. Washington, DC, (US), World Bank; 2013 Available from https://openknowledge.worldbank.org/handle/10986/16252 [accessed 31 October 2017]
  5. Alexander CL, Cottom L, Smith K, Perrow K, Coyne M et al. Schistosomiasis in Scottish travellers: public health importance of laboratory testing and the need for enhanced surveillance. J Public Health 2018; 40:138–145 [View Article][PubMed]
    [Google Scholar]
  6. Health Protection Scotland Establishment of the Scottish Schistosomiasis National Advice, Investigation and Liaison Group (SNAIL). HPS Weekly Report 2016 Available from www.hps.scot.nhs.uk/documents/ewr/pdf2016/1649.pdf [accessed 23 August 2017]
    [Google Scholar]
  7. Colley DG, Bustinduy AL, Secor WE, King CH. Human schistosomiasis. Lancet 2014; 383:2253–2264 [View Article][PubMed]
    [Google Scholar]
  8. European Centre for Disease Prevention and Control Local transmission of Schistosoma haematobium in Corsica, France. ECDC Rapid risk assessment 2015 Available from https://ecdc.europa.eu/en/publications-data/rapid-risk-assessment-local-transmission-schistosoma-haematobium-corsica-france-0 [accessed 09 January 2018]
    [Google Scholar]
  9. Redman C, Spence G, Smith H, Smith K. Travel medicine: Schistosomiasis in Scotland 2005-2009. HPS Weekly Report 2010 Available from www.documents.hps.scot.nhs.uk/ewr/pdf2010/1003.pdf [accessed 23 August 2017]
    [Google Scholar]
  10. Blach O, Rai B, Oates K, Franklin G, Bramwell S. An outbreak of schistosomiasis in travellers returning from endemic areas: the importance of rigorous tracing in peer groups exposed to risk of infection. J Public Health 2012; 34:32–36 [View Article][PubMed]
    [Google Scholar]
  11. Röser D, Bjerrum S, Helleberg M, Nielsen HV, David KP et al. Adventure tourism and schistosomiasis: serology and clinical findings in a group of Danish students after white-water rafting in Uganda. JMM Case Rep 2018; 5:e005141 [View Article][PubMed]
    [Google Scholar]
  12. Travel and International Health Team: Health Protection Scotland Travel Health Guidance For Schools Scotland (UK): Health Protection Scotland; 2013 Available from www.fitfortravel.nhs.uk/advice/general-travel-health-advice/school-groups.aspx [Updated 2017 August; accessed 25 April 2017]
    [Google Scholar]
  13. Lingscheid T, Kurth F, Clerinx J, Marocco S, Trevino B et al. Schistosomiasis in European travelers and migrants: analysis of 14 years TropNet surveillance data. Am J Trop Med Hyg 2017; 97:567–574 [View Article][PubMed]
    [Google Scholar]
  14. Grobusch MP, Mühlberger N, Jelinek T, Bisoffi Z, Corachán M et al. Imported schistosomiasis in Europe: sentinel surveillance data from TropNetEurop. J Travel Med 2003; 10:164–167 [View Article][PubMed]
    [Google Scholar]
  15. Munro J, Redman C, Smith K, Macconnachie A, Perrow K. A report on GeoSentinel data collected at the Brownlee centre for infectious & communicable diseases, April 2011–March 2013. HPS Weekly Report 2014; 48:571–582
    [Google Scholar]
  16. Yong MK, Beckett CL, Leder K, Biggs BA, Torresi J et al. Long-term follow-up of schistosomiasis serology post-treatment in Australian travelers and immigrants. J Travel Med 2010; 17:89–93 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmmcr/10.1099/jmmcr.0.005166
Loading
/content/journal/jmmcr/10.1099/jmmcr.0.005166
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error