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How to Avoid and Treat Schistosomiasis (Bilharzia)

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According to the Carter Center, “in terms of socioeconomic and public health impact, schistosomiasis, also known as bilharzia or snail fever, is second only to malaria as the most devastating parasitic disease in tropical countries.” 207 million people worldwide are infected with Schistosomiasis.

Thankfully, it is also one of the most avoidable diseases for travelers.

What is Schistosomiasis?

Schistosomiasis is a disease caused by a parasitic worm. It works as follows:

  1. An infected person passes the eggs of the worm into a water source via fecal matter.
  2. The eggs hatch and the larvae take up residence in fresh water snails.
  3. Inside the snail, the parasite begins to produce thousands of cercariae, tiny larvae that will then seek out a human host.
  4. The cercariae find their way to the skin of bathing or swimming humans (they are attracted to chemicals secreted by our skin).
  5. Once they penetrate the skin, the cercariae find a blood vessel and travel to the lungs, then the liver.
  6. At this point, the cercariae have become a worm and once they arrive in the liver, they will develop an oral sucker, which they will use to feed on red blood cells (not what you wanted to hear, we know).
  7. Different species of the worm will move to different parts of the body, some taking up residence in the bladder or kidneys. After feasting on your red blood cells for a period of 6-8 weeks, the worm will begin producing eggs.
  8. The eggs will make their way through blood vessels to the intestines where they will eventually leave the body as fecal matter.
  9. Some of the eggs will not make it out of the body. They will get trapped in blood vessels near the small intestine or they will end up back in the liver. It is then, as your body’s immune response is triggered to do battle with the eggs, that many of the symptoms of schistosomiasis will emerge.

Where is schistosomiasis (bilharzia) found?

Africa, the Middle East, the Caribbean, Brazil, Venezuela, Suriname, China, Indonesia, the Philippines, Several districts of Cambodia and the Lao People’s Democratic Republic.

What are the symptoms of schistosomiasis (bilharzia)?

schistosomiasis (bilharzia)Many of the symptoms are similar to giardiasis or amoebic dysentery. Like giardiasis, there are cases where schistosomiasis is largely asymptomatic with signs of anemia and malnutrition showing up over time. In some cases, acute schistosomiasis develops and causes abdominal pain, diarrhea, coughing, fever, fatigue, an enlarged liver and spleen and an elevated white blood cell count. Genital sores and papular dermatitis are also a possibility (papular dermatitis refers to the small pimple like bumps that occasionally form on the skin where the larvae enter the body – see the photo to the right). If acute schistosomiasis persists, fibrosis (the process in which an excessive amount of connective tissue forms) is possible in the affected organs.

Avoiding and preventing schistosomiasis (bilharzia)

– Avoid swimming in freshwater in countries where schistosomiasis is endemic (see above for countries where schistosomiasis can be found). In some cases, it is safe to swim in freshwater rivers, lakes and pools fed by waterfalls, but make sure to ask around in that area to find out if the water is free of schistosomiasis/bilharzia.

– If you do somehow have a monumental brain lapse and you find yourself swimming in a fresh water lake where schistosomiasis is present, get out as quickly as possible and use a towel to vigorously dry your body.

– Drink treated and purified water. Schistosomiasis cannot be caused by eating or drinking anything, but it’s possible for the larvae to enter in through your lips when you are taking a drink. Make sure your water is filtered and purified by either buying bottled water or treating water yourself. For information on treating and purifying water, see our article 4 ways to treat water when traveling or our steripen video review and demonstration (we recommend the steripen as the best water treatment option for travelers).

How to treat schistosomiasis (bilharzia)

If you are experiencing any of the above symptoms and you have recently been swimming or bathing in fresh water, you should go to a clinic for an official diagnosis. Treating schistosomiasis is incredibly straightforward. One single oral dose of praziquantel, an anthelmintic (anthelmintics are a class of drugs that rid parasitic worms from the body), is often enough. If you have acute schistosomiasis, a doctor may prescribe additional doses over time. Untreated, schistosomiasis worms will often live in the body for 4-4.5 years. It is thought that they can last up to 20 years in the human body. Let’s be thankful for praziquantel.

There are, however, instances where treatment is difficult due to ongoing infection. We have one reader that actually wrote about this experience here.

Have you had schistosomiasis (bilharzia) before? Or do you know someone that has? Let us know about it in the comments.

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{ 67 comments… add one }

  • Matt August 10, 2011, 10:20 am

    It’s fascinating to read about the life cycle of some of these organisms. It’s just amazing the way this thing has evolved. I’d be curious as to what the rate of infection is in these countries where it is endemic. I’m sure lots of people swim and bathe in freshwater in these countries so what are your chances of getting this?

    • admin August 10, 2011, 11:10 am

      The infection rate is relatively high in countries where it is endemic. The Carter Center considers it the second most destructive illness in tropical developing areas, in terms of socioeconomic cost: http://www.cartercenter.org/health/schistosomiasis/index.html

      The life cycle is really fascinating. Another one that blows my mind is guinea worm. It has evolved so that when it emerges from your body, it produces a very intense burning situation, so much so that you want to put the affected area in water to relieve it. Well, guess what? The guinea worm needs water to deposit its eggs. Very crafty stuff. Thanks for the comment Matt!

  • Maurice Diamond October 31, 2011, 5:58 am

    Hi Matt. After reading your post I though you might be interesting in reading my experience as someone living in Zambia. I live in an area where bilharzia is endemic and as I swim often, I often get infected. I currently self medicate with praziquantel every 6 months but after doing further research have realize that this may not be nearly enough. My last test (over a year ago) showed a heavy infection of 3 different species of the 5 tested for.
    I am aware that people living in endemic areas can be infected almost daily and probably should be treat every 6-8 weeks in line with the gestation period. With this in mind I would like to know what are the side effects of taking praziquantel often? I’m also looking for information on the most effective dosing plan?

    • phil October 31, 2011, 8:54 am

      Hi Maurice,
      Sorry to hear that re-infection has happened so often for you. Praziquantel has few side effects, but as far as long-term consequences of taking the drug often and a dosing plan, you should talk to your doctor. In my own research, there is not a lot of info on prolonged, long-term use of praziquantel.

  • martin bird April 27, 2012, 11:01 am

    I was diagnosed with long term untreated bilharzia this week. Diagnosis carried out by ultra sound finding scarring on various parts of my body. My question is as follows, how long can the body be infected with bilharzia for?

    • phil April 28, 2012, 7:13 am

      Hi Martin,
      Are you asking how long it will remain infected once treatment has started?

  • Nhlahla September 6, 2012, 11:41 am

    After urinating the little blood also comes, is it Bilharzia. Please help, it has been like this for more than 10 years.

    • phil July 27, 2013, 7:10 am

      This is definitely something that a doctor needs to address. It is very concerning that it has been going on for more than 10 years. If your current doctor or specialist is unable to make a diagnosis you need to get other opinions.

  • Susan July 26, 2013, 7:57 pm

    I contracted this in the Dominican Republic – I’ve just finished the round of antibiotics today, but I’m wondering how long it takes the sores and bumps to heal…

    • phil July 27, 2013, 7:11 am

      Hi Susan,
      It’s hard to say. A big factor is the extent of the infection and how quickly you started treating it. It will also be different person to person depending on your healing rate. If you’ve finished treatment, it shouldn’t be long – enjoy the fact that you are bilharzia free!!

  • Craig Forde September 19, 2013, 1:38 pm

    I travelled in Southern Africa in 1993 when I was a 19year old and hadn’t even heard of bilharzia. I swam daily in lake Malawi and contracted it. It was 10 years later that I mentioned to my doctor about some symptoms if been having for a while and wondered about bilharzia I was sent straight to Liverpool to the tropical medicines centre and was treated immediately. Symptoms gone.

  • Emil von Broembsen October 8, 2013, 9:17 am

    I have been diagnosed with bilharzia a week ago , I am sure I have had the parasit e for a very long time . They have put me on a drug called. BILTRICIDE 4 days ago ,I have never felt worse in my whole life,hope it is because of the drug killing the paracite.

    • phil October 9, 2013, 11:21 am

      Sorry to hear that, Emil, but Biltricide is what you want to be taking. As far as how long it will take to start feeling better that really depends on the nature of the infection and how long you have been living with bilharzia. Get well soon!

  • Emil October 19, 2013, 10:48 am

    Hi Phil, how long more or less does it take to get rid of the eggs in your system after you have been treated for bilharzia. Regards Emil

    • phil October 20, 2013, 6:43 am

      Hey Emil,
      Sorry I can’t provide a concrete answer again as this really depends on the extent of infection, how long it’s been in your system etc. Symptoms usually manifest specifically because of the eggs and not the worms so the presence of symptoms can be an indicator. Are you see an infectious disease specialist for this?

  • Emagee February 17, 2014, 2:47 am

    Dear Phil,
    I was diagnosed with the B-word on Friday, took Biltrizide – 5 tablets on Saturday & have to repeat the dosage in a week as we don’t know how long I’ve had it for – being in South Africa… wth??? Anyway, my symptoms include severe depression & anxiety with increased levels of adrenallin – increased pulse, sharp pains in upper left chest area etc, at first only thinking it was panic attacks. No results appeared on sonar. Is it really possible to have this thing killed if it is “chronic” and could one foresee some relieve of the symptoms following the medication? Thanks a plenty.

    • phil February 17, 2014, 6:37 am

      Hey Emagee,
      Sorry to hear this. Where were you in South Africa? You should definitely find some relief after this course of medication. As far as reoccurrence of symptoms that really depends on the extent of the infection. The good news is that now that you have had a proper diagnosis, even if the disease is not entirely eliminated, you can manage it. Even if it is just an annual dose of praziquantel, which is the active agent in biltricide. I assume you are receiving proper medical attention for this? You will have to follow up with your doctor and see how things progress. Best of luck to you and I hope the infection is eliminated in the first rounds of treatment!

      • Emagee February 17, 2014, 9:34 am

        I’m from South Africa, unfortunately I have no idea where I could have contracted it nor when as we are familiar with some of the lesser good our water is here. I don’t feel any change in my symptoms as yet but it’s only been two days now. My Dr is on the case yes. My wish too – I’ve felt like this the good part of 3 months now and is so looking forward to recovery & complete health. Any further info you can share with us?

  • Tami Wilson-Deffenbaugh June 27, 2014, 3:24 pm

    I believe I have 2 or more of the schistome species. I see them everyday in my stool , urine, and my blood during menestration. I find the eggs and skin that are shed in my stools. I have been taking samples and pictures for 3 years now. I have no insurance and the one doctor I do see for pain tells me I’m fine and that I do not look sick. I’ve taken eggs to his office and use this as anything. I’m at a loss but you do you have children I have a husband. Nobody seems to care. Except for my four-year-old when I cry. You’re anybody out there that can help me direct me

    • phil June 28, 2014, 5:24 am

      Hi Tami,
      Have you seen our latest post on this topic? I think you may find it very relevant. It’s about ongoing schisto infection and the difficulty of finding proper diagnosis and treatment. You can read it here: http://sickontheroad.com/2014/06/26/ongoing-schistosomiasis-infection-difficulty-finding-treatment/ It was written by a woman who has been dealing with ongoing schisto infection and she may have many of the same frustrations as you. I am very sorry to hear about your situation in any case, and I hope you are able to find thorough and comprehensive treatment, I’ve recommended to people in the past traveling to a tropical developing world country where you can often find cheaper medical care and the doctors are already familiar (VERY familiar) with schisto.

    • Erika Klemas July 29, 2017, 2:51 am

      Hi Tammy,
      I’m curious if you have found any help? I have been dealing with similar issue for1 year without proper diagnosis. I have taken pictures and video and recently traveled out of the USA to South America to seek help. The issue is that regardless of my pictures and video, my samples come negative for parasites. I only had one become positive and was for a microscopic parasite. I continue to expel this things in my urine and stool. I am very discouraged because doctors in the USA look at me like I am crazy after I have had colonoscopy, endoscopy and other studies not showing evidence. Any advise?

  • shitu July 28, 2014, 1:44 pm

    I am a Nigerian,i contracted d disease from my viillage when am abt 15 yrs,now am 25,i went to d hospital and my doctor prescribe praziquantel for me,i av finished usin d 10 tablets abt a wk ago bt yet am still seeing blood after my urine,secondly,d growth of my penis av been affected wen i was growin,now my penis is small,can diz drug also help to make my penis grow like it suppose to be? Or what can i use to help it grow like d normal size ?

    • phil July 28, 2014, 5:06 pm

      Hi Shitu,

      Unfortunately, we don’t have any information on that. If the round of treatment did not succeed, you should return to the doctor and explain the situation. This is a disease that is known for recurring infection and it can be difficult to snuff out even after several rounds of treatment, depending on the extent of infection.

  • shitu July 28, 2014, 7:50 pm

    But is it adviceable for me to use enlargement drug? Secondly my penis is 4.8 inches wen erect n am sure its bcos of schistosome,what is d average lenght of penis wen erect? And can i perform sex or rather enjoy sex wt this?

  • Johien van Niekerk August 22, 2014, 2:58 am

    I am suffering from a heavy feeling on my bladder and a urge to go to the toilet very often and from time to time, say twice a year my body aches all over. After consulting a doctor and blood tests. The answer was that that the wall of my bladder is thickened and can only hold a little volume of fluid. The blood test showed that I had bilharzia. My question – can bilharzia die or disappear on its own?

    • phil August 22, 2014, 4:27 am

      We have not heard of cases of bilharzia dying or disappearing on its own. It’s best to follow the prescribed courses of treatment.

  • lilpee October 20, 2014, 5:24 pm

    Hi,,is it true that,if you don’t get treated for bilharzia, it will damage your sexual reproductive system??

  • Sue November 6, 2014, 5:10 am

    My daughter had her appendix removed 9 yrs ago, which they found in her appendix snail fever, they done urine and stool test, which showed nothing, so she was never treated, for the last 5 yrs she has been getting very un well, ever test they do don’t show anything, she has all the symptoms off a tropical dieses, but bloods test, say she hasn’t, she has had raised white blood cells for 9 yrs now, we are going to see a rheumatology next week, to see if they can find out what is wrong with her, but my question is, could she still have snail fever, even though test are not showing anything ?

    • phil November 13, 2014, 3:42 am

      Hi Sue,

      We have heard of multiple people having recurring infections, but as for hiding from test results that is another question, and one that we are not qualified to answer. Your best bet is a tropical infectious disease specialist. I hope she is able to have a complete recovery as soon as possible !!

  • Tracy November 12, 2014, 7:39 pm

    Hi I have been freaking out since I found a maggot like worm come out of my uretha. I am on what’s suspected as my 3rd uti in 6-8 wks when I never suffered at all before. I have been wiping blood after I pee for 2 wk’s now. Because of what I found I searched the Internet and found Schistosomiasis. I saw my doctor today and explained all my symptoms point to this I threw the freaky thing down the toilet but she took me seriously and has put me in for an urgent ultrasound and I had bloods taken. I have been checking my pee ever since to no avail but this evening found a smaller greyer looking thing in the pan so have scooped it up and will present to my doctor tomorrow morning. I have never visited a tropical country but went to marmaris Turkey 4 yrs ago and swam in a few freshwater lagoons so can only conclude it must have been from there. If I am diagnosed with this and have had it for 4 yrs will it have caused damage to me internally and how quickly will I be rid of this disgusting parasite? I feel so alone right now and grossed out so appreciate your time and response.

    • phil November 13, 2014, 3:45 am

      Hello Tracy,

      It is difficult to provide a definitive answer to your question, unfortunately. If you do indeed have schisto, each case is different and the level of infection depends on multiple factors, not just the duration. Is your doctor a tropical disease specialist? I would try to get with one as quickly as possible. The good news is that it is possible to completely treat schisto, but in some cases, especially with long exposure, multiple rounds of treatment are needed. We wish you all the best, and we hope you have a speedy recovery.

  • Henk November 18, 2014, 12:56 am

    Hi, I am 28 years old and have been treated for Bilharzia with Biltirizide about 6 months ago, since the treatment I have been suffering from abdominal pain, and feeling I have to go to the toilet all the time. I have been to the urologist and had a cystoscopy and they could find nothing. I want to know if it is normal for it to take so long to heal. I also have sudden episodes of high urine volume for about 3 hours then it subsides. Did anybody else suffer after treatment? And how long did it take to get better. One of the doctors told me it is because the eggs is coming out and causing inflammation.

    • phil November 18, 2014, 4:31 am

      Hi Henk,

      This is the biggest problem with schisto treatment. Times of recovery and amount of treatment required vary with the level of infection, and no two cases are the same. This is why it’s difficult to say whether your progress is stunted or if you are simply going through some normal ups and downs of recovery from a heavier infection. I assume you are seeing a tropical disease specialist as opposed to a gp? If you feel like the treatment is not working or going too slowly, feel free to seek a second opinion from a different specialist. Unfortunately, in an online forum like this it is difficult to get the answers you need as schisto manifests differently depending on multiple factors.

  • abbey March 7, 2015, 4:18 am

    I have been diagnosed with schistosomiasis haematobium . I wish to know what praziquantel does to eggs of the worms? Do they die ? and why do body shows tingling sensations on body due to this infection?

  • jack March 31, 2015, 10:34 am

    hi . i have been infected with bilharzia for over 8years and i went to the clinic for treatment bat the doctor just told me to buy praziquantel and i don’t know how many dosed to take my question is that how many dosed can i take at my age 20 years

  • alan May 19, 2015, 4:38 pm

    is it safe to take praziquantel as a precaution/preventative in your opinion?

  • Dak gatpan July 15, 2015, 5:46 am

    Can bilharzia also be contacted throught sexual contact with infected person ?

  • lovemore kanyayi November 4, 2015, 3:00 pm

    hi am above 6 years with this disease . i was treated several times with praziquantel 3-4 times changing the dosages but didnt cure me, can u help

  • Farhana Mahomed March 1, 2016, 5:40 am

    I’m in South Africa ,my 12 year old son has been diagnosed with Bilharzia. We haven’t been to any dams, lakes or rivers yet he has this. Where could he have gotten it from I’m really worried .He has been given his 1 dose of 4 tablets. I will be doing a follow up in 2 weeks but I really need to know how his gotten it, I have two other kids .

    Thank You

  • Andrew March 3, 2016, 9:06 pm

    Are there any ways to pass on the infection one human to another (other than as u mentioned, indircectly defecating in rivers that thers later swim in)?
    I am wondering more sexual intercourse? Sneezing/ coughing? Sharing drinks?

  • Wale akande March 30, 2016, 11:08 pm

    Hi, I was diagnose of klebsella disease, or infection and zinnat was prescribed for treatment, but I discover that I was cured but my penis becomes weak every hour the more I use any drug but reading through this page I realise that there was a day I saw snail on my penis cos I was lying naked on my bed and it was just moving around my penis and ever since I always smell the odour of snail on my penis my question is is this not an infection caused by this snail and how can I treat it I need your professional advice.

    • phil April 1, 2016, 7:17 am

      hi Wale,
      You will not be able to be infected with schisto in this manner, even if you did see a snail. I would implore you to visit a doctor and receive a proper diagnosis.

  • Jackie May 16, 2016, 1:20 am

    I went on a Carnival Cruise and went cave tuning in Belize. I know this is where I contracted Schostosomasis 7 years ago.
    I became deathly ill 2 months after the trip and my Dr thought it was Gallbladder. They took out my Gallbladder and I NEVER got better. I have seen multiple specialists in Urology, Infectious Disease, GI, Neurologists, Healers. and the list goes on. I lost all joy of life and lived in constant fatigue and agony. My legs turned purple and mottled. I urinated blood and twig looking substances frequently. I was diagnosed with Interstitial Cystitis and had multiple bouts of Kidney infections leading to multiple bouts septicemia and was near death on several occasions.
    Nobody could figure out what was wrong. I have been on Antibiotics for 4 straight years.
    After 7 years of debilitating pain and exhaustion, recurrent infections, decreased immunity, and decreased overall function, and living Hell I finally came across a Utube video of a Urologist speaking at a conference to other Urologists. He says always rules out Schistoaomasis before diagnosing with Interstitial Cystitis….because misdiagnosis can be deadly. I immediately went to my Dr to be tested. He did the Antigen/Antibody test…and said he would faint if it was positive. It was positive and my doctor had never heard of it. He gave me the recommended dose of 20mg Kg…taken every 4-6 hours X’s 3. So….1 day of pills of 7 years of agony. I treated 2.5 months ago….my symptoms got worse for 6 weeks and I am at long last starting to feel better. I will probably retreat one more time because infection was so severe and so long. Good-luck everybody and thank you for spreading the word.

    • phil May 16, 2016, 5:06 am

      Hi Jackie,

      So sorry to hear about this, but also very glad that you got correct treatment in the end!!! UNfortunately, this is an illness that is far too often misdiagnosed. Wishing you the best of health and a continued recovery.


      • Isaac September 14, 2017, 1:52 pm

        Hey Jackie, what is the “20mg Kg” U referred to?

  • Edmond September 15, 2016, 8:03 am

    Hi,pls was see blood in my urination,but it stoped and started experiencing white fluid after urinating..and it lead to sexual weakness..I have been ti the hospital for all the laboratory text cos I thought it was a sexually transmitted disease..but all the the proved am negative..even though they have been given me medicine afterwards,I still experience the same problem..can I use Bilricide or can you prescribe any preferable drug for me..thanks

  • Cathy October 18, 2016, 3:22 pm

    I was in Jinja Uganda six weeks ago. We white water rafted in the Nile river and did get out of the boat and swim at one point. I developed an itchy hive like rash on my arm that lasted two weeks. I am worried that I may have schistosomiasis, although I have no intestinal problems or any other symptoms at this point that I am aware of. Is it possible for me to see the actual worms/larva in my stool or is it only eggs that can be detected with a microscope? I think I am seeing tiny tiny white worms in the toilet but can’t find any literature that says you can and visually see larva in your stool.

  • Abass Amoako November 7, 2016, 6:52 am

    pls I have been diagnosed of bilharzia in Ghana and I was given double dozes of praziquantel to treat it. Bt im having severe pains in my penis, yellow urine and general discomfort for one week now since I took the drug. im really suffering. please help me out . what should I do

  • Am bikooh December 12, 2016, 12:50 am

    hi phyl …am 23years ..from Kenya its two days that I felt sick…I had a fever..some pichy sweats ,headaches, muscle pain and abdominal pain and tiredness followed by dizziness…wanted some inquiries ..am I infected with bilharzia??

  • Precious Mbanda December 18, 2016, 12:46 am

    I am experiencing diarrhoria mostly in the morning, urinating redish urine, have fatique, abdominal pain somtimes 8 weeks ago i went to the wheretthere were huge amount of people. Can it be bilhazia!?


  • TW December 20, 2016, 7:21 am

    I am a photographer and I have schistosomiasis and likely another helminth, have been treated with good results. It is not a sexually transmitted disease as the infective stage of the larvae must first be in a snail to develop into the stage where it can infect a human. The adult worms which grow in you are a fixed number of worms from a single infection from comtaminated water, which can include taking a shower in some places or drinking the water. If the water has the infective larvae, you can contract the disease from any bodily exposure. The biltricide kills the adult worms, but not all the larvae and the eggs can also still cause inflamation for many months, but once the adults are dead, your symptoms will deminish over time. But repeat dosage of Biltricide is often required because sometimes adults will not all die from one treatment. As long as you are not re-exposed, you will not get sick again, but there are other helminths that can cause similar symptoms, like hookworms and many others. These parasites are oftern hard to diagnosis and it can be so frustrating.

  • TW December 20, 2016, 7:28 am

    To continue… Anyone who thinks they may have a travel disease needs to go to a travel clinic, period. You cannot see the eggs or larvae with the naked eye, so doctors who know this will think you are imagining seeing them, it requires special photography to both photograph and enlarge images enough to see the critters/eggs and you have to know absolutey for sure what they look like, so you need to depend on a lab. Stool samples are inconsistant, blood tests are best, but there are newer, more reliable test.

  • TW December 20, 2016, 8:13 am

    More… Bilharzia can cause terrible back pain, eggs go through the mesenteric artery through the spine at the T12-L1 level, eggs cause a tranverse myelitis or inflamation of the spinal cord there, they travel to the outside of the intestines from the mesenteric artery causing inflamation of the intestines, eggs travel even to the brain and larvae as well, they cause damage to your arteries, vasculitis, but many things do this as well, so getting proper workups are required, get tested once a year for say 3 years to be sure, then if negative, consider other options. Eggs and larvae get into everything, muscles, sometimes joints, causing inflamation and pain, but this will go away in time once no more eggs are being laid by adults, but they can live in you for 5 to 25 years, no one really knows for sure how long they live, depends on species I suppose.Sonagram of liver may show something. Go to a travel clinic! Also, the adults cause little symptoms, but can cause anemia if there are enough of them, stages of larvae also use blood, if you have a heavy infection, you will be anemic. Immune response to helminths sometimes cause the body to produce high ferritin, which causes iron to load into the spleen, the body’s way of starving the parasite of the iron it needs to flourish, not that this does much for you, but ask for a ferritin panel when getting blood work done, if high, maybe you have a parasite, this will in time cause your spleen to go bad, swell. But all these markers on a complete blood count simply point to a cause, does not usually identify the cause, so you need an experienced, knowledgeable physician and if they are not friendly, do not look you in the eye, take the time to reasure you, run out the possibilities, change your doctor, find one that will check it all out. If you have the travel or have lived in, do live in an endemic area for parasites, you may well have them, but schistosomiasis will eventually kill you after making you less than healthy for decades. but they eventually die, but they can do a lot of damage and make you sick or kill you before they get old enough to die. Key sympotms are eye pain, mid/low back pain, leg pain, vasculitis, white scale on the feet, lower leg rash, nails start to separate and flake, this is the larvae coming out of the nails, makes the nails look dirty underneath them, if you clean them and they get dirty without touching anything and they are crumbling, get it looked at by a dermatologist that knows about the condition, which usually is a doctor from an endemic area, otherwise you will just be frustrated. Once treated you will improve, but may take up to a year for symptoms to resolve, stay out of questionable water, if you travel, boil all water you drink, use same boiled water to clean yourself, do not trust tap water in countries where the parasite is known to be there. If you have the exposure, symptoms, ask for propholictic treatment with Biltricide, 2 treatments. But blood tests for the antigen is the only good method, stool sample is the gold standard, but in long term disease, eggs may be hard to find, requires serial stool exams. I have been through all of the problems, including physicians labeling you as a mental case, which of course is always possible, who would not be a little nuts if they have this terrible disease, so do not get too crazy about it, just get the bloomin tests! But one or 2 negitive tests are not good enough, but 3 negative tests, look for someting eles. Enough said!

    • phil December 20, 2016, 8:54 am

      Hi TW,

      Thanks for all of this valuable information. I would encourage everyone to heed the advice that you have shared.


      • lindie November 16, 2017, 1:30 pm

        i can really relate with this person, been ill for a long period Dr’s didnt know what was wrong, had a historectomy, was told it is depression, but i knew something else was wrong, Gynaecologist suggested a Bilharzia test, and it was positive, my symptoms was, Lowerback paid, funny taste in the mouth, tiredness, forgetfull, high stress levels, heavyness in breathing….. was a mess, was treated and felt much better after a month, went very well for a view months like crazy good i was n new person, tested again after a view month only with urine, it was negative, but now 4 months after the last test, my lover back pain again, funny taste in the mouth again and pressure on my chest…. so im going to test again tomorrow. do i only need a urine test, should i go for a kidney test….. just so sick and tired of this….what if the test is negative and i still feel terrible….. oh im from South Africa Pretoria, think i had it for a view years. im 46.

        • marli December 11, 2017, 3:07 pm

          Lindi….also from Pretoria. 49. same symptoms…

  • diane February 26, 2017, 9:53 pm

    Hi! I haven’t seen a doctor yet for a check-up but I guess am infected with the disease. I have researched about symptoms of schistosomias and some of it I am feeling right now like frequent urination and itching, and sometimes I feel like there’s something moving inside my body. I don’t know but this is only my presumption and it makes me worried. I really need to see a doctor soon to be sure what really is this.

  • Jeff March 23, 2017, 6:38 am

    After two month of antibiotics due to miss diagnose to sexually transmitted diseases i tested positive on schistomiasis.

    Been suffering from blihazia (haemotobium) am now on praziquantel .. had mis dosed on week one and two.. and now on the 40kg weight..its jus too much pain daily in the penis i
    Will defiantly repeat the dose for sometime then get tested.

    Hope to recover soon

    • Elvis Asiedu September 20, 2017, 3:58 pm

      What is 40 kg.I bought the madicine but each contains 600 mg prazi. So how can I take 40mg. Thanks

  • Gyimah Shadrack May 26, 2017, 4:31 am

    I treated mine for about 15 years but no sign of improvement. I had been in big hospital but yet it is not cureable .please can it lead to death .

  • Gyimah Shadrack May 26, 2017, 4:37 am

    Hi i am 31and diagnose with bilharzia but i treated it but it is çureble .what should i do

  • Nick September 10, 2017, 4:31 am

    Good day, I noticed blood in my urine and after doctors diagnosis I was given praziquantel and gramocef – cv I have finished the praziquantel but still notice the blood in my urine…

  • Isaac September 14, 2017, 2:03 pm

    Is bilharzia/schistomiasis related to Mansonella perstans and if so is Doxycycline for 30 days or 6 week a possible treatment for the worms and/or eggs?

  • Barns October 29, 2017, 3:38 am

    Very grateful for this website. Very few sites discuss or mention recovery. They are all quick to point out the treatable nature of the illness leaving you hopeful of a very quick or immediate recovery. This is simply not the case. Would be really helpful to mention time to wellness, even if it’s a function of the extent of the infection. Thanks again to you and your contributors. Wishing good health to all those infected.

  • Lucy Montgomerie January 5, 2018, 1:17 pm

    I was very excited to find this website…there seems to be a lot of mis-information around concerning Bilharzia. I can tell you reliably that it can stay in your body for at least 20 years as I caught it in Kenya 20 years ago and only discovered that I still had it two weeks ago…! I assumed it had gone but in retrospect I have had some of the symptoms on and off over the last 20 years, and never understood why my immune system was always so compromised. The good news is I actually felt a bit better the day after I took the Praziquantel (possibly as I had felt so entirely ropey beforehand, more or less forever…!) so hang on in there…
    Also, maybe unrelated, but I had to stop drinking as I was getting horrendous hangovers from very small amounts of alcohol..has anyone else had this huge misfortune?!

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