Rural tourism: a risk factor for schistosomiasis transmission in Brazil

Abstract

This paper reports an outbreak of acute schistosomiasis among 38 tourists who rented a country house in the district of Igarapé, the metropolitan region of Belo Horizonte, Brazil, during a holiday period in 2006. A total number of 32 individuals were positive for Schistosoma mansoni. Results of stool examinations revealed individual S. mansoni egg counts per gram of faeces (epg) ranging from 4-768 epg with a geometric mean egg count of 45. The most frequent clinical symptoms were abdominal pain (78.1%), headache (75%), fever (65.6%), dry cough (65.2%) and both diarrhoea and asthenia (59.4%). A malacological survey of the area, where 22 specimens of Biomphalaria glabrata were collected, revealed three (13.6%) specimens eliminating Schistosoma cercariae. This investigation re-confirms a recently described pattern of schistosomiasis infection, resulting in the acute form of the disease and connected to rural tourism, which contributes to the spread of the disease among the middle-class and into non-endemic areas. The lack of specific knowledge about acute schistosomiasis among health services causes an increased number of unnecessary diagnostic procedures and delays in accurate diagnosis and treatment, resulting in considerable discomfort for the patients

Turismo de risco em áreas vulneráveis para a transmissão da esquistossomose mansônica no Brasil

“…However, in order to enjoy the environments and attract and accommodate visitors, natural landscapes have been modified, harming environmentally fragile areas 4 . These modifications, imposed on natural spaces and caused by the real estate speculation from tourism's dynamics, expose both the local population and visitors to the risk of acquiring diseases, including schistosomiasis mansoni 5,6,7,8,9,10 .…”

The Pampulha reservoir remains a potential urban focus of schistosomiasis mansoni in Brazil: changes in the occurrence patterns of Biomphalaria species and a new record of the parasite

“…Human cases of schistosomiasis have been registered in the metropolitan region of Belo Horizonte, including recent outbreaks related to rural and ecological tourism 3,[47][48][49][50] . Although the Pampulha reservoir remains a place for recreational activities, its contribution to maintaining the prevalence of schistosomiasis in Belo Horizonte is low given that its poor water quality discourages people from coming into contact with it.…”

“…However, in recent decades, mainly due to human migration, a change has occurred in the transmission pattern of this parasite, as observed in different metropolitan areas of the country [2][3][4][5] . With the goals of eliminating active transmission foci and preventing outbreaks of schistosomiasis in urban areas from Brazil, the monitoring of molluscan transmitters of Schistosoma mansoni Sambon, 1907, is an important aspect of epidemiological surveillance of the disease 6 .…”

“…However, the latest published information dates to more than two decades ago; thus, an update is required. 3 , with a maximum depth of 13.3m and a perimeter of 14km. This reduction has primarily resulted from silt accumulation, mainly due to the discharge of untreated sewage into the reservoir, which since the 1970s has contributed to the current state of eutrophication, and phenomena such as algal blooms and the proliferation of aquatic macrophytes are commonly observed [18][19] , factors that contribute to the establishment of high densities of snails in this water body.…”

The Schistosomula Tegument Antigen as a Potential Candidate for the Early Serological Diagnosis of Schistosomiasis Mansoni

“…If schistosome infections could be detected before the egg deposition in the host tissues, chemotherapy could be effective and the development of severe pathologic lesions in host tissues could be prevented 6,7 . It is therefore imperative to have a straightforward, low-cost assay capable of detecting the initial phase of the infection, which can be used in the field and/or for the increasing number of travelers and the floating population.…”