Efficacy of Praziquantel During the Incubation and Invasive Phase of Schistosoma Haematobium Schistosomiasis in 18 Travelers

Grandière-Pérez, L.; Ansart, Séverine; Paris, Luc; Faussart, Alexandra; Jauréguiberry, Stéphane; Grivois, Jean-Philippe; Klement, Elise; Bricaire, François; Danis, M.; Caumes, Éric

doi:10.4269/ajtmh.2006.74.814

Cited by 81 publications

(68 citation statements)

References 22 publications

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“…Physicians should also be reminded that the pre-patent period of the infection, during which serological tests are still negative, may last for more than three months [11] and that seroconversion such as assessed by Western blot could be delayed when compared with the results provided by ELISA or IHA screening tests.…”

Section: Resultsmentioning

confidence: 99%

Evidence for a permanent presence of schistosomiasis in Corsica, France, 2015

et al. 2016

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We present a case of acute schistosomiasis acquired in Corsica after bathing in the Cavu River during the summer of 2015. The diagnosis was made following epidemiological, laboratory and serological assessments. After a previous outbreak of urogenital schistosomiasis during the summer of 2013, when more than 120 infections were diagnosed, this further case indicates transmission was still effective in 2015, thus suggesting a permanent presence of schistosomiasis in Corsica.We report a case of schistosomiasis acquired in 2015 in Corsica, indicating that permanent transmission of this helminthiasis has been established on the island. Case descriptionOn 11 September 2015, a person in their 40s presented to the Consultation Board at the Infectious and Tropical Disease Department of Toulouse University Hospitals in France with a 15-day history of diffuse abdominal pain, headache and asthenia. The patient had no fever, and physical examination was unremarkable. In particular, the patient neither displayed any skin rash nor complained of pruritus. The white blood cell count was 6.0 × 10 9 /L, within the normal range (4.0-10.0 × 10 9 cells/L), but a blood eosinophilia (3.2 × 10 9 cells/L, normal range: < 0.5 × 10 9 cells/L) was observed by differential count. Biochemical tests of liver function found several abnormalities, namely a serum alanine aminotransferase level at 140 UI/L (normal range: 0-40 UI/L) and a gamma-glutamyl transferase level at 323 IU/L (normal range: 0-60 IU/L). Aspartate aminotransferase and total bilirubin levels were within the normal range. C-reactive protein was 11.7 mg/L (normal value: < 5 mg/L).By serology, the patient tested negative for cytomegalovirus, Epstein-Barr virus, hepatitis A, B and C, and Leptospira infections. Serodiagnostics of ascariasis, alveolar and cystic echinococcoses, fascioliasis, filariases, strongyloidiasis, trichinellosis and schistosomiasis were negative. The ELISA result for schistosomiasis (expressed as a ratio), although negative with a ratio of 0.770, was close to the cut-off value of 1.0. Schistosomiasis serology relied upon commercial ELISA kits (Bordier Affinity Products, Crissier, Switzerland) and indirect haemagglutination assay (IHA) (Fumouze Diagnostics, Levallois-Perret, France), which are both screening tests using Schistosoma mansoni extracts as antigen.Because an aetiological diagnosis was not reached, the patient attended a further consultation on 24 September. The clinical picture remained unchanged, but blood eosinophilia decreased to 2 × 10 9 cells/L. By that time, specific laboratory examinations for urogenital schistosomiasis had been carried out because of the previous ELISA result and also because the patient informed us of their vacation in Corsica in summer 2015. Urinalysis was normal, and microscopic search for Schistosoma haematobium eggs remained negative. Serology was positive, with an ELISA ratio of 2.65 (cutoff: 1.0). The IHA result (expressed as a titre of dilution) was 160 (cut-off: 160). These results were checked by a commercial West...

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Section: Resultsmentioning

confidence: 99%

Evidence for a permanent presence of schistosomiasis in Corsica, France, 2015

et al. 2016

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“…No adverse reactions were recorded in any case. This is in contrast to other series and may reflect either use of a lower dose of praziquantel or failure to report or record adverse reactions 6,9,[11][12][13] ; only nine were prescribed steroids, which may have been caused by the relatively mild nature of the symptoms experienced by this cohort of patients.Over half were seen for follow-up and 41% of these were given a second dose of praziquantel to treat any residual schistosomes. Forty-six did not receive a second dose of praziquantel, mainly because they did not attend.…”

mentioning

confidence: 46%

Acute Schistosomiasis in Travelers: 14 Years' Experience at the Hospital for Tropical Diseases, London

Logan¹,

Armstrong²,

Moore³

et al. 2013

The American Journal of Tropical Medicine and Hygiene

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Abstract. We report 79 cases of acute schistosomiasis. Most of these cases were young, male travelers who acquired their infection in Lake Malawi. Twelve had a normal eosinophil count at presentation and 11 had negative serology, although two had neither eosinophilia nor positive serology when first seen. Acute schistosomiasis should be considered in any febrile traveler with a history of fresh water exposure in an endemic area once malaria has been excluded. Acute schistosomiasis was first described in 1847 in the prefecture of Katayama, Hiroshima district, Japan.1 Women brought to the region to be married were found to become acutely unwell with a fever after they had been exposed to fresh water. Acute schistosomiasis, or Katayama fever, is classically seen among travelers to regions where the disease is endemic. It is thought to be an immune-complex phenomenon, precipitated by the onset of egg-laying by newly matured adult female schistosomes. This occurs between 2 and 12 weeks after exposure 2 ; the syndrome is seen almost exclusively among people who have no history of previous exposure to the infection. The symptoms of Katayama may include fever, cough, an urticarial rash, and diarrhea, with an elevated eosinophil count as a characteristic laboratory finding 2 ; not every individual will have all of these. We report the clinical and laboratory features of acute schistosomiasis among 79 travelers who presented to the Hospital for Tropical Diseases (HTD) in London between 1998 and 2012.Acute schistosomiasis is often a clinical diagnosis at the time of presentation and may only be confirmed later in the illness once a serological test has had time to become positive. We therefore defined cases according to the following five predefined criteria, with each case fulfilling all five.1. Presence of at least one: fever, cough, rash, diarrhea. 2. A recent history of fresh water exposure in an area where schistosomiasis is endemic. 3. Positive schistosomal serology, either at presentation or follow-up. 4. Raised eosinophil count at some point during the illness. 5. Symptoms not attributable to any other condition.Cases were identified from three sources: a database of schistosomiasis cases and two prospective databases of both inpatients and outpatients seen at HTD. Clinical notes and laboratory data were reviewed using a standard proforma.Time from exposure to symptoms was taken as the first date of potential exposure to the date of symptom onset. Laboratory results were obtained from the appropriate clinical laboratories in University College London Hospitals. The schistosomal serology is an "in-house" enzyme-linked immunosorbent assay (ELISA) detecting antibody to Schistosoma mansoni soluble egg antigen; once positive this test may remain so for years despite successful treatment. Positive results are reported as levels (bands of optical density from 1 to 9) with a result of one or more regarded as positive. 3 The serology test has a sensitivity of 96% for S. mansoni and 92% for Schistosoma haematobium, whereas t...

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“…Praziquantel is not effective during AS and, as described in our second patient, is associated with worsening of signs and symptoms in 40% of cases. 17 In addition, praziquantel does not prevent the chronic phase of the disease. 17,18 Instead, corticosteroids are the recommended treatment of severe complications occurring during AS.…”

Section: Discussionmentioning

confidence: 99%

“…17 In addition, praziquantel does not prevent the chronic phase of the disease. 17,18 Instead, corticosteroids are the recommended treatment of severe complications occurring during AS. 19 Obviously corticosteroids might attenuate the cardiac and neurologic toxicity of eosinophils and immune complexes and also the hypersensitivity reaction to parasite toxins and surface antigens.…”

Section: Discussionmentioning

confidence: 99%