Schistosomiasis in European Travelers and Migrants: Analysis of 14 Years TropNet Surveillance Data

Abstract

Schistosomiasis remains one of the most prevalent parasitic diseases worldwide and the infection is frequently found in travelers and migrants. The European Network for Tropical Medicine and Travel Health conducted a sentinel surveillance study on imported schistosomiasis between 1997 and 2010. This report summarizes epidemiological and clinical data from 1,465 cases of imported schistosomiasis. Direct pathogen detection and serology were the main diagnostic tools applied. Of these, 486 (33%) cases were identified among European travelers, 231 (16%) among long-term expatriates, and 748 (51%) among non-European immigrants. Overall, only 18.6% of travelers had received pretravel advice; 95% of infections were acquired in the African region. On species level, was identified in 570 (39%) and in 318 (22%) cases; 57.5% of patients were symptomatic. Acute symptoms were reported in 27% of patients leading to earlier presentation within 3 months. Praziquantel was used in all patients to treat schistosomiasis. Many infections were detected in asymptomatic patients. In 47.4% of asymptomatic patients infection was detected by microscopy and in 39% by serology or antigen testing. Schistosomiasis remains a frequent infection in travelers and migrants to Europe. Travelers should be made aware of the risk of schistosomiasis infection when traveling to sub-Saharan Africa. Posttravel consultations particularly for returning expatriates are useful given the high potential for detecting asymptomatic infections.

Neglected tropical diseases in Europe: rare diseases and orphan drugs?

“…The migration from low-income countries to Europe, as well as international travels, are making these conditions more and more frequent nowadays even out of endemic areas [3,4], but the European health systems are far to be prepared to face these increasing challenges.…”

Tropische Infektionserkrankungen bei schwangeren Migrantinnen in Deutschland

“…In 2016 more than 700 000 asylum requests were registered in Ger- [17]. In einer amerikanischen Publikation aus 2015 lag die Bilharzioseprävalenz bei Migranten aus Afrika bei 6 % [5].…”

Macroscopic hematuria: A rare etiology in western countries

“…Although schistosomiasis is one of the most prevalent parasitic diseases worldwide, the infection frequently being found in travelers and migrants, its recognition may be delayed as patients may either be asymptomatic 1 or present symptoms, especially with regard to localization in the bladder, in a similar way to other infectious diseases. 1 The European Network for Tropical Medicine and Travel Health carried out a sentinel surveillance study on imported schistosomiasis between 1997 and 2010; in summary: of the 1,465 cases of imported schistosomiasis, direct pathogen detection and serology were the main diagnostic tools applied: one-third of the cases were identified among European travelers, and one half among non-European travelers.…”

“…Acute symptoms were reported in 27% of patients leading to earlier presentation within 3 months. 1 Clinical presentation is sometimes challenging, especially in its early phases when clinical signs and symptoms are poor and overlap with other diseases. For this reason we believe that the case we present is worth reporting.…”

“…1 The European Network for Tropical Medicine and Travel Health carried out a sentinel surveillance study on imported schistosomiasis between 1997 and 2010; in summary: of the 1,465 cases of imported schistosomiasis, direct pathogen detection and serology were the main diagnostic tools applied: one-third of the cases were identified among European travelers, and one half among non-European travelers. Almost all the infections were acquired in Africa and Schistosoma mansoni was identified in 39% of the cases, whereas Schistosoma haematobium was found in 22% and about 60% of the patients presented symptoms.…”