Schistosomes belong to the class of distomas (trematodes). They rank among the most frequent pathogens. Estimations originate in more than 200 million affected people. The mature parasites are 6 – 22 mm long. The most important species are Schistosoma mansoni, S. japonicum and S. haematobium. Schistosoma mansoni is common in Africa, South America and Middle East.
Schistosomiasis (bilharziosis) is – depending on species and location of the parasites – a disease of the intestine, liver and spleen resp. urinary passages. Humans are (re)infected by contact with fresh water which is contaminated by ova containing urine or faeces. If larvae bore into human skin, first a transient skin reaction appears (itch with exanthema or erythema, by repeatedly infection cercarial dermatitis is possible). After 3 - 10 weeks the meanwhile sexually mature worms synthesize cytotoxic and allergic substances which course feverish reaction in humans (Katayama fever). The infected person is mostly harmed by the eggs, which get into organs via blood excreting proteins and glycoproteins. The person reacts under participation
of own antibodies and immune complexes with formation of granuloma and granulomatous proliferation in intestine and urinary bladder mucosa. Not excreted eggs die after 3 weeks and will be dissolved or calcified. The affected tissue gets fibrous. In final stage bilharziosis will cause dead.
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