[Acute schistosomiasis in French travellers]. / La bilharziose d'importation chez les voyageurs: enquête en France métropolitaine.

ABSTRACT

OBJECTIVE: The clinical presentation of acute schistosomiasis in travellers differs from those observed with chronic schistosomiasis in people from endemic areas. The objective of this study is to describe the main clinical and biological characteristics of the acute schistosomiasis in French travellers. METHODS: Retrospective study conducted in 42 hospital laboratories of parasitology in France, based on a questionnaire filled out for each case of schistosomiasis diagnosed in subjects non-originating from an endemic country and returning from of a stay in Africa, between 2000 and 2004. RESULTS: Seventy-seven cases of acute schistosomiasis diagnosed between 2000 and 2004 were reported by 15 of the 33 laboratories having taken part in the study. The patients were 26 years old on average and 60% were contaminated in West Africa. Seventy patients (91%) presented at least one symptom at the moment of the diagnosis, but only 44 (57%) presented sufficiently intense symptoms to justify a medical consultation spontaneously. The most frequently reported clinical signs were fever (44%), diarrhoea (40%), pruritus (25%), cough (21%) and hematuria (20%). Hypereosinophilia (82%), elevated liver enzymes and positive serology were respectively reported in 82, 23 and 90% of the cases. Ova were found in the urines or the stool in 60% of the cases. Eleven patients were hospitalized. DISCUSSION: Acute schistosomiasis must be evoked in patients returning from endemic country and presenting with non-specific symptoms; including patients whose bathes in contaminated water was limited to a short contact of the feet in a river. The high frequency of the asymptomatic or paucisymptomatic forms exposes the infected people to a delayed diagnosis and therefore to an evolution towards the chronic form of schistosomiasis. The increase in tourism towards the endemic areas could be accompanied by an increase in the frequency of the schistosomiasis, and encourages setting-up an active monitoring of acute schistosomiasis.