What would you do if worms ate up your income?

By Tiffany S. Schluter

We who don’t live in tropical and subtropical regions of the world, especially those who have high poverty rates, don’t worry about things like getting WORMS from just going outside, swimming, bathing, drinking water, and NORMAL EVERYDAY THINGS for us. Can you even imagine? We take it all for granted. If it even was a risk for us, we have the means to go to the doctor and be diagnosed and treated before the more serious complications occur, but what about other countries? What happens to them? What happens to people that can’t get rid of their worms and not just right now… for the rest of their lives??? First, we will talk about a major worm, Schistosoma, and all of its facts then we’ll talk about what it causes.
Schistosomiasis is a Neglected Tropical Disease (NTD) caused by parasitic worms (trematodes to be specific). This disease is also called bilharzia. The only parasitic disease that is more devastating than Schistosomiasis is Malaria. Over 230 MILLION people are treated for Schisto yearly according to the World Health Organization. Basically, it is a HUGE problem.
There are 5 different species of Schistosoma that affect different areas of the world. The United States is not affected. The areas of the world that are affected by each type of Schistosoma are:
1)  S. mansoni: Africa, South American and the Caribbean.
2) S. haematobium: Africa and the Middle East.
3) S. japonicum: Indonesia, China and Southeast Asia
4) S. mekongi:  Cambodia and Laos
5) S. intercalatum: Central and West Africa.
How do you get it?? The stage of the parasite life cycle that infects people, called cercariae, emerges from snails, which are the intermediate hosts, to INFECT THE FRESHWATER that they’re in. The cercariae can only survive alone in the water for 48hours. The way that the water gets infected to begin with is by poor sanitation such as people peeing or pooping in the water, because the eggs come out in the urine and feces.  Once the cercariae get into your system, all they have to do is come in to contact with your skin, they migrate to the blood vessels then to the liver, they mature. After they mature, the worms pair up and go to the intestine or bladder for the female to lay eggs. The eggs either leave in the pee or poop or they can stay in the tissue, which is what causes the problems associated with the disease.

Symptoms of Schisto vary, and they aren’t caused by the worms but rather they are the body’s response to the eggs aren’t excreted, which cause an immune response (Like allergies).
Commonly, people don’t have symptoms at first, but after a few days people sometimes get an itchy rash. After a few months, flu-like symptoms can occur such as fever, chills, cough and muscle aches. If the disease becomes chronic, it can cause complications such as kidney failure, bloody pee or poop, enlarged spleen, liver damage, colon inflammation, bladder obstruction, which causes trouble passing urine, and leads to increased risk for CANCER. In rare cases, eggs can get into the brain or spine, which can inflame the spine or cause seizures or paralysis. Kids that are repeatedly infected can suffer anemia, malnutrition, and LEARNING DIFFICULTIES!!! On average, this disease takes up to TEN YEARS off of people’s lives!!!
So, how is it detected? By a simple microscopic examination of stool or urine for eggs. Also, a blood test can be done. What’s so hard about that?
Treatment: It’s treated by a drug called praziquantel, which is used in a lot of de-worming stuff that we give our pets, and if the disease is severe corticosteroids are also administered.  Also, the antimalarial drug artemesinin (this drug is old) has proven to work on the immature stages of all 5 species of Schistosoma.
So, what will be the result when Schisto, and NTDs altogether, are gone from a population? With decreased worm burdens on poor populations, people are HEALTHIER, have the chance to fully develop, can raise their own families, and are PRODUCTIVE in their community. The lack of productivity in countries that have heavy worm loads help to keep impoverished countries in a cycle of poverty. So, decreasing worm loads one LITTLE step at a time is a GIANT step towards helping impoverished countries break free of the chains of poverty and improving their lives, communities, and countries as a whole.
So, how could we help PREVENT this ghastly disease? Just IMPROVED SANITATION could lessen/eradicate transmission!  KEEP THE WATER CLEAN!!! One control measure that has been, and is being, used is mass drug treatment of entire communities and targeted treatment of school-age children, but drugs cost money so people and children in affected countries would have NO WAY of getting these meds WITHOUT HELP. Donations to charities are a great way to do your part in trying to better our world by improving at least one person’s life! You can do this by helping to give them the opportunity to either have CLEAN WATER to drink/swim/bathe in or, if they’re already infected, to be able to take medicine to kick these worms OUT!! We de-worm our pets without a second thought; it’s just something you do, right? The SAME MEDICINE can cure the people afflicted with this disease! So, how about next time you go to get your dog’s meds you think about the people with this disease and throw a little bit of spare change their way. Every cent counts. Can you imagine living this way, and with no way out? Your help can help to give them that push in the right direction towards a better life for themselves, their families, their communities and eventually their countries.
Sites to donate to the Schistosomiasis Control Initiative (SCI) to help control this disease are http://www.givewell.org/international/top-charities/schistosomiasis-control-initiative and http://www3.imperial.ac.uk/schisto.

For more information about Schistosomiasis:

https://gsa.confex.com/gsa/2011AM/finalprogram/abstract_194053.htm

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002298/

http://www.cdc.gov/parasites/schistosomiasis/index.html

http://www.who.int/mediacentre/factsheets/fs115/en/index.html

http://www.medicalecology.org/water/schistosomiasis/schistosomiasis.htm