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, Schistosoma mansoni was identified in 570 (39%) and Schistosoma haematobium 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.

Abteilung Tropenmedizin Missionsärztliche Klinik Würzburg Germany

Berlin Centre for Travel and Tropical Medicine Berlin Germany

Center of Tropical Medicine and Travel Medicine Academic Medical Center University of Amsterdam The Netherlands

Centro Hospitalar e Universitário de Coimbra Coimbra Portugal

Centro per le Malattie Tropicali Ospedale S Cuore Negrar Verona Italy

Clinic of Infectious Diseases University of Udine Udine Italy

Consultation de médecine tropicale Hôpital Avicenne Bobigny France

Department and Clinic of Tropical and Parasitic Diseases Karol Marcinkowski University of Medical Sciences Poznan Poland

Department of Ambulatory Care and Community Medicine Travel Clinic University Hospital Lausanne Switzerland

Department of Infection and Tropical Medicine Royal Victoria Infirmary Newcastle upon Tyne United Kingdom

Department of Infectious Diseases Aalborg University Hospital Aalborg Denmark

Department of Infectious Diseases University Hospital Heideberg Heidelberg Germany

Department of Infectious Diseases University Hospital Hradec Králové Czech Republic

Department of Internal Medicine 2 Section Infectious Diseases and Tropical Medicine University Hospital Frankfurt Main Germany

Department of Internal Medicine 3 Comprehensive Infectious Diseases Center Ulm University Hospital Ulm Germany

Department of Medicine National Centre for Tropical Infectious Diseases Haukeland University Hospital Bergen Norway

Department of Microbiology Tumor and Cell Biology Karolinska Institutet Stockholm Sweden

Division of Infectious Diseases and Tropical Medicine Medical Centre of the Ludwig Maximilians University Munich Germany

Division of Tropical Medicine and Infectious Diseases Rostock University Medical Center Germany

Epidemiology Biostatistics and Prevention Institute University of Zurich Zurich Switzerland

Hospital Carlos 3 Madrid Spain

Infectious Diseases Unit Department of Experimental and Clinical Medicine University of Florence Florence Italy

Infectious Diseases Unit Herlev University Hospital Copenhagen Denmark

Infectious Diseases Unit Hospital General Universitario de Elche Alicante Spain

Inflammation Centre Clinic of Infectious Diseases University of Helsinki and Helsinki University Hospital Helsinki Finland

Institute of Tropical Medicine Antwerp Belgium

ISGlobal Barcelona Centre for International Health Research Hospital Clínic Universitat de Barcelona Barcelona Spain

Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie Charité Universitätsmedizin Berlin Berlin Germany

Oslo University Hospital Ullevål Norway

Service de Parasitologie Hôpital Saint Antoine Paris France

Swiss Tropical and Public Health Institute Basel Switzerland

Travel Medicine Unit Department of Infectious Diseases Amedeo di Savoia Hospital ASLTO2 Turin Italy

Tropical Medical Bureau Dublin Ireland

Tropical Medicine and International Health Unit Hospital Vall d'Hebron Drassanes PROSICS Barcelona Barcelona Spain

Unit of Infectious Diseases Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden

University of Basel Basel Switzerland

See more in PubMed

Colley DG, Bustinduy AL, Secor WE, King CH, 2014. Human schistosomiasis. Lancet 383: 2253–2264. PubMed PMC

Chitsulo L, Engels D, Montresor A, Savioli L, 2000. The global status of schistosomiasis and its control. Acta Trop 77: 41–51. PubMed PMC

World Health Organization, 2015. Weekly epidemiological record No. 5, Vol. 90. Geneva, Swizerland: World Health Organization, 25–32.

Clerinx J, Van Gompel A, 2011. Schistosomiasis in travellers and migrants. Travel Med Infect Dis 9: 6–24. PubMed

Ross AG, Vickers D, Olds GR, Shah SM, McManus DP, 2007. Katayama syndrome. Lancet Infect Dis 7: 218–224. PubMed

Zhang Y, Zhao J, Wang X, Xu X, Pan W, 2015. Evaluation of six novel antigens as potential biomarkers for the early immunodiagnosis of schistosomiasis. Parasit Vectors 8: 447. PubMed PMC

Meurs L, Brienen E, Mbow M, Ochola EA, Mboup S, Karanja DMS, Secor WE, Polman K, van Lieshout L, 2015. Is PCR the next reference standard for the diagnosis of Schistosoma in stool? A comparison with microscopy in Senegal and Kenya. PLoS Negl Trop Dis 9: e0003959. PubMed PMC

Gautret P, et al., 2012. Infectious diseases among travellers and migrants in Europe, EuroTravNet 2010. Euro Surveill 17: pii: 20205. PubMed

Mendelson M, et al., 2014. Regional variation in travel-related illness acquired in Africa, March 1997–May 2011. Emerg Infect Dis 20: 532–541. PubMed PMC

Holtfreter MC, Moné H, Müller-Stöver I, Mouahid G, Richter J, 2014. Schistosoma haematobium infections acquired in Corsica, France, August 2013. Euro Surveill 19: pii: 20821. PubMed

Berry A, et al., 2014. Schistosomiasis haematobium, Corsica, France. Emerg Infect Dis 20: 1595–1597. PubMed PMC

Grobusch MP, et al., 2003. Imported schistosomiasis in Europe: sentinel surveillance data from TropNetEurop. J Travel Med 10: 164–169. PubMed

Jelinek TEuropean Network on Imported Infectious Disease Surveillance, 2008. Imported schistosomiasis in Europe: preliminary data for 2007 from TropNetEurop. Euro Surveill 13: pii: 8038. PubMed

Nicolls DJ, Weld LH, Schwartz E, Reed C, von Sonnenburg F, Freedman DO, Kozarsky PE; GeoSentinel Surveillance Network, 2008. Characteristics of schistosomiasis in travelers reported to the GeoSentinel Surveillance Network 1997–2008. Am J Trop Med Hyg 79: 729–734. PubMed

Coltart CEM, Chew A, Storrar N, Armstrong M, Suff N, Morris L, Chiodini PL, Whitty CJM, 2015. Schistosomiasis presenting in travellers: a 15 year observational study at the Hospital for Tropical Diseases, London. Trans R Soc Trop Med Hyg 109: 214–220. PubMed

Leder K, Tong S, Weld L, Kain KC, Wilder-Smith A, von Sonnenburg F, Black J, Brown GV, Torresi J; GeoSentinel Surveillance Network, 2006. Illness in travelers visiting friends and relatives: a review of the GeoSentinel Surveillance Network. Clin Infect Dis 43: 1185–1193. PubMed

Bierman WFW, Wetsteyn JCFM, van Gool T, 2005. Presentation and diagnosis of imported schistosomiasis: relevance of eosinophilia, microscopy for ova, and serology. J Travel Med 12: 9–13. PubMed

Meltzer E, Artom G, Marva E, Assous MV, Rahav G, Schwartzt E, 2006. Schistosomiasis among travelers: new aspects of an old disease. Emerg Infect Dis 12: 1696–1700. PubMed PMC

Whitty CJ, Mabey DC, Armstrong M, Wright SG, Chiodini PL, 2000. Presentation and outcome of 1107 cases of schistosomiasis from Africa diagnosed in a non-endemic country. Trans R Soc Trop Med Hyg 94: 531–534. PubMed

Rochat L, Bizzini A, Senn N, Bochud P-Y, Genton B, de Vallière S, 2015. Acute schistosomiasis: a risk underestimated by travelers and a diagnosis frequently missed by general practitioners-a cluster analysis of 42 travelers. J Travel Med 22: 168–173. PubMed

Visser LG, Polderman AM, Stuiver PC, 1995. Outbreak of schistosomiasis among travelers returning from Mali, West Africa. Clin Infect Dis 20: 280–285. PubMed

Corachán M, Ruiz L, Valls ME, Gascon J, 1992. Schistosomiasis and the Dogon country (Mali). Am J Trop Med Hyg 47: 6–9. PubMed

Colebunders R, Verstraeten T, Van Gompel A, Van den Ende J, De Roo A, Polderman A, Visser L, 1995. Acute schistosomiasis in travelers returning from Mali. J Travel Med 2: 235–238. PubMed

Cetron MS, Chitsulo L, Sullivan JJ, Pilcher J, Wilson M, Noh J, Tsang VC, Hightower AW, Addiss DG, 1996. Schistosomiasis in Lake Malawi. Lancet 348: 1274–1278. PubMed

Rapoport AB, McCormick D, Cohen PA, 2015. Screening for Schistosoma mansoni and Strongyloides stercoralis infection among Brazilian immigrants in the United States. Open Forum Infect Dis 2: ofv003. PubMed PMC

Utzinger J, Becker SL, van Lieshout L, van Dam GJ, Knopp S, 2015. New diagnostic tools in schistosomiasis. Clin Microbiol Infect 21: 529–542. PubMed

Cnops L, Soentjens P, Clerinx J, Van Esbroeck M, 2013. A Schistosoma haematobium-specific real-time PCR for diagnosis of urogenital schistosomiasis in serum samples of international travelers and migrants. PLoS Negl Trop Dis 7: e2413. PubMed PMC

Cnops L, Tannich E, Polman K, Clerinx J, Van Esbroeck M, 2012. Schistosoma real-time PCR as diagnostic tool for international travellers and migrants. Trop Med Int Health 17: 1208–1216. PubMed