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MEDICAL FAQs |
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Dive Medical questions & answers for common scuba diving conditions and illness provided in conjunction with the doctors at the London Diving Chamber and Midlands Diving Chamber. | |
All Categories » Animal Hazards » Bilharzia
QUESTION My son and I swam in Lake Malawi this summer. My son, who is 16, did an intensive 5 day scuba diving course.After reading the travel books, we decided to take action, even though we have no bilharzia symptoms. Sixweeks after exposure, our GP agreed reluctantly to sendoff stool samples for testing for 'all egg infestations'. The results have come back 'normal'. Should we take any other action? ANSWER Sadly, Lake Malawi is now known for harbouring bilharzia, and I see your point about getting checked for it now you are back. QUESTION I'm planning a trip to Malawi, and obviously want to dive Lake Malawi when I'm there. I've read that there is a problem with something called bilharzia there. Should I take any precautions whilst diving there?ANSWER You're right there. Lake Malawi always had the reputation of being bilharzia free, but recently more and more cases of this problem have been reported from the Lake. The area most affected is in the Southern part , around a place called Cape Maclear. This may be as it's the most popular part as it's the most beautiful and hence has most visitors. QUESTION The shores of Lake Malawi have been my home for the last few months. I've been seeking inspiration for my latest work and I thought I'd found the perfect location to galvanise my literary brain into sensuous and romantic outpourings. Sadly after an ill-advised snorkelling trip in the lake I've contracted a vulgar disease called bilharzia instead. I felt fine initially but a few weeks after my dive I was prostrated by severe abdominal pains, fever and diarrhoea. What's the prognosis, doctor?ANSWER I’m quietly confident that the outlook is good, Kenneth. You’ve been the victim of a nasty water-borne illness which is a growing menace to the idyllic shores of Lake Malawi. Bilharzia (or schistosomiasis – careful how you say that) is a disease caused by parasitic flukes that use humans as hosts. The eggs breed in snails that live in the reeds in the stiller areas of the lake, and once they’re released into the water they develop into larvae that are capable of infecting mammals. They cleverly secrete enzymes that break down human skin, allowing them to penetrate it and migrate to the lungs and liver. Once there, they grow and start feeding on red blood cells, and they may end up moving to the kidneys, bladder or intestine. After loitering maliciously for 6 to 8 weeks the mature worms start producing eggs, anywhere between 300 and 3000 a day, many of which are shed in faeces and urine. It’s the eggs that don’t make it out but stay trapped in the body that stimulate a massive immune response, giving rise to the fatigue, fevers, pains, swollen livers/spleens and genital sores that are the hallmarks of the disease. Disconcertingly, the worms survive in the body for an average of 4 and a half years, sometimes much longer. Counting eggs per gram of poo isn’t my idea of a good day out, but this is how the disease is most commonly diagnosed. But happily, it’s easily treated, by a single oral dose of the drug praziquantel. The WHO is promoting efforts to eradicate bilharzia and some countries have managed it, but Malawi isn’t yet one of them. As we all know, prevention is better than cure, so avoid areas known to be infested; don't swim, wash, paddle, push vehicles or wade through rivers or water, especially if slow-flowing or stagnant; don't drink potentially infected water without at least boiling it for a minute or more; and wear protective footwear if you are walking through mud or damp areas near rivers or lakes. |