Maluil Samuel, Stevens Rom A
Department of Internal Medicine, Naval Medical Center, 620 John Paul Jones Circle, Portsmouth, VA 23708.
Department of Surgery, CAPT James A. Lovell Federal Health Care Center, 3001 Green Bay Road, North Chicago, IL 60064.
Mil Med. 2016 Nov;181(11):e1495-e1498. doi: 10.7205/MILMED-D-15-00269.
Schistosomiasis is a known risk after exposure to freshwater in tropical parts of the world. In March 2014, 28 off-duty U.S. service members went on a water adventure in the Nile River in Jinja, Uganda. In April 2014, 10 of the 28 service members returned for a second water adventure. Twelve weeks after freshwater exposure, schistosomiasis enzyme-linked immunosorbent assay testing was performed. Twenty-five percent had elevated Schistosomiasis mansoni immunoglobulin G (7 positive of 28 exposed); all had negative pre-exposure serology. The serology-positive service members were treated with oral praziquantel 60 mg/kg in divided doses. Our report is the first schistosomiasis report among U.S. service members deployed to Africa since World War II. The absence of reports among U.S. service members and several reports among deployed foreign military units and tourists in sub-Saharan Africa suggest a lack of postexposure testing. We recommend schistosomiasis testing of prior and future U.S. military units deployed to sub-Saharan Africa with fresh water exposure. Unit commanders and medical personnel should discourage unnecessary fresh water contact in sub-Saharan Africa.
在世界热带地区接触淡水后，血吸虫病是一种已知的风险。2014年3月，28名美国现役军人在乌干达金贾的尼罗河进行水上探险。2014年4月，这28名军人中有10人再次进行水上探险。接触淡水12周后，进行了血吸虫病酶联免疫吸附测定检测。25%的人曼氏血吸虫免疫球蛋白G升高（28名接触者中有7名呈阳性）；所有人接触前血清学检测均为阴性。血清学检测呈阳性的军人接受了口服吡喹酮治疗，剂量为60mg/kg，分剂量服用。我们的报告是自第二次世界大战以来美国部署到非洲的军人中首例血吸虫病报告。美国军人中没有相关报告，而撒哈拉以南非洲地区部署的外国军事单位和游客中有几份报告，这表明缺乏接触后检测。我们建议对部署到撒哈拉以南非洲且接触过淡水的美国军事单位进行血吸虫病检测。部队指挥官和医务人员应劝阻在撒哈拉以南非洲不必要的淡水接触。
