Rabinowicz Shira, Leshem Eyal, Schwartz Eli
Paediatric Neurology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
J Travel Med. 2021 Aug 27;28(6). doi: 10.1093/jtm/taaa238.
Schistosomiasis in non-immune travellers can cause acute schistosomiasis, a multi-systemic hypersensitivity reaction. Little is known regarding acute schistosomiasis in children. We describe acute schistosomiasis in paediatric travellers and compare them with adult travellers.
A retrospective study of paediatric travellers (0-18 years old) diagnosed with schistosomiasis at Sheba Medical Center. Patients' findings are compared with those of adult travellers from the same travel groups.
in total, 18 children and 24 adults from five different trips to Tanzania, Uganda, Nigeria and Laos were infected (90% of the exposed travellers). The median bathing time of the infected children was 30 min (interquartile range (IQR) 15-30 min). The most common presentations were respiratory symptoms in 13 (72%), eosinophilia in 13 (72%) and fever in 11 (61%). Acute illness included a median of 2.5 symptoms. Three children required hospitalization and three were asymptomatic. Fatigue was significantly less common in children compared with similarly exposed adults (33% vs 71%, P = 0.03). Rates of hospitalization and steroid treatment were similar. The median eosinophil count in children was 1045 cells/μl (IQR 625-2575), lower than adults [2900 cells/μl (IQR 1170-4584)], P = 0.02.
Children may develop acute schistosomiasis following short exposure to contaminated freshwater, demonstrating a high infection rate. Severity seems to be similar to adults, although children report fatigue less commonly and show lower eosinophil counts. The disease should be suspected in children with multi-systemic illness and in asymptomatic children with relevant travel history.
非免疫旅行者中的血吸虫病可引发急性血吸虫病，这是一种多系统超敏反应。关于儿童急性血吸虫病的了解甚少。我们描述了儿科旅行者中的急性血吸虫病，并将他们与成年旅行者进行比较。
对在舍巴医疗中心被诊断为血吸虫病的儿科旅行者（0至18岁）进行回顾性研究。将患者的检查结果与来自相同旅行团的成年旅行者的结果进行比较。
共有来自五次不同前往坦桑尼亚、乌干达、尼日利亚和老挝旅行的18名儿童和24名成年人受到感染（占暴露旅行者的90%）。受感染儿童的中位洗澡时间为30分钟（四分位间距[IQR]为15至30分钟）。最常见的表现为13例（72%）出现呼吸道症状，13例（72%）出现嗜酸性粒细胞增多，11例（61%）出现发热。急性疾病的症状中位数为2.5种。三名儿童需要住院治疗，三名儿童无症状。与暴露情况相似的成年人相比，儿童疲劳症状明显较少见（33%对71%，P = 0.03）。住院率和类固醇治疗率相似。儿童的嗜酸性粒细胞计数中位数为1045个细胞/微升（IQR为625至2575），低于成年人[2900个细胞/微升（IQR为1170至4584）]，P = 0.02。
儿童在短时间接触受污染淡水后可能会患上急性血吸虫病，感染率很高。虽然儿童较少报告疲劳症状且嗜酸性粒细胞计数较低，但疾病严重程度似乎与成年人相似。对于患有多系统疾病的儿童以及有相关旅行史的无症状儿童，应怀疑患有此病。
