bilharziasis (schistosomiasis)

Infection caused by the Schistosoma worm, roughly 1 cm long, which has a freshwater snail as intermediate host. It is one of the most prevalent tropical diseases: about 200 million people are infected, particularly in developing countries of South America, Africa and eastern Asia. The worms lie twisted in the blood vessels of the intestine or bladder, where they live on blood. The female lays her eggs in the blood vessel; they are excreted into water in urine or faeces, develop into larvae, enter a snail and multiply; they then leave the snail and are able to infest man (e.g. swimmers) by penetrating the skin. The There is no effective treatment, although hormones to check inflammation can aid recovery. If the paralysis is still present after six weeks the bone channel in which the nerve is trapped can be widened by surgery. Prevented by correcting the diet. Larvae develop into full-grown worms in the liver and then enter the blood vessels. The eggs cause the most discomfort: they can remain in the intestinal wall, causing abdominal cramps and diarrhoea containing blood. The intestinal wall loses elasticity. Blood is passed in the urine if the particular schistosoma lives in the blood vessels of the bladder. The eggs can block the vessels of the liver, causing it to cease functioning. Vessels in the lung then become blocked, causing coughing and shortness of breath. Treatment of the infestation is by medication, and it can be avoided by not swimming in stagnant pools and ponds where the snails live. Usually caused by difficult labour or an assisted delivery, the injuries can take various forms. Excessively rapid delivery, breech delivery, forceps

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