Schistosomiasis In Africa

Schistosomiasis in Africa is an unpleasant disease spread by contact with fresh water. The disease is also known as bilharzia.

Darker areas = prevalent disease - WHO 2020

In Africa there are 2 types of worm, whose life cycles require fresh water snails, that cause schistosomiasis or bilharzia.
These worms either inhabit the bladder veins causing urinary schistosomiasis or inhabit the walls of the intestines causing intestinal schistosomiasis.
Worm eggs leave the body via urine or faeces and hatch in fresh water where they need water snails to develop further.
More larvae are produced and swim freely in fresh water seeking to penetrate the skin of a human host
Schistosomiasis in Africa is contracted through the skin from fresh water contaminated with urine or faeces of an infected person.
Baboons can also be responsible for water contamination. So even places with minimal human habitation, bilharzia can still flourish in fresh water.
It is second only to malaria as a public health problem in tropical and sub-tropical areas.
Any hunter in areas where schistosomiasis is endemic is at risk. This includes most of Africa.

Watch out for a tingling skin sensation and/or rash (swimmer's itch) a few hours after being in infected water.
Though this subsides, it does not mean you have not got bilharzia.
See a doctor if you get fevers, general malaise, abdominal pain and blood in the urine or stool.

Never assume fresh water to be free from bilharzia in any endemic area. Even deep water, far offshore cannot be regarded as safe. Salt, brackish and polluted waters are safe.
Hunters should avoid paddling or swimming in fresh water lakes, streams, rivers or slow running water. Sometimes it may be unavoidable if you need to cross a small, shallow river when out hunting. A good hunter's tip is to carry a couple of strong bin bags and put one on each leg to wade the water.
Cross rivers upstream of human habitation if possible.
Avoid neglected swimming pools.
Wear long trousers and long sleeves and dry out immediately after getting wet.
Quick drying of exposed areas can offer some protection, due to larvae needing water to survive.
Wear water-proof boots when possible.
If you know you have been in potentially infected water, get a medical check-up when home, 30-40 days after infection. Any earlier and the eggs may not show up as they take 30-40 days to be produced. Make sure stool and urine samples are taken.