So you are on holiday and Lake Malawi looks cool, refreshing and inviting, but should you swim in it? The simple answer is no. Fresh water sources such as Lake Malawi are infected with parasites that cause Schistosomiasis, otherwise known as Bilharzia and swimming should be avoided if you don't want to become infected with this parasite. So however inviting the water looks - Don't be tempted to swim in it.
The inviting waters of Lake Malawi should be avoided.
Bilharzia is caused by infestation by a type of flatworm, or fluke (parasite). Fluke larvae are released by freshwater snails. These larvae penetrate the human skin and mature into adults. Adult worms live for many years in mesenteric or vesicular veins. They release ova which cause scarring of the bladder and rectum.
Bilharzia is caught through swimming or showering/ bathing with water fresh from lakes or rivers. Bilharzia mainly affects people in developing countries Africa, South America, and less so in the Middle and Far East .People from the UK become infested only when visiting tropical countries. About half of all those who swim in Lake Malawi test positive for Bilharzia on their return.
Symptoms
'Swimmer's itch' develops where the parasite enters the skin, and is often the only symptom noticed.
Other possible symptoms include muscle pain, headache, diarrhoea, fever, vomiting, coughing, a burning sensation when passing urine, passing urine more frequently and blood in the urine.
The infection can be avoided by not swimming, paddling, wading, washing or drinking water in tropical lakes, rivers, canals or freshwater pools (that haven’t been chlorinated) . Swimming pools that have been chlorinated and well maintained pose no risk. There is no vaccination or medication that can be taken to prevent infestation.
How is Bilharzia treated?
If exposure has occurred, seek medical advice. Infestation is treated with medication (Praziquantel ) to kill the parasite.
Untreated Bilharzia may cause life-threatening urinary system or liver damage, bladder tumours and bowel cancer.
What should I do if I have returned from a trip and been swimming in a fresh water source in an endemic area?
You should seek advice from your GP who will refer you to an infectious disease or tropical medicine specialist for treatment.
Remember, you should always seek travel advice from your nurse or GP before you plan an overseas trip to ensure you have the correct vaccinations and malaria tablets if required for your destination.
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