Schistosomiasis (also known as bilharzia) is a parasitic infection caused by Schistosoma worms. Infection occurs through direct contact with contaminated fresh water where certain snails may harbour the infection. Larval forms of the worm are released from these snails into fresh water and may penetrate human skin and migrate to internal organs.

Although schistosomiasis is found throughout tropical regions, in travellers it is most often acquired in Africa. Common travel destinations where schistosomiasis occurs include Malawi (particularly from Lake Malawi), Egypt, Kenya, Tanzania, South Africa and some areas of Brazil. 

Travellers are at risk if they wade, swim or have other contact with fresh water from lakes or rivers in areas where schistosomiasis is common. Chlorination kills the parasite; therefore there should be no risk in well maintained swimming pools. Schistosomiasis cannot be contracted through sea water contact. Infection may cause no symptoms, but early symptoms can include a rash and itchy skin (‘swimmer’s itch’), fever, chills, cough, or muscle aches. If not treated, it can cause serious long term health problems such as intestinal or bladder disease.


There is currently no vaccine against schistosomiasis and no drug available to prevent infection. Where possible travellers should avoid contact with fresh water rivers and lakes in risk areas. This includes popular destinations such as Lake Malawi. Topical application of insect repellent before exposure to water or towel drying after accidental exposure to schistosomiasis are not reliable in preventing infection.

Schistosomiasis in travellers commonly occurs without symptoms. Those who have been swimming or bathing in fresh water in areas where the disease is common should be advised to undergo screening, ideally by an infectious diseases specialist.



The National Travel Health Network and Centre (NaTHNaC) is commissioned by Public Health England to provide health information for both healthcare professionals and travellers. Information is compiled by the NaTHNaC clinical and scientific team, and updated regularly. Further advice on health risks and disease outbreaks is available at

Date last reviewed: November 2015

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Already registered?
Sign in

MIMS Product Slides

Product overviews prepared by the MIMS team, in a handy slide format.

Click here

Slides are initiated, funded & reviewed by the companies specified.

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

MIMS Adviser

Especially created for prescribing influencers.

Request free copy

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases