WILLIAM D. CLARK, M.D.; PAUL M. COX JR., M.D.; LYNN H. RATNER, M.D.; RAFAEL CORREA-CORONAS, M.D.
In August 1968 acute Manson's schistosomiasis occurred in 10 adolescent boys 2 to 8 weeks after swimming in the Turabo River. Clinical, laboratory, and serologic responses to infection were studied, and the river was surveyed for sources of infection. Striking variations in clinical manifestations were noted in the nine boys studied. One boy remained asymptomatic; six boys had fever and diarrhea; seven had hepatomegaly or splenomegaly, or both; and all had eosinophilia. Each boy had Schistosoma mansoni ova in his stool or rectal biopsy, or both. Fluorescent, complement-fixing, and flocculating antibodies were present 8 weeks after exposure, whereas circumoval precipitins did not appear until later. Skin test positivity increased from 56% to 100% between the eighth and 22nd week after exposure. Sewage effluent flows directly into the river, and 52 of 297 Biomphalaria glabrata collected shed S. mansoni cercariae.
CLARK WD, COX PM, RATNER LH, et al. Acute Schistosomiasis Mansoni in 10 Boys: An Outbreak in Caguas, Puerto Rico. Ann Intern Med. 1970;73:379–385. doi: https://doi.org/10.7326/0003-4819-73-3-379
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Published: Ann Intern Med. 1970;73(3):379-385.
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