This year, for the family holiday, we spent a few days at Lake Malawi, a beautiful place, unique in Africa and in the world. When we got to our lodge, the hosts let us know that the waters may be infected with bilharzia but, we can go ahead an enjoy our stay, everything can be treated quickly and safely.
The waters of the Lake were amazing and the multitudes of fish unique to this lake were enough to make us take the risk.
Bilharzia is a parasitic disease, caused by a worm. It affects the intestines and the urinary system first but, since it lives in the blood, it can affect other systems also. There are different species of the parasite; some will affect the lungs, others the brain, others the spinal cord or the central nervous system. Though not immediately fatal, bilharzia is a chronic disease that can seriously damage the internal organs.
The disease is also known as snail fever, because the snails in the water carry it. Lake Malawi as experienced an increase in number of these snails, mostly due to overfishing around the shores. Those fish would normally keep the snails under control. Humans get infected when the larvae enter the body through the skin. They then develop into adult worm that live in the blood, being transported to the liver, lungs or other places. As adults, the worms will release more eggs inside the body, which will then be eliminated usually through the urinary system, thus restarting the cycle.
The initial symptoms may include fatigue, fever and chills, muscle pains, cough, diarrhea, most of which I’ve been experiencing lately. Left untreated and by the time the eggs pass into the urinary system, it can cause bladder damage, kidney failure and even bladder cancer, not to mention death.
The second week of December represented 3 months since the infection and when the treatment should be started. The right medicine for it is called “Praziquantel” and our doctor recommended that we only take it before going to sleep. Most of the side effects have to do with the release of the contents of the parasites as they are being killed and the immediate immune reaction from the host.
The reason the doctors recommend the medicine to be taken at night is because it will temporarily affect the central nervous system, causing dizziness and headaches. Other possible side effects: abdominal pains, diarrhea, sweating, fever, rashes, lower back pain, cardiac arrhythmias and hypotension.
Due to our doctor insisting on several occasions to take the medicine only at night, we have decided to go the safe way and only 2 of us to take it on the first night; in case something were to happen, we needed one of us, the adults, to be alert. Two dizzy adults would not be good in case we had to take ourselves to the hospital due to other severe side effects. Lita and Aimee took it the first night and Jessica and I last night. Ethan is safe as he didn’t get in the water.
From my own experience, I can tell you that this is not as bad as it sounds, probably because we have gone through the treatment according to the recommendations. After taking the pills last night, I started having some mild headaches and I could feel myself becoming more and more drowsy. Once in bed, though, I felt asleep right away. In the morning, I could feel a bitter taste in my mouth, but otherwise I feel fine. The pills were very bitter and we only have to take one course.
Praziquantel is very effective, even in cases of severe infections, leaving no worms or eggs behind. Other medicines used in the past would leave the eggs untouched, raising the risks of future reinfections.
Looking at the infections and the side effects of the medicine, one may ask if the risks are worth it? The answer is yes, especially if you live in Malawi for a long period of time. There is not much to do here as far as entertainment goes and a trip to the Lake without experiencing the Lake is pretty much a wasted trip. The Lake is gorgeous, the water is very clear and the millions of colors of fishes will fascinate you. Just like malaria or other tropical diseases, bilharzia is best accepted as a risk and treated when necessary.