The 2d stage shows more or less intestinal disturbance with at times bloody mucus containing ova. The ova may not be present for long intervals or may never be found. Where reinfection does not take place the patient tends to recover but if exposure to infection be kept up then the 3d stage sets in with rather marked dysenteric manifestations, emaciation, anaemia, ascites, dropsy and a terminal cachexia.
The bladder never seems to be involved in Japanese schistosomiasis. The eggs, however may be carried to the brain and produce symptoms of Jacksonian epilepsy.
Laboratory Diagnosis
This consists in the search for ova in the centrifuged urine of vesical bilharziasis or in the bloody mucus of the intestinal manifestations of the disease. If one adds water to the urine the ciliated embryo will be noticed to break out of the shell in a few minutes and move about actively as if in search for some host.
The eosinophilia is of great diagnostic value and is usually associated with an increase in the leucocyte count.
Fairley has introduced a complement fixation reaction in diagnosis, using an extract of the livers of infected snails as antigen. The reaction appears early in the infection but disappears in the later stages. It is a group reaction as the livers of Bullinus answer for the S. mansoni serum as well as for the specific S. haematobium serum.
Prophylaxis
Bathing should be allowed only in filtered water, there being an absence of the infecting cercariae in such a supply.
Then, too, if a water which does not contain fresh water snails is stored for three or four days the cercariae which might have been present in the freshly pumped up water will have died out, such free cercariae only surviving for about this period. The gastric juice will destroy cercariae so that it would seem impossible for an infection to occur by the alimentary tract atrium with the exception that cercariae might bore their way through the buccal mucosa as well as through the skin. The sterilization of the urine of cases of vesical bilharziasis and of the faeces in other forms should be carried out where practicable. It is now considered practicable to eradicate carriers of the infection with antimony treatment.