Praziquantel has been demonstrated to be safe in pregnancy, and current World Health Organization (WHO) guidelines recommend that symptomatic pregnant woman be treated. Some experts, however, advise delaying treatment until after the first trimester.

Glucocorticosteroids can reduce the inflammation associated with egg release, but they are recommended only in the setting of neurologic disease or in acute infection.

PREVENTION

Travelers should be advised to avoid contact with fresh water reservoirs when visiting endemic areas. When contact does occur, travelers should aggressively dry off with a towel to prevent cercariae from penetrating the skin. Medical evaluation, as outlined above, should be sought upon return home.

Efforts aimed at improving water and sanitation infrastructure in endemic countries may have a significant impact on infection rates. In areas of high prevalence, the WHO recommends regular administration of antischistosomal medications.