Schistosomiasis among travellers returning from Malawi: a common occurrence.
Sir,

In August 2001, 11 pupils accompanied by four teachers, from a secondary school in London, visited Malawi for 4 weeks. During their trip they swam in Lake Malawi, having been assured by local people that this area was free of schistosomiasis.

Five weeks later, one of the pupils, a 17-year-old boy, presented with a history of ‘flu-like’ symptoms, an itchy rash and swelling of the eyelids. On direct questioning, he remembered a generalized itchy rash that occurred immediately after swimming. Clinically, he was apyrexial with an extensive urticarial rash. The rest of the examination was unremarkable. He had an eosinophilia at 0.98 × 109/l and elevated alanine transaminase, but otherwise investigations were normal. …