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Almeida, H. O., Barbosa, A. J. A., Gobbi, H., Reis, M. A., Teixelra, V. P. A. & Brandlo. M. C. (1987a). Leimkkitos e miocard&itos parasitados pelo Typankma kwi em chag& sicos cr8nicos: estudo comparative. Arquivos Brasileiros de Cardiologia, 48,2 17-222. Almeid?, H. O., BrandHo, M. C., Reis, M. A., Gobbi, H. & Teixena, V. P. A. (1987b). Denerva@o e cardiopatia no chagPsicocr6nico. Arquivos Brasileiros de Cardiologia, 48,43-47. Chapadeiro, E. (1967). Peso de cora@o e intensidade do processoinflamat6rio na cardiopatia chag&ica cr6nica. Bolezin de la Ojicina Sanitaria Panamericana, 63,236-239. Frenkel, J. K. (1961). Infections involving the adrenal cortex. In: The Adrenal Correx, Moon, H. D. (editor). New York: Paul B. Hoeber, pp. 201-219. Gorza, L., Sartore, S. & Schiaffmo, S. (1982). Myosin types and fiber types in cardiac muscle. II. Atria1 myocardium. Jownal of Cell Biology, 95,838-845. Jones, E. M., Colley, D. G., Tostes, S., jr, Lopes, E. R., Vnen&-Tones. C. L. & McCurlev. T. L. (in Dress). Polvmerase ch& reaction detection of T$anos& cr& DhA &human hearts. AmericanJournql of Tropical,hfedicine and,Hygiene. K;b;le, F. (1958). CarhopaDa chagaslca. 0 Hosprtal, 53, 311Ribeiro dos Santos, R. & Hudson, L. (1980). Typanosoma

cruzi: binding of parasite antigens to mammalian cell surfaces. ParasiteZmmUnolbgy,2, l-10.Rossi, M. A. (1990). Microvascular changes as a cause of chronic cardi&myopathy in Chagas’ disease. American Heart Journal, 120,233-236. Santos-Buch, C. A. & Teixeira, A. R. L. (1974). The immunology of experimental Chagas’ disease. III. Rejection of allogenic heart cells in vitro. Journal of Experimental Medicine, 140,38-53. Sartore, S., Gorza, L., Bormioli, S. P., Libera, L. D. & Schiaffine, S. (1981). Myosin types and fiber types in cardiac muscle. I. Ventricular myocardium. Journal of Cell Biology, 88.226-233. Tav&es-Neto, J. (1990). CorreIa@o do peso do cora@o de chaghsicose controles corn algumas caracteristicas anatomopato16gicas.Revista de Patologia Tropical, 19,25-34. Teixeira, V. P. A. & Ahneida, H. 0. (1986). Parasitism0 da veia central de supra-renal em diferentes formas anhtomo-clinicas da doensa de Chagas. Revista Goiana de Medicina, 32, 115110 1LO. Teixeira, V. P. A., Reis, M. A., Aradjo, M. B. M., Silveira, S. A., Reis, L. & Ahneida, H. 0. (1991). Compara@o do parasitismo da veia central da supra-renal corn o de outros tecidos em chaghsicoscrbnicos. Revista da SociedadeBrasileira deMedicina Tropical, 24, 73-78.

Received 21 Jui~ 1992; revised 8 October 1992; accepted for publication 24 November 1992

TRANSACTIONS OF THE ROYALSOCIETYOF TROPICALMEDICINEANDHYCIENE(~~~~) 87, 554

fGi-T&q Laboratory infection with Schistosoma mansoni Aifons Van Gompell, Erwin Van den Endenl, Jef Van ‘Outpatients Department den Endel and Stanny Gee& and *Department of Animal Health and Production, Institute of Tropical Medicine, Antwerp, Belgium We report an infection with Schistosoma mansoni in a laboratoj assistant who has never been in the tropics. Between 22 Tanuarv and 5 Februarv 1991 a laboratorv assistant workid wit6 snails (Biomphdlaria pfeiffti) originating from an irrigation canal in Richard-Toll, Senegal. This is an area known to be infected with Schistosoma mansoni (TALLA et al., 1990). The snails were brought to Belgium on 21 January 1991 for breeding and testing molluscicides. As advised, the assistant wore protective gloves when manipulating the snails and cleaning the aquaria. After 3 weeks, from 11 February (day l), she no longer took this precaution because she thought that the snails were no longer infectious. On day 31 she developed fever, headache and fatigue, lasting 5 d. No blood test was performed. A tentative diagnosis of a flu-like illness was made by her general practitioner. On day 54 a blood examination. carried out because she had reoorted vaeue digestive co&plaints lasting 3 d, showed^eosinopl&a (2360/mm3). Serology for schistosomiasis (antibody detection enzyme-linked itnmunosorbent assay (ELBA) using a total extract of adult S. mansoni prepared in the Address for correspondence: Dr A. Van Gompel, Outpatients Department, Institute of Tropical Medicine, Kronenburgstraat 43/3,2000 Antwerp, Belgium.

laboratory) was ne ative. On day 82 the eosinophil count was 790; serology Bor schistosomiasis remained negative. Microscopical examination of a stool sample using the saline-aerosol-ether-xylol enrichment technique (LOUGHLIN & SPITZ, 1949) on day 94 was negative. bn days 101 and 103, eggs of S. mansoni (10 eggs/g) were seen in a stool sp&&n. The ELISA fdr S&to&ma was weakly positive. At that time she reported no subjective complaint. A retrospective diagnosis of Katayama fever was made, and the patient was treated with praziquantel, a single dose of 40 mg/kg, repeated after 4 months. On day 234 the patient was in good health, the blood picture was normal, antibodies against Schistosoma were strongly positive, and a repeat stool examination was negative. This is, to our knowledge, the first report of Schistosoma infection in a person in Europe who has never been in an endemic region, but was accidentally infected in a laboratory. The period during which snails excrete cercariae is not easy to determine. In theory, it can continue for several months (THERON, 1981). Laboratory workers are advised to consider all snails collected from endemic areas to be potentially infective for their entire life. References Loughlin, E. & Spitz, S. (1947). Diagnosis of helminthiasis. Journal of the Amencan Medical Association, 139,997-1000. Talla, I., Kongs, A., Verlt, P., Belot, J., Sarr, S. & Coil, A. (1990). Outbreak of intestinal schistosomiasisin the Senegal River basin. Annales de la Socikd Beige de Midecine Tropicale, 70, 173-180. Theron, A. (1981). Dynamics of larval po ulations of Schistosoma mansoni in Biomphalaria glabrata. PI. Chronobiology of the, intramolluscal larva! develop,yent during th’ shedding ~;~~~~4Annals of Tropxal Medune and Parasltologv, 75, Received 25 November 1992; revised 4 January acceptedfor publication 6Januay 1993

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