Relationship between the transmission of schistosomiasis japonica and the construction of the Three Gorge Reservoir.

OBJECTIVE: To study the relationship between the changes of environment and the transmission of Schistosomiasis japonica after the construction of the Three Gorge Reservoir.
METHODS: On the basis of the predictive data on changes of water level and sediment in the middle and lower reaches of the Yangtze River after the dam construction provided by the Yangtze River Committee on Water Conservancy, corresponding data were collected and analyzed. In order to understand the effects of changes of water level and sediment on Oncomelania hupensis, the intermediate host of Schistosoma japonicum, field surveys and ecologically intimated experiments were done. The prevalence status and factors related to transmission were investigated by epidemiology, medical geography and public health.
RESULTS: Positive impact on control of schistosomiasis is that floods in the Yangtze River will occur less and will decrease the dispersal of snails and the chances of infection for humans and animals as well. Snail habitats' beach will be reduced in the flushed area along the Yangtze River. Exploitation of beach and elimination of snails will benefit from the beach's uplift in flushed area. The floods ahead of time in autumn will interfere with the development of snails. Negative impact is that the flushed beaches and migratory settlements at certain altitude may become snail habitats. So the reservoir area will be a potential transmission area of schistosomiasis due to dispersal of infectious resources and Oncomelania snails. The uprising of the water body level may cause the expending of the snail habitats in some places of Jianghan plain during the transition of spring to summer. The destruction of the embankments of the Dongting Lake will be put off by its delayed flush, which causes the beach in a situation of growing reed-grass or grass for a long time that benefits the reproduction of the snails. The chances for schistosome infection to humans and animals will be on the increase, because the water regression occurs ahead of time in the Dongting Lake beach in autumn. The distribution of snails will not be affected by the changes of water level in the lower reaches of the Yangtze River after the dam is built, but the flushed section in Anhui in the recent 80 years are suitable for the snails' development. The environmental changes due to dam construction will not obviously affect the development of snails and the transmission of schistosomiasis in the Poyang Lake area.
CONCLUSION: The construction of the huge dam and the formation of the Three Gorge Reservoir on the Yangtze River may have both positive and negative impact on schistosomiasis transmission and control. Great effort must be made to decrease the negative impact to avoid or, at least, to decrease S. japonicum transmission.