A review on swimmer's itch and the occurrence of bird schistosomes in Iceland.

In the past decade, swimmer's itch (SI) has repeatedly occurred in people who have been wading or bathing in ponds or lakes in Iceland where water birds and snails are abundant. Some of the affected sites were warmed by geothermal activity, and others were not. A search for the causative agent of SI, ocellate furcocercariae that have been found in Iceland only in Radix peregra snails, revealed an average infection prevalence of 1.4% (n = 12,432). Locally, infection rates commonly exceeded 6%, the highest value observed being 24.5%. A search for adult schistosomes in visceral organs and the nasal cavities of 110 water birds belonging to the orders Gaviiformes, Podicipediformes and Anseriformes revealed eggs, miracidia or adult stages of at least seven previously identifiable schistosome species in four anseriform bird species. A previously unknown species of schistosome, Allobilharzia visceralis, was detected in whooper swans (Cygnus cygnus), and classified in a new genus. In mallards (Anas platyrhynchos) a nasal Trichobilharzia sp. and the visceral schistosome T. franki were identified. In red-breasted merganser (Mergus serrator), distinct egg types belonging to two species of the genus Trichobilharzia have been found. In grey-lag goose (Anser anser) two different egg types were also found - a large Trichobilharzia sp. and small eggs of a Dendritobilharzia sp. Additionally, unidentified cercariae, probably belonging to a previously undescribed genus were detected in R. peregra in Oslandsstjörn. Taken together, the data obtained by morphological examination of eggs and recent DNA sequencing results, indicate that at least eight species of bird schistosomes occur in Iceland.