Swimmer's itch: etiology, impact, and risk factors in Europe.

This review summarizes current knowledge about the occurrence and distribution of swimmer's itch, with a focus on Europe. Although recent publications have reviewed the biology and systematics of bird schistosomes and their complex host-parasite interactions, the underlying ecological factors that create favorable conditions for the parasites and the way humans interact with infested water bodies require further attention. Relevant studies from the past decade were analyzed to reveal an almost complete set of ecological factors as a prerequisite for establishing the life cycle of bird schistosomes. Based on both records of the occurrence of the parasite infective agents, and epidemiological studies that investigate outbreaks of swimmer's itch, this review concentrates on the risk factors for humans engaged in recreational water activities.