Following a lengthy African transport experience (detailed below) we arrived at Lake Malawi in high spirits. Cape Maclear boasts white sand, islands for exploration, sunset cruises and an array of eateries adorning the beach. It’s much like spending a holiday on the Med but with a few added bonuses. The water is fresh – so when snorkelling there is a distinct lack of stinging eyes or collection of salt at the back of your nose. On holiday completion there is no need to remortgage your house to cover that second bottle of wine (if only because there are more of bottles of Smirnoff Ice in the fridge than Chateauneuf-du-Pape in the cellar). After school the kids come hurtling to the lake side to loll in the shallows and race up and down the sand in the late afternoon sun. In the evening workers arrive to wash off the cares of the day. To spice things up at dusk you could head for an evening swim in nearby murky waters and find a croc or hippo to wrestle.
Maybe the most significant, and most dangerous animal in Lake Malawi is actually the lowly aquatic snail. Famous not for particularly for its rarity, beauty or big teeth but rather for its near permanent parasitic house guest, Bilharzia.
Bilharzia (Schistosoma haemotobium in posh circles) is crafty. The number of infected snails varies hugely throughout different areas of Lake Malawi, and indeed many collections of fresh water in Africa. It’s eggs infect aquatic snails where they incubate and hatch, developing into microscopic tadpole-like babies, plumes of which are released back into the water. Here they wait patiently for paddling ankles, collection in pots or for a friendly pipe to helpfully pump them into the nearest hotel shower. These Schisto tadpoles are expert diggers and are capable of burrowing through skin, where they continue on until they find a nice comfortable home to develop into healthy adults.
While some of you might have a shiver down the spine at this, never worry. While us big old humans can get sick during the initial infection (sometimes accompanied by the wonderfully named ‘swimmer’s itch’), the majority of us are relatively unaware of our new blossoming friendship. Unfortunately though, Bilhariza is much more frenemy than friend. Apart from the possibility of getting sick quickly there can be some serious side effects in long term infection or, like the kids frolicking in the shallows, you are exposed regularly over time. Some researchers got a bunch of kids in Kenya to run a bleep test (seems a little harsh) and it was compared to kids of the same age in Canada. While the Kenyan kids appeared for all intents and purposes healthy and happy, their exercise performance was significantly reduced in comparison to the youngsters from Canada. This is compounded by other research showing decreased levels of cognitive development (memory and attention), anaemia and growth stunting*. In an example more close to home, Chris Frome got rid of Bill and started making some serious money on the roads in France. If in doubt folks, let’s blame our lack of sporting excellence on a parasitic infection. Because let’s be honest, we all know it’s got nothing to do with talent, hard graft or sheer iron will.
To me, all this just adds a bit of flavour to a lovely holiday and yet another possible addition to my tropical disease menagerie. In truth I am much looking forward to the delightful chalky taste of Praziquantel tablets washed down by luke warm water, if only to alleviate the anxiety of my long suffering mother (and bring her voice back to a pitch that can be understood by species other than dolphin or dog). I suppose it does also have the added bonus of reducing the risk of serious health complications.
All travellers from honeymooners to hardcore adventurers to foot loose and fancy free hippy dippy types are equally at risk from this infection. Advice is to do a little research; steer clear of swimming in areas where infection rates are high (be aware of the showers or an inviting looking swimming pool too). And if in doubt, get the treatment. Because really, everybody loves a pill popper.
Happy travels happy campers.
*References available on request