Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: no known allergies / adverse drug reactions attending: chief complaint: upper gi bleed major surgical or invasive procedure: egd : large adherent blood clot was seen in the fundus, that was expansile and enlarging slowly. varices at the mid esophagus normal mucosa in the duodenum blood in the fundus and feeding gastric varices noted (injection) otherwise normal egd to third part of the duodenum egd : clotted blood in the fundus otherwise normal egd to third part of the duodenum history of present illness: this is a 37 yo female from with known hx of schistosomias complicated by hypertension and esophageal varices, s/p splenectomy, 3 months post-partum who presented with melena and hematemesis. her last endoscopy was in revealing two cords of grade 2 varices and two cords of grade 1 varices in the distal esophagus. she is currently on labetalol 100 mg b.i.d and on omeprazole 40mg . during her last gi visit in early , she was noted to have epigastric pain which was worse at night while laying down. her omeprazole was then increased to . she was also found to have significant iron deficiency and her iron supplemmentation was increased to 3 x a day. she states that she started to feel nauseous the day pta in the afternoon and was feeling dizzy when she stood up. she woke up at around 3 am and had a dark black stool. she then felt nauseas, lightheaded, feeling as she would faint. . in the ed, her vitals were: hr 105, sbp 110s. she had one episode of large amount of hematemesis, guaiac +. ng tube was placed and now draining coffee ground fluid/dark blood. she was started on ppi and octreotide. given 1 l of iv fluids, typed and crossed for 2 units. her hct was 27. gi was notified. . on the floor, she was comfortable and denied having any c/o at this time. her ng tube is draining dark red fluid with clots. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies constipation or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: obhx:one prior missed abortion requiring a d&c and a therapeutic abortion. gynhx: one prior missed abortion requiring a d&c and a therapeutic abortion. pmhx: - schistosomiasis-induced hypertension complicated by recurrent upper gi bleeds from esophageal varices. in , she underwent vessel banding. she has also had a splenectomy in in . her last upper gi bleed was possibly in , although there was no evidence of bleed on endoscopy. at that time she received 2 units of blood. at her most recent type and screen, she was found to have anti-c and anti-s antibody. her most recent endoscopy on revealed grade varices. she was taking propranolol 20 mg twice a day prior to pregancy but in light of the pregnancy propranolol was changed to labetolol. she had a liver biopsy in that showed no significant inflammation and rare mild lobular inflammation. there was no definite cirrhosis seen but there was focal bridging and fibrosis noted. pshx: splenectomy, d&c social history: patient moved to the united states from approximately six years ago. she lives in with her sister. she works as a house cleaner. she reports no alcohol or tobacco use or illicit drug use. family history: she has one uncle who is status post splenectomy for unclear reasons. physical exam: admission physical exam vitals: t: 98.5, hr 107, bp 98/72, rr 19, o2 sat 98% on ra general: alert, oriented, pale female in no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: tachy, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, mildly distended and tender at epigastric area, + hyperactive bs, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: chest x-ray : pulmonary vasculature is mildly engorged but there is no edema. heart size is normal. no pleural effusion. et tube ends at the upper margin of the clavicles, no less than 43 mm from the carina. nasogastric tube ends in a mildly distended stomach. no pneumothorax. ruq u/s doppler : 1. heterogenous hepatic echotexture without focal mass. 2. patent hepatic vasculature with normal directional flow. 08:23pm hct-30.4* 04:00am pt-13.0 ptt-22.7 inr(pt)-1.1 04:00am plt count-168 04:00am neuts-71.9* lymphs-23.8 monos-3.3 eos-0.3 basos-0.5 04:00am wbc-8.7# rbc-3.19* hgb-9.0* hct-27.5* mcv-86 mch-28.1 mchc-32.6 rdw-15.2 04:00am albumin-3.9 04:00am alt(sgpt)-22 ast(sgot)-24 alk phos-68 tot bili-0.1 04:00am estgfr-using this 04:00am glucose-121* urea n-35* creat-0.7 sodium-137 potassium-3.9 chloride-106 total co2-22 anion gap-13 04:21am hgb-9.2* calchct-28 05:08am urine rbc-* wbc-1 bacteria-none yeast-none epi-0-2 05:08am urine blood-lg nitrite-neg protein-neg glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-5.0 leuk-tr 05:08am urine color-yellow appear-clear sp -1.026 05:08am urine ucg-negative 05:08am urine hours-random 05:08am urine hours-random 06:45am hct-23.8* 10:16am hct-26.6* 03:47pm fibrinoge-167# 03:47pm fibrinoge-167# 03:47pm fdp-0-10 03:47pm plt count-122* 03:47pm plt count-122* 03:47pm hct-32.4* 03:47pm hct-32.4* 05:21pm freeca-1.03* 05:21pm freeca-1.03* 05:21pm type- ph-7.31* comments-green top brief hospital course: 37 yo female with hx of schistosomis complicated by hytertension with esophageal varices who presents with hematemesis and melena. . # upper gi bleed: pt with hx of esophageal varices grade 2 with prior hx of variceal bleed. this is secondary to schistosomiasis leading hypertension. she was receiving labetalol 100mg and omeprazole 40mg . she was switched from propanolol to labetolol due to her recent pregnancy. her hct at admission was 27 with her last hct in of 36(her baseline hct has ranged from mid 20s to mid 30s in the last few months). her hct decreased from 27->23.8 within 3 hours. she was noted to have dark blood in ng tube and had blood clots with her ng lavage. she received 4 units of prbc's and was for intubated for egd. egd showed a large adherent blood clot in the fundus, that was expansile and enlarging slowly. she was extubated the following day after second egd which revealed a clot in the fundus but no active bleed. she was placed on an octreotite drip for 72 hours and continued on ceftriaxone 1gm iv q 24 for ppx for 5 days. her hematoctit was stable in the unit and transferred to the floor. on the floor, her hct remained stable with no further episodes of hemetemesis. she was continued on po ppi which will be continued as an outpatient. she will need f/u endoscopy as an outpatient. . # schistosomiasis: treated in , leading to liver fibrosis and hypertension. s/p splenectomy . as per records, she had pneumovax . she does not have cirrhosis as per liver bx in and is not at increase risk for hcc. she is followed by dr. . # anemia: hx of with last iron level at 14, currently on iron 325mg tid. this is likely due to recent pregnancy, and possible gi bleed. for now transfuse for acute bleed as noted above and continue iron once tolerating po. no colonoscopy in our system. she will follow with gi as outpatient. . # communication: sister, (hcp) husband, , . # code: full (discussed with patient) medications on admission: -labetalol 100 mg twice a day -omeprazole 40 mg -ferrous sulfate 325, one 3 x a day discharge medications: 1. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 2. propranolol 10 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 3. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po three times a day. discharge disposition: home discharge diagnosis: melena, hematemesis esophageal varices schistosomiasis - dx , s/p splenectomy discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to for blood in your stools and vomit. you were treated with medications and you underwent a procedure called endoscopy to visualize your gi tract. your symptoms are likely secondary to schistosomiasis infection. you will need a follow-up endoscopy in 1 week. the following changes were made to your medications: stop labetalol 100 mg twice a day start propranolol 20 mg twice a day followup instructions: the following appointments have been made for you: egd with dr. next tuesday - please arrive at 7:30am in preparation for the procedure at 8:30am. you need to go to the building (). department: when: friday at 11:10 am with: dr. location: post clinic address: , sc clinical ctr campus: east best parking: garage this appointment is with a hospital-based doctor as part of your transition from the hospital back to your primary care provider. this visit, you will see your regular primary care doctor in follow up. department: digestive disease center when: tuesday at 8:00 am with: , md building: building (/ complex) campus: east best parking: main garage procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours other endoscopy of small intestine insertion of endotracheal tube endoscopic excision or destruction of lesion or tissue of stomach diagnoses: iron deficiency anemia secondary to blood loss (chronic) portal hypertension blood in stool hematemesis varices of other sites esophageal varices in diseases classified elsewhere, without mention of bleeding other chronic nonalcoholic liver disease esophageal varices without mention of bleeding late effects of other and unspecified infectious and parasitic diseases 

Answer: The patient is high likely exposed to