Delays may lead to seizures (due to hypoglycaemia), hypotension (due to cortisol deficiency), and/or intellectual disability (due to thyroid endocrine deficits). Due to the before-mentioned factors, mortality and morbidity is higher than that of the general population, particularly during the first 2 years of life. Epidemiology
The prevalence of PSIS is unknown, however, some 1,000 cases have been reported either with or without the full triad. References


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Studies of infested lakes and outbreaks in Europe and North America have found cases where infection risk appears to be evenly distributed around the margins of water bodies as well as instances where risk increases in endemic swimmers itch "hotspots". Children may become infected more frequently and more intensely than adults but this probably reflects their tendency to swim for longer periods inshore, where cercariae also concentrate. Stimuli for cercarial penetration into host skin include unsaturated fatty acids, such as linoleic and linolenic acids. These essential fatty acids are found in many edible crops, derived plant oils, sun lotions and creams based on plant oils. Control
Various strategies targeting the mollusc and avian hosts of schistosomes have been used by lakeside residents in recreational areas of North America to deal with outbreaks of swimmers itch. In Michigan, for decades, authorities used copper sulfate as a molluscicide to reduce snail host populations and thereby the incidence of swimmers itch. The results with this agent have been inconclusive, possibly because:

Snails become tolerant
Local water chemistry reduces the molluscicides efficacy
Local currents diffuse it
Adjacent snail populations repopulate a treated areaMore importantly, perhaps, copper sulfate is toxic to more than just molluscs, and the effects of its use on aquatic ecosystems are not well understood.Another method targeting the snail host, mechanical disturbance of snail habitat, has been also tried in some areas of North America and Lake Annecy in France, with promising results. Some work in Michigan suggests that administering praziquantel to hatchling waterfowl can reduce local swimmers itch rates in humans.