cartsman wrote:
Does your wife also work with top-level athletes who push themselves to the limits of what their body can handle in training? If not, do you think she would agree that it's possible that training that hard could cause them to experience more severe side-effects or complications than normal? And/or that such a finely tuned athlete would have a very different definition of what qualifies as an "adverse effect" to a normal person? They're genuine questions, I know nothing about the disease than what can be found on the internet, and there's a lot of things out there like "the disease can normally be treated..." which don't really give much clue as to what complications or "non-normal" cases can look like.
No, she does not work with top level athletes, and no studies have been done on top level athletes. This is the first case where an athlete of his caliber has a claimed history of schistosomaisis that I can find. In her studied opinion based on the literature and experience, the fitness level of the person does not change the efficacy of praziquantel in treatment of schistosomaisis / bilharzia. This drug has been used since the 1970s and is heavily monitored for efficacy and for the development of drug resistant parasites.
Most of the side-effects are due to dying worms, and not to the drug itself. The data that exists for side effects for praziquantel use in schistosomiasis indicate that the driving factor for side effects is number of worms in the patient, not the fitness of the person. In adverse effects vs. a "normal" person, you obviously can't quantify what Froome would feel when taking praziquantel, but his statement that "It basically kills everything in your system" is misleading. The drug has virtually no effect on the cells of your body (targeting the adult worms), it is rapidly excreted in urine and not stored in fat. The most commonly reported side effects for treatment of schistosomiasis are all intestinal.