Theodor Bilharz, a German surgeon working in Cairo, identified the parasite as a causative agent of urinary infection in 1851.

[5] Along with other helminth parasites Clonorchis sinensis and Opisthorchis viverrini, S. haematobium was declared as Group 1 (extensively proven) carcinogens by the WHO International Agency for Research on Cancer (IARC) Working Group on the Evaluation of Carcinogenic Risks to Humans in 2009.

[6] Bloody urine (haematuria) was recorded by Ancient Egyptians in papyri 5,000 years ago.

[9] Since the cause of the disease was unknown, Napoleon's army in 1798 called Egypt as "the land of menstruating men.

"[10] In 1851, Theodor Maximillian Bilharz, a German physician at the Kasr el-Aini Hospital in Cairo recovered the adult fluke from a dead soldier.

He named it Distomum haematobium, for its apparent two mouths (now called ventral and oral suckers) and habitat of the blood vessel.

Another German physician Heinrich Meckel von Hemsbach introduced a new name Bilharzia haematobium in 1856 to honour the discoverer.

[13] Unbeknown to von Hemsbach, a German zoologist David Friedrich Weinland established a new genus Schistosoma in 1858.

[15] He successfully infected mice, rats, guinea pigs, and monkey using cercariae from four species of snails, belonging to Bullinus (now Bulinus) and Planorbis, which were collected from El Marg canal near Cairo; proving that snails are the intermediate hosts.

[16] Its role in cancer was first noted by a British Surgeon Reginald Harrison, at the Liverpool Royal Infirmary, in 1889.

A German physician Carl Goebel confirmed in 1903 that bladder tumour occurred in most bilharzia patients.

[6] Adult Schistosoma haematobium has male and female, which are permanently paired (a condition called in copula) as what looks like an individual.

Its leaf-like flat body is curled up from both sides to form a channel or groove called gynaecophoric canal in which the female is wrapped up.

Its pathogenic armament, the eggs are oval-shaped, measuring 144 × 58 μm in diameter, with characteristic terminal spine.

Epidermal plate is absent only at the extreme anterior called apical papilla, or terebratorium, which contains numerous sensory organelles.

Species of snail belonging to the genus Bulinus, including B. globosus, B. forskalii, B. nasutus, B. nyassanus, and B. truncatus, can harbour the miracidia.

[27] The involvement of the Planorbarius metidjensis snail, which is native to Northwestern Africa and the Iberian peninsula is possible, though clear evidence only stems from experimental infections.

The female body becomes enveloped within the rolled-up gynaecophoric canal of the male; thus, becoming partners for life.

This is the condition behind the pathological lesions found in the bladder wall, ureter and renal; and also tumour, both benign and malignant.

However, agricultural activities such as fishing and rice cultivation involve long contact with water, making avoidance impractical.

Infections are characterized by pronounced acute inflammation, squamous metaplasia, blood and reactive epithelial changes.

The eggs induce a granulomatous host immune response which is indicated by lymphocytes (which mainly produce T-helper-2 cytokines such as interleukins 4, 5, and 13), eosinophils, and activated macrophages.

[29] In late stage, the infection may lead to extra-urinary complication named Bilharzial cor pulmonale.

In endemic regions, haematuria is so widespread that it is thought a natural sign of puberty for boys, and is confused with menses in girls.

The first epidemiological survey in 1937 indicated that infection rate was as high as 85% among people in the Northern and Eastern parts of the Delta.