schistosomiasis (shĭsˈtəsōmĪˈəsĭs) [key], bilharziasis, or snail fever, parasitic disease caused by blood flukes, trematode worms of the genus Schistosoma. Three species are human parasites: S. mansoni, S. japonicum, and S. haematobium. The disease is prevalent in Asia, some Pacific islands, Africa, the West Indies, South America, Spain, Puerto Rico, and Cyprus. The larvae of the parasite are harbored by snails, which serve as intermediate hosts, and infect humans who bathe in or otherwise come in contact with infested waters. The larvae enter through the skin, migrate via the blood vessels, and mature in the lungs. From there they travel to the veins of the upper or lower intestine or bladder and reproduce. Some eggs pass out in the feces. Others are carried into the liver, where the body surrounds them with white blood cells, forming hundreds of tiny ball-like granulomas that eventually impair the liver's ability to function. It is believed that the flukes settle in blood vessels that have a particular human immune substance, tumor necrosis factor, that they require in order to reproduce.
The disease is characterized by a skin eruption at the site of entry, fever, diarrhea, and other symptoms, depending on the tissues affected; cirrhosis of the liver is common. The disease can be cured with the drug praziquantel, but reinfection can occur. Although symptoms vary according to the species of infecting fluke, all forms can result in general weakening and eventual death. Control of the disease is difficult, but attempts have been made to eradicate the snail hosts. Proper sanitation and disposal of human wastes are also important.