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Schistosomiasis and its intermediate hosts in the Lesser Antillean islands of the Caribbean.

The discontinuous distribution of Schistosoma mansoni in the Caribbean islands results from accidents of history, geography, and the migration of both infected people and intermediate host snails. The spread of infection requires the presence of infected people, a susceptible snail host, poor sanitation, and human dependence upon snail-infested water. The various Caribbean countries differ in these regards, and the relationships between the various critical factors determine whether and to what extent the disease exists. Sturrock and Sturrock (I) cite reports of transmission in the following places: the Dominican Republic, Puerto Rico, Vieques, St. Maarten, St. Kitts, Montserrat, Antigua, Guadeloupe, Martinique, and Saint Lucia in the Caribbean and Venezuela and Suriname on the South American mainland. Ferguson et al. (2,3) report that the infection has been eliminated from St. Kitts and Vieques. Of the remaining places, Trinidad, Grenada, Barbados, and St. Vincent are apparently free of Biomphalariu glubrata (the most important snail host in the area), although B. straminea is present in Trinidad and Grenada. Sturrock and Sturrock (I) showed that B. glubrata from Dominica, the Dominican Republic, Puerto Rico, and French Guiana were susceptible to St. Lucian S. mansoni, although the snails from French Guiana