A soluble material has been isolated from schistosome eggs which in minute quantities without the addition of adjuvant induces sensitization to a delayed hypersensitivity type of granuloma forming around intact schistosome eggs. This material is secreted by intact eggs and is found in high concentration in the fluid released during the hatching process. When adsorbed to bentonite particles this substance elicits hypersensitivity type granuloma formation in specifically sensitized animals. The granuloma sensitizing factor also both induces and elicits delayed footpad swelling in mice. Quantities which sensitize with respect to these delayed type reactions do not induce antibody formation detectable by a sensitive hemagglutination. technique within the duration of the above experiments.

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Priorities among the infectious diseases affecting the three billion people in the less developed world have been based on prevalence, morbidity, mortality and feasibility of control. With these priorities in mind a program of selective primary health care is compared with other approaches and suggested as the most cost-effective form of medical intervention in the least developed countries. A flexible program delivered by either fixed or mobile units might include measles and diphtheria-pertussis-tetanus vaccination, treatment for febrile malaria and oral rehydration for diarrhea in children, and tetanus toxoid and encouragement of breast feeding in mothers. Other interventions might be added on the basis of regional needs and new developments. For major diseases for which control measures are inadequate, research is an inexpensive approach on the basis of cost per infected person per year.

Although the general pathology of schistosomiasis has been well understood for more than 70 years, it is only recently that it has been possible to analyse the disease at the molecular level and to understand the relationship between the number of parasites in an infected individual and the appearance of overt disease.

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