Bilharzia. Doctor measuring the swollen abdomen of a man suffering from advanced intestinal schistosomiasis (bilharzia). The disease is caused by blood flukes (in this case Schistosoma japonicum). The flukes have reached the blood vessels of his intestines, causing dramatic enlargement of his liver and spleen. Other symptoms include anaemia, diarrhoea, dysentery and liver cirrhosis. Infection occurs when the fluke's larvae penetrate the skin of someone in infected water. Photographed at the Hunan Institute of Parasitic Diseases, China, in 1999.