NIAID Schistosomiasis Resource Center


Schistosomes Request for Research Materials

	Name and complete mailing address
	Full Name		This form will be sent to: Dr. Glen C. McGugan PIPB, DMID, NIAID, NIH 6610 Rockledge Drive Room 5044; MSC 6604 Bethesda, MD 20892-6603 email: gmcgugan@niaid.nih.gov
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	Principal Investigator (Name and Address)
	Full Name
	Address
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	email

	Schistosoma haematobium	Schistosoma mansoni
	Quantity needed	Quantity needed
	Unexp. B. truncatus truncatus	Unexp. Biomphalaria glabrata
	Exp. B. truncatus truncatus/S. haematobium	Exp. B. glabrata/S. mansoni
	(annual limit - 500 Egyptian strain)	(annual limit - 3000)

	Schistosoma japoncium	Schistosome Exposed Animals
	Quantity needed	Note: Annual limit per investigator
	Unexp. Oncomelania hupensis quadrasi	100 exposed hamsters
	Exp. O.h. quadrasi/Schistosoma japonicum	250 exposed mice
	(annual limit - 500 Philippine strain)
		Quantity needed
	Unexp. O. hupensis hupensis	S. mansoni-exposed mice
	Exp. O. hupensis/S japonicum	Dose
	(annual limit - 500 Chinese strain)
		S. mansoni-exposed hamsters
		Dose

		S. haematobium-exposed hamsters
		Dose

		S. japonicum-exposed mice
		Dose

	Frequency of shipments

	Remarks


	Shipper Preference
	Shipper Account #

	Billing address (if different from above)
	Full Name
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