This document provides an overview of parasitology and various parasites. It discusses parasitism as a symbiotic relationship where the parasite lives in or on the host. Various types of parasites are described based on their habitat (ecto- vs endoparasite) and relationship to the host (obligate, facultative, etc.). Key parasites are then discussed in more detail, including their morphology, life cycles, modes of transmission, symptoms, diagnosis and treatment. These include Trichinella spiralis and Trichuris trichiura. Epidemiological concepts are also defined.
This document provides an overview of parasitology and various parasites. It discusses parasitism as a symbiotic relationship where the parasite lives in or on the host. Various types of parasites are described based on their habitat (ecto- vs endoparasite) and relationship to the host (obligate, facultative, etc.). Key parasites are then discussed in more detail, including their morphology, life cycles, modes of transmission, symptoms, diagnosis and treatment. These include Trichinella spiralis and Trichuris trichiura. Epidemiological concepts are also defined.
This document provides an overview of parasitology and various parasites. It discusses parasitism as a symbiotic relationship where the parasite lives in or on the host. Various types of parasites are described based on their habitat (ecto- vs endoparasite) and relationship to the host (obligate, facultative, etc.). Key parasites are then discussed in more detail, including their morphology, life cycles, modes of transmission, symptoms, diagnosis and treatment. These include Trichinella spiralis and Trichuris trichiura. Epidemiological concepts are also defined.
Prepared by: Jasmen S. Pasia, RMT, MSMT MLS Department, San Pedro College
Parasitology is the area of biology concerned with the __________________ of one living organism on another. Medical Parasitology is concerned with the animal parasites of humans and their medical significance, as well as their importance in human communities. _________ is a branch of medicine which deals with tropical diseases and other special medical problems of tropical regions. A tropical disease is an illness, which is indigenous to or endemic in a tropical area. Many tropical diseases are ______________________. Biological Relationships Symbiosis ___________________________________ Commensalism - is a symbiotic relationship in which two species live together and one species benefits from the relationship ____________________________ _______________________________. Mutualism - is a symbiosis in which two organisms _____________ from each other Parasitism - is a symbiotic relationship where one organism, the parasite lives in or on another for its __________________________ of the host. Parasitism Parasite - organisms which ____________ of another organism for growth and survival Host - ________________ that harbors the parasite and is usually larger than the parasite
Types of Parasite: 1. According to its habitat Ectoparasite - lives on the outside of the host (______________) Endoparasite - lives within the body of the host (_____________) 2. According to its relationship with the host Obligate - when they take up ______________ in and are completely dependent upon the host (Ascaris lumbricoides) Facultative - they are capable of leading both a ____________ ______________ existence even if they are outside the body of the host (Strongyloides stercoralis). Intermittent - visit the host only during feeding time (_______________) Incidental - establishes itself in a host in which it __________ ordinarily live ( Trichinella spiralis). Permanent - remains on or in the body of the host from early life until maturity, sometimes for its entire life cycle (______________________) Pseudoparasite - __________ mistaken as parasites (pollen, hairs) Types of Hosts: Definitive host - harbors the _____________________________ stages of the parasite (humans). Intermediate host - harbors the _____________________________ of the parasite (snails). 2
Paratenic Host - a host which act as a __________________ for the parasite and in which the parasite does not _____________________ (prawns). Reservoir - a host in which the parasite is __________________ and act as a source of ___________ for new cases (rodents). Incidental Host - refers to a situation in which the _______________ is not necessary for the parasite _______________________ (trichinosis). Nomenclature Classified according to the International Code of _______________________ Each parasite belongs to a Phylum, Class, Order, Family, Genus, and Species At times the further divisions of Suborder, Superfamily, Subfamily, and Subspecies are employed Family Name - ___________________ Superfamily - ___________________ Subfamily - ___________________
Names are binomial for species and trinomial for subspecies Names are in latin or Latinized. Modes of Transmission 1. Soil-transmitted = undergo ______________________ to reach the infective stage Ex: Ascaris lumbricoides Trichuris trichiura 2. Snail-transmitted = undergo further development in the ___________ to reach their infective stage. Ex: Schistosoma japonicum 3. Arthropod Transmitted = undergo further development in _______________ to reach their infective stage Ex: malaria _______________ filariasis - _______________ leishmaniasis sandfly trypanosomiasis A. American reduviid bug B. African - tse-tse flies
4. Food-Animal Transmitted = undergo further development in _____________ to reach their infective stage. Ex: Taenia solium pork Taenia saginata - beef 5. Contact Transmitted = parasite is really __________________ = parasite does not have to go further development Ex: Trichomonas ________________ ________________ vermicularis 6. Animal-borne = animal to human = zooanthroponosis
b) rectal biopsy amoebiasis secondary Schistosoma infection
Epidemiologic Measures
Epidemiology = is the study of patterns, _____________, and occurrence of disease
1) Incidence = is the number of _______________ of infection appearing in a population in a given period of time
2) Prevalence = is the number (______________________) of individuals in a population estimated to be infected with a particular parasite species at a given time
3) Cumulative Prevalence = is the percentage of individuals in a population infected with at least one parasite
4) Intensity of Infection = refers to the ______________ per infected person = this may be measured directly or indirectly and is also called as the _________________
5) Morbidity = clinical consequences of _________________ that affect an individuals well-being
6) Mortality = incidence of ____________ in a given population
Parasitic Infection and Disease
The transmission of parasites involved 3 factors: a) source ____________ b) mode of __________________________ c) _________________ of susceptible host
A human being, when infected by a parasite may serve as: a) its only ______________ b) its principal host with ____________ also infected c) its ______________ host with 1 or other animals as principal host
Phylum Nematoda
General Characteristics Females ________ than males and have a ________ tail. Males have ___________ tail with spicules for _________________. Unsegmented Round elongated worms measuring from a few mm to meter in length Complete digestive tract (mouth to anus) ___________ circulatory system Found in the intestine, blood, and tissue Worldwide _______________ There are sensory organs
Large Intestine Trichuris trichiura Enterobius vermicularis
PARASITOLOGY HELMITHS PHYLUM PLATYHELMINTHES Class Cestoda Class Trematoda PHYLUM NEMATODA PROTOZOA ARTHROPODS 4
Tissue Nematodes Trichinella spiralis Wuchereria bancrofti Brugia malayi Onchocerca volvulus Loa loa Dirofilaria immitis Gnathostoma spinigerum
Larva Migrans in Man Dracunculus medinensis Angiostrongylus cantonensis Ancylostoma caninum Ancylostoma braziliense
Trichinella spiralis Also known as the ______________, Pork Worm Diseases: - Trichinosis - ________________ - Trichinelliasis Morphology: Male Worm Measures _______ in length by 40-60 micra in transverse diameter. Cloaca is found at the caudal end which is evertible during coitus. It is guarded by 2 conspicuous _______ which clasp the female during copulation. Spicule is ______________. Posterior end of the worm is curved ventrad.
Female Worm About 3-4 mm long and 60-80 micra in width. Vulva opens at the __________ of the body.
Has a single uterus which contains ________________.
Encysted Larva measures __________ micra when extruded by the female worm provided with a ___________ burrowing tip at its tapering anterior end in the striated muscles, the larva grows to about 0.8-1mm and becomes encrusted along the axis of the muscle fibers
Life Cycle Infective Stage - _____________ larva Definitive Host - ______________ - man (accidetnal host) Diagnostic Stage - encysted larva
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Diagnosis - Muscle Biopsy - Bentonite _______________ Test
Clinical Disease 1. Destruction of the muscle fiber. 2. Eosinophilia 3. May have ____________ involvement
Prevention and Control 1. Sterilizing garbage containing ____________ scraps. 2. Cook meat properly (77 o C or 170 o F). 3. Storage at -15 0 C for 20 days or -30 0 C
for 6 days. 4. Screening of _____________. 5. Public Education.
Treatment: 1. Thiabendazole 2. Mebendazole
Trichuris trichiura Also known as the _______________ Diseases: - Trichuriasis - _____________ Infection
Morphology: Male Worm: Measures 3 - 3.5 cm. A single lanceolate spicule protrudes through a refractile penial sheath which has a bulbous termination covered with ___________________________. Distinguished from the female by its coiled caudal extremity about 360 degrees or more. Female Worm: Measures 3.5 - 5.5 cm in length. Vulva opens at the ____________, the fleshy portion of the body. Has a single ____________________. Bluntly rounded at the posterior end.
Ova: characteristically _________________ with bipolar unstained intralaminar prominences which have the appearance of mucoid plugs measures ________ micra by 22-23 micra in addition to a vitellaine membrane, it has a triple shell consisting of chorionic layer, albuminous layer and the bile-stained layer
Life Cycle Infective Stage - _______________ egg Definitive Host - humans Diagnostic Stage - ________ (unsegmented) No _________________ phase Resides in the ____________ intestine No intermediate host needed
Diagnosis: 1. ________________________________ 2. Kato-Katz Technique 3. ___________________ Technique (Recovery of eggs in the stool specimen)
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Prevention and Control: 1. Proper disposal of feces. 2. Hand ____________________. 3. AVOID using human fecal matter as fertilizer. 4. Community education.
History: - was 1 st recognized in the Philippines in 1963 at PGH - ____________________, Ilocos Norte - 1967, epidemic in Capillariasis in Pudoc, West Tagudin, Ilocos Sur (approximately 1,300 persons became ill and 90 persons died of the infection)
Morphology: Male Worm: Small, measuring ____________mm in length. Characterized by caudal alae and long, non- spiny sheaths
2 Types of Female Worm:
Atypical Female ___________________ (responsible for population build-up)
Typical Female- _____________________
NB: Both has an esophagus with secretory cells called _____________________ and the esophageal structure is called _______________________________
Female Worm: Measures _______________ mm in length. Body is divided into 2 almost equal parts, the anterior containing esophagus and esophageal glands and the posterior containing intestine and reproductive system with slightly prominent vulva.
Eggs: similar to that of the whipworm but are smaller about ____________________ micra usually in the single or 2-segmented stage of development more oval in shape _________________ plugs that are not protruberant shell is thick and pitted which appear as _______________ hence peanut-shaped
Male Worm Measures ____________ cm with smooth striated cuticles. They have a terminal mouth with ____________ with a sensory papillae. They have a ventrally curved posterior end with two ______________________.
Female Worm Measures ____________ cm with smooth striated cuticles. They have a terminal mouth with ______________ with a _____________ papillae. They have paired _____________ organs in the posterior 2/3. Posterior end is blunt. Productive capacity of 26 million eggs or 200, 000 eggs per day.
Egg (3 layers) 1. Albuminous covering - outer ______________ covering - serves as an auxiliary barrier to __________________________
2. Hyaline Shell - ____________________ structure
3. Vitelline Lipoidal Layer - highly impermeable
Egg (3 Types)
1. Fertilized Egg
measures ____________ micra by ____________ micra, shorter than the infertile eggs there is an outer coarsely mammilated albuminous covering _____________ yolk granules
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2. Unfertilized Egg measures ________ micra by 39 to 44 micra, longer and narrower than fertilized eggs it is _____________ with an irregular mammilated coating filled refractile granules they are difficult to identify and are found only in the ____________________.
3. Decorticated Egg
___________ of albuminous coating
Life Cycle: Infective Stage - _____________ egg - embryonation in soil (_______ weeks)
Definitive Host - _______________________
Diagnostic Stage - fertilized or unfertilized eggs in the feces
Clinical Disease:
1. Worm Ball __________________ in the intestine 2. Ascaris pneumonitis- due _____________ __________________ in the lungs
Diagnosis: 1. Demonstration of characteristic ___________ in feces. 2. Recovery of adult worms from _________, nasal passage, or even _____________.
Prevention and Control: 1. Proper ______________ of feces. 2. Cooking well of vegetables. 3. Avoid using human feces as ____________. 4. Proper _______________.
Treatment: 1. Pipperazine citrate. 2. Mebendazole or pyrantel pamoate.
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Strongyloides stercoralis
Common Name: Threadworm Disease: Strongyloidiasis Conchin-China Diarrhea Morphology: Parasitic or Filariform Female: smallest nematodes measuring 2.2 x 0.04 mm it has a slender tapering anterior end and a short conical pointed tail the short buccal cavity has 4 indistinct lips the vulva is located 1/3 the length of the body from the posterior end the uteri contain a single file of eight to twelve thin-shelled, transparent, segmented ova Parthenogenetic/ parthenogenic
Free-Living Female: measures 1 mm by 0.06 mm and is smaller than the parasitic female it has a muscular double-bulbed esophagus and the intestine is a straight cylindrical tube
Free-Living Male: measures 0.7 mm by 0.04 mm and is smaller than the female it has a ventrally curved tail, two copulatory spicules, a gubernaculum but no caudal alae
Rhabditiform Larva: measures 225 micra by 16 micra it has an elongated esophagus with a pyriform posterior bulb differs from hookworm in being slightly smaller and less attenuated posteriorly it also has a shorter buccal capsule and a larger genital primordium
Filariform Larva: is the non-feeding stage slender measuring about 550 micra it is similar to the hookworm filariform larva but usually is smaller, with a distinct cleft (notched) at the tip of the tail
Egg: rarely seen in the stool specimen it has a clear, thin shell and are similar to those of hookworms except that they measure about 50-58 micra by 30 to 34 micra
Life Cycle: Infective Stage - Filariform Larva Definitive Host - Humans, Monkeys Diagnostic Stage - Rhabditiform Larva in stool sample NB: Eggs hatch in mucosa of intestines and are rarely seen in feces. It has both a free-living and parasitic cycle.
Clinical Disease: A) Three stages based on Life Cycle 1. Cutaneous - initial skin penetration 2. Pulmonary - larval migration in the lungs 3. Intestinal - symptoms depend on worm load, immunocompromised patients may exhibit leukocytosis and eosinophilia
B) Hyperinfection Syndrome - may lead to death due to tissue damage - occurs in immunosuppressed patients (AIDS, drugs) - can be transferred through organ transplantation - transmammary
C) Autoinfection - some of the rhabditiform larva develop into filariform larva in the bowel and reinfect the host
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Diagnosis: Demonstration of _______________ and/or filarform larvae in the feces using: a) DFS b) concentration technique c) Baermann technique
Male Worm: 8-11 mm long Posses a bursa (____________) which aids in the speciation of hookworms Exhibits dental pattern
Female Worm: 10-13 mm long _____________ tail Adults may live 2-14 years Rarely seen in the stool since firmly attached to the mucosa
Rhabditiform Larva: _____________, feeding stage Bulbuous esophagus Long buccal cavity (approximately as long as the width of the body) _____________ genital primordium
Filariform Larva: ______________, non-feeding stage 700 um long Straight espohagus (1/4 of the length of the body) Pointed tail
1. Pneumonitis 2. Allergic Reactions 3. Anemia (each adult worm consumes ________ of blood/day) 4. Cutaneous Larva Migrans (due to migration of dog hookworms) * A. braziliense & A. caninum through the subcutaneous tissue causing itching and he formation of _____________________
Diagnosis: 1. Demonstration of characteristic egg in the feces (________________ cell stages) Larva is not seen in feces (unless the specimen is left for 24 hours)
R-E-M-E-M-B-E-R If a stool specimen is left at room temperature, the larva may continue to develop and must be differentiated with _____________________..
Diagnosis: Should you recover the adult Hookworm, easier differentiation is done by observing the buccal capsule. 11
N. americanus ____________ cutting plates A. duodenale ______ pairs of ventral teeth A. caninum ______ pairs of ventral teeth A. ceylanicum ______pairs of ventral teeth with outer bigger than the inner pair A. braziliense _______ of big teeth
Prevention and Control: 1. Proper disposal of feces. 2. Avoid walking barefooted. 3. Health education on personal, family, and community hygiene. 4. Treatment of infected individuals. 5. Mass chemotherapy when prevalence is greater than ___________ 6. Protection of susceptible individuals.
Enterobius vermicularis Common Name: 1. ________________ 2. Sitworm 3. ________________
Disease: 1. Enterobiasis 2. __________________
Male Worm: Measures 2 to 5 mm by 0.1 to 0.2 mm. It has a characteristic curved tail with a single spicule. Relatively smaller that the female worm. They are rarely seen because they die after copulation.
Female Worm: Measures 8 to 13 mm by 0.4 mm. It has a long ____________ hence the common name pinworm. The uteri of the gravid female are distended with eggs. They are capable of laying as much as 4, 672 to 16, 888 eggs/day.
Ova: are assymetrical, with one side flattened and the other side _____________ measures 50 to 60 micra by 20 to 30 micra averaging 55 by 36 micra the translucent shell consists of an outer, triple albuminous covering for mechanical protection and an inner lipoidal membrane for ____________ outside the host , eggs become infective in ________________________
Life Cycle: Infective Stage - ___________________ Definitive Host - Humans No IH needed Autoinfection is very possible
Diagnosis: 1. Scotch tape technique (cellulose tape) - ____________ stick to the tape - since migration of female occurs at ___________, the method is performed before the patients bowel movement or before the patient has taken a bath - adults may become stuck to the outside of the stool as it passes the perianal folds where the female migrates to lay eggs
Prevention and Control: 1. Proper hygiene. 2. Public Education. 3. Familial treatment.
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Blood and Tissue Nematodes
The microfilariae group 1. Wuchereria bancrofti 2. Brugia malayi 3. Loa loa 4. Onchocerca volvulus
Wuchereria bancrofti
Diseases: - Bancroftian filariasis - Wucheriasis - _________________ Microfilaria: - sheathed - no nuclei at the tip of the tail - norturnal periodicity (9pm-2am is its greatest concentration in the tblood) Elephantiasis: - permanent blockage of lymphatic system can occur in _________________ Diagnosis: - demonstrate in blood smears (thick and thin) sheathed microfilariae with ________________ at the tip of the tail
Brugia malayi Disease: - Malayan filariasis Microfilariae: - sheathed - nuclei stops then there is a clear space with __________________ at the tip of the tail - exhibits ____________ periodicity Elephantiasis: - restricted to the ____________ extremities Diagnosis: - demonstrate in blood smears (thick and thin) sheathed microfilariae with __________ terminal nuclei in tail Generally found in the Far East
Loa loa
Also known as the _________________ Microfilariae - sheathed - nuclei _________________ of the tail - exhibits _________l periodicity (microfilaria is shed in peripheral blood constantly day or night)
Causes ________________ swellings - allergic reaction due to worm migration in tissue and death in capillaries
Diagnosis: - demonstrate in blood smears (thick and thin) sheathed microfilariae with continuous nuclei to the tip of the tail - found in Africa
Onchocerca volvulus Also known as the Blinding Worm Disease: - Onchocerciasis - Onchocercosis - _____________________ Microfilariae - only pathogenic tissue nematode which is not sheathed - ____________ at the tip of the tail - found in nodules under skin, not in peripheral blood
Clinical Significance/Disease: - sever dermatitis - microfilaria in ocular structures may result in blindness - leading cause of blindness in Africa Diagnosis: - demonstrate from skin snips/tissue scrapings unsheathed microfilariae with no nuclei in tail
NB: _______________________ eosinophilia is associated with the microfilariae of these nematodes
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Microfilariae Disease Arthropod Vector Diagnostic stage found in W. bancrofti Elephantiasis Mosquito (Culex/ Anopheles) Blood B. Malayi Elephantiasis Mosquito (Mansonia) Blood L. Loa Calabar swelling Blindness Fly (Chrysops) Blood O. volvulus River blindness Fly (Simulian) Tissue from nodule
LIFE CYCLE
1. Ingestion of the microfilariae from the blood or tissues by a blood-sucking insect. 2. The metamorphosis of the microfilaria in the arthropod vector 1 st into rhabditiform larva and then into an infectious filariform larva. 3. The transfer of the infective larva to the skin of a new host by the proboscis of the biting insect. 4. The development of the larva after entry to the bite wound into a mature worm at its selective site. Treatment/Prevention/Control 1. Control on mosquitoes and human sources of infection. 2. Spraying of houses with residual insecticides. 3. Diethylcarbamazime (DEC) 4. Ivermectin
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Dracunculus medinensis
Common Name: ____________________ ____________________ Medina Worm Disease: Dracunculiasis
parasite is frequently found in the subcutaneous tissues and mucscles of humans, dogs and sometimes cattles and horses The disease causes cutaneous nodules and subsequent ulcers.
Morphology Males are small (1.2-2.9 cm long) Females measures 60cm in length The larvae, which measure between 500 and 700 micrometers, can live for 6 days in clean water and 2 to 3 weeks in muddy water.
Treatment: Removal of Worm Filtering water sources Avoid contact with contaminated water
Angiostrongylus cantonensis
Common Name: ____________________ Was described by Chen in 1935 from domestic rats in Canton, China The worm normally lives in the lungs of rats but can cause eosinophilic meningoencephalitis in man
Morphology Male: - pale and filifprm - 16 to 19 mm x 0.26 mm in diameter - they have a well-developed caudal bursa (kidney-shaped and single-lobed)
Female: - pale and filiform - 21 to 25 mm x 0.30-0.36 mm in diameter - has uterine tubules which are round spirally around the intestine (__________________) - lays 15,000 eggs/day
Eggs Have delicate hyaline shells Measure 46-48 micra x 68 micra Unembryonated when oviposited
Diagnosis Relatively difficult Presumptive diagnosis is made by travel history and exposure CSF (10% eosinophilia in proportion to the WBC) CT Scan ELISA
Treatment No antihelminthic treatment is recommended Thiabendazole, Medendazole, Albendazole, Ivermectin (effective in experimental animals) Prevention/Control ______________________ Safe food preparation Elimination of IH Washing of leafy vegetables Eating sufficiently cooked prawns and crabs