TISSUE NEMATODES

Wuchereria bancrofti causes lymphatic filariasis (elephantiasis)

DISTRIBUTION: Asia (particularly India), Africa, Northern South America (Brazil).
VECTOR: MOSQUITO (Culex/Anopheles)
PATHOLOGY/CLINICAL
1. Elephantiasis caused by blocked lymph vessels
2. Tropical Pulmonary eosinophilia = hyper-reaction to microfilaria.
DIAGNOSIS:
1. microfilaria in blood- nocturnal periodicity (++ 10:00PM - 2:00 AM)
a. (W. bancrofti in South Pacific: periodicity absent.)
b. (Brugia malayi: nocturnal periodicity)
2. Thin and thick blood smears + filter methods.
CONTROL: mass treatment of infected patients
short-time travelers to filarial areas are a low risk group

Onchocerca volvulus causes onchocerciasis (river blindness)

DISTRIBUTION: Central Northern South America/ tropical Africa
VECTOR: black fly (Simulium)
SYMPTOMS:
1. Skin rash - heavy itch Inflammatory reaction to microfilaria
2. Onchocercomas. subcutaneous nodule harboring adult worm.
3. !!!!!!!!!!!!! Remove onchocercomas in face = lower risk of blindness
4. River Blindness 30% of villagers blind = end of village life/community!!!!!!!!!!!!
DIAGNOSIS: skin snips, look for microfilaria in skin.
(The bacterium, Wolbachia is an endosymbiont of the female worm. This symbiosis greatly
enhances the fertility of the female worm.)

Loa loa causes loaiasis (eye worm) West Africa

Vector: deer fly (Chrysops)
CLINICAL PICTURE: Calabar swelling no lasting harm to host
DIAGNOSIS: clinical diagnosis or microfilaria (+) late in disease.
Daytime periodicity

Dracunculus medinensis causes GUINEA WORM

It was an Epidemic problem (harvest not brought in)
LIFECYCLE: copepod > human > copepod.
CONTROL MEASURES:
nylon filters to remove copepods from drinking water
control of copepod population
building walls around water holes to prevent man-to-water contact.
IN 2010 THANKS TO THE CARTER CENTER, GUINEA WORM ALMOST ERADICATED.
Cases left (only ~ 3500 cases in 2009) are in southern Sudan)

LARVA MIGRANS (CREEPING ERUPTION):

Ancylostoma braziiiense (dog hookworm) contaminated beaches (dog feces) strictly
confined to skin in humans.

PARASITES OF PARTICULAR IMPORTANCE IN AIDS/IMMUNOSUPPRESSED PATIENTS

Toxoplasma gondii
Cryptosporidium parvum
Cyclospora cayetanensis
Isospora belli
Microsporidia
Strongyloides stercoralis

Leishmaniasis
Babesiosis
American Trypanosomiasis (Chagas
Disease).
Giardiasis higher incidence
Sarcoptes scabiei

NEED MATURATION IN SOIL TO BECOME INFECTIVE

Toxoplasma
Trichuris trichiura
Cyclosporidium
Hookworm *
Isospora belli
Strongyloides stercoralis *
Ascaris lumbricoides *
Miscellaneous information:
* Three that have lung cycles can cause symptoms in lungs, pneumonia.
PLEASE NOTE THAT THE OOCYSTS OF THE COCCIDIUM, Cryptosporidium parvum, ARE
IMMEDIATELY INFECTIVE
In certain lifecycles of protozoa:
Definitive host = sexual cycle sporogony
Intermediate host = asexual cycle merogony (schizogony)
In certain lifecycles of worms:
Definitive host = where eggs are formed
Intermediate host = where eggs transform into infective larvae