Causal Agent:

Ascaris lumbricoides is the largest nematode (roundworm) parasitizing the human intestine.
(Adult females: 20 to 35 cm; adult male: 15 to 30 cm.)

Life Cycle:

Adult worms live in the lumen of the small intestine. A female may produce approximately
200,000 eggs per day, which are passed with the feces . Unfertilized eggs may be ingested but
are not infective. Fertile eggs embryonate and become infective after 18 days to several weeks
, depending on the environmental conditions (optimum: moist, warm, shaded soil). After
infective eggs are swallowed , the larvae hatch , invade the intestinal mucosa, and are carried
via the portal, then systemic circulation to the lungs . The larvae mature further in the lungs
(10 to 14 days), penetrate the alveolar walls, ascend the bronchial tree to the throat, and are
swallowed . Upon reaching the small intestine, they develop into adult worms . Between 2
and 3 months are required from ingestion of the infective eggs to oviposition by the adult female.
Adult worms can live 1 to 2 years.
LIFE CYCLE Adult worms inhabit the lumen of the small intestine, usually in
the jejunum or ileum. They have a life span of 10 months to 2 years and then are
passed in the stool. When both female and male worms are present in the intestine,
each female worm produces approximately 200,000 fertilized ova per day. When
infections with only female worms occurs, infertile eggs that do not develop into
the infectious stage are produced. With male-only worm infections, no eggs are
formed.

The ova are oval, have a thick shell, a mamillated outer coat, and measure 45 to 70
m by 35 to 50 m. The ova are passed out in the feces, and embryos develop into
infective second-stage larvae in the environment in two to four weeks (depending
upon environmental conditions). When ingested by humans, the ova hatch in the
small intestine and release larvae, which penetrate the intestinal wall and migrate
hematogenously or via lymphatics to the heart and lungs. Occasionally, larvae
migrate to sites other than the lungs, including to the kidney or brain.

Larvae usually reach the lungs by four days after ingestion of eggs. Within the
alveoli of the lungs, the larvae mature over a period of approximately 10 days, then
pass up via bronchi and the trachea, and are subsequently swallowed. Once back in
the intestine, they mature into adult worms. Although the majority of worms are
found in the jejunum, they may be found anywhere from the esophagus to the
rectum. After approximately two to three months, gravid females will begin to
produce ova which, when excreted, complete the cycle.

Adult worms do not multiply in the human host, so the number of adult worms per
infected person relates to the degree of continued exposure to infectious eggs over
time. Worm burdens of several hundred per individual are not uncommon in highly
endemic areas, and case reports of more than 2,000 worms in individual children
exist [8]. However the number of eggs produced per female worm tends to
decrease as the worm burden increases. It has been estimated that 9 x 10(14) eggs
contaminate the soil per day worldwide .
(https://web.stanford.edu/class/humbio103/ParaSites2005/Ascaris/JLora_ParaSite.
htm)
 Ascaris lumbricoides is one of the commonest and most prevalent parasites infecting
humans in the world today (14,42). Ascariasis is endemic in parts of tropical and temperate
regions of the world, where there is sufficient moisture and particularly in areas characterised
with poverty, ignorance and low standard of hygiene and sanitation(20). Over one billion people
are infected world-wide (4), most of whom reside in developing countries of Africa, Asia and
South America (3,25).

Ascaris lumbricoides is the largest nematode inhabiting the human alimentary tract, usually
found residing in the jejunum of the small intestine (3,4,16). The males are usually smaller than
the females and have a curved posterior end. They measure 15 to 31 cm in length and 2 to 4 mm
in width while females are 20 to 49cm long and 3 to 6 mm wide. Life worms appear creamy
white to yellow and often translucent with a pinkish tint. A. lumbricoides has a direct life cycle.
Eggs released by the females are passed with host faeces. The eggs appear brownish in colour.
Both fertilised and unfertilised eggs can be detected in host faeces. Fertilised eggs are round to
oval, measuring 45 to 75 by 35 to 50 m, containing a developing embryo and covered by a thick
shell with an outer surface that appears rough or irregular. The unfertilised eggs are larger and
elongated in shape, measuring 60 to 100 by 40 to 60 m.

The detailed life cycle of A. lumbricoides has been described previously (16). Under conducive
climatic conditions of temperature (25-30C), high humidity and sufficient supply of oxygen,
fertilised eggs moult once and embryonate in 15 to 35 days to become infective. The infective
egg contains a second stage larva, coiled within the eggshell. Infection occurs when the infective
eggs are ingested with contaminated food and water. The eggs hatch into larvae in the jejunum a
few hours after being swallowed. The larvae penetrate the intestinal mucosa, migrate via the
portal vessels and lymphatic system into the liver from where they are carried through the heart
into the lungs. Subsequently, they penetrate the capillary walls and enter into the lung alveoli.
After about 10 days in the lungs they move up the bronchi and trachea to the pharynx and are
then swallowed down the oesophagus. This migratory phase lasts for about two weeks during
which the larvae undergo two additional moults. On arrival at the small intestine, the fourth
moult occurs and the larvae form immature adult worms. The worms mature and copulation
takes place between adult male and female worms. The release of eggs by the female worm
commences about 60 days after swallowing an infective egg. Adult worms survive for one to two
years in the human host during which time each female worm produces about 200,000 eggs per
day. Diagnosis is by examining the host faeces for Ascaris eggs or adult worms. The fertilised
egg of A. lumbricoides is the most resistant of all soil-transmitted helminth eggs and can remain
viable in the environment for many years. (http://www.antimicrobe.org/new/b17.asp)
Ascaris lumbricoides, giant roundworm, is the most common parasitic worm in humans.
According to some estimates 25 % of humans are infected with the disease, ascariasis. Ascariasis
occurs worldwide, mostly in tropical and subtropical countries. It has highest prevalence in areas
of poor sanitation and where human feces are used as fertilizer.

The life cycle of Ascaris lumbricoides takes about three months. Ascariasis starts, when Ascaris
lumbricoides eggs are accidentally swallowed. They can be acquired from dirty fingers, water or
food that has been contaminated with feces of an infected human. Larvae hatch from the eggs,
penetrate the intestinal wall and enter the bloodstream. They stop at pulmonary arteries and stay
in the lungs for two weeks. They break into the alveoli and travel up the respiratory system to the
throat to be swallowed again. The migration is needed for the larvae to develop into adults. Adult
worms attach themselves to the intestinal wall ready to mate. Adults survive by eating food
digested by the host and live up to 2 years. A female produces about 200 000 microscopic eggs
per day that are passed in feces. The eggs fertilize into infective stage within a few weeks in the
right conditions in the soil. Unfertilized eggs are not infective. The eggs are very resistant to
chemicals, extreme temperatures and other rough conditions and can survive for months. Adult
females are 2035 cm long and 36 mm in diameter. Male worms are a little smaller reaching
1530 cm in length and 24 mm in width.
Ascariasis can be asymptomatic, if there are only a few worms. If there are tens or hundreds of
worms, symptoms might include:

diarrhea

fever

nausea

stomach ache

slower growing of a child or a teen

vomiting

weakness.

Unlike many other human roundworms, Ascaris lumbricoides does not usually feed on blood.
When larvae migrate through the lungs, the following pulmonary symptoms may occur:

breathing difficulty

cough and/or coughing up blood

 eosinophilic pneumonitis.

If you happen to vomit or defecate an adult Ascaris lumbricoides, take the worm to your health
care provider for diagnosis. Usually however, the diagnosis is done by examining your feces for
the presence of Ascaris lumbricoides eggs. Your health care provider asks you to provide stool
samples for testing.

Ascariasis is usually treated for 13 days with ascaricides medicine prescribed by your health
care provider. Some common drugs are albendazole, ivermectin, nitazoxanide and mebendazole,
which kills roundworms by preventing them from absorbing nutrients. You may be asked to
provide additional stool samples 12 weeks after the treatment to confirm that the worms are
dead.

To prevent new infections:

Avoid touching soil that might be contaminated with human feces.

When traveling to areas where hygiene and sanitation are poor, avoid food
and water that might be contaminated with soil.

Wash hands with water and soap before eating or preparing food.

Wash, peel or cook all fruits and vegetables before eating.

Also check out the Ascaris lumbricoides pictures and videos.

Ascaris lumbricoides Quiz

To reveal the answer you need to click the correct option.

How many humans are infected with ascariasis?

+ A) More than one billion people (1,000,000,000+)

+ B) More than one million people (1,000,000+)

What does an adult Ascaris lumbricoides usually eat?

+ A) Blood

+ B) Intestinal bacteria

+ C) Digested food

How big do they grow?

+ A) 3 cm
+ B) 30 cm

+ C) 3 m

How is ascariasis diagnosed?

+ A) From a stool sample

+ B) From a blood sample

How do you get infected?

+ A) Tiny larvae penetrate your skin with their sharp teeth

+ B) You accidentally swallow microscopic eggs

http://www.parasitesinhumans.org/ascaris-lumbricoides-giant-roundworm.html