Ascariasis

Bambi Carrino
What is ascariasis?
 Ascaris lumbricoides- large intestinal
roundworms of humans.
 Ascaris suum- similar parasite of pigs that
rarely affects human, but may cause larva
migrans.
 A helminthic infection of the small intestine.
How often do they occur?
Who is susceptible?

 Common and worldwide.

 Often > 50% in moist tropical countries.
 Intensity and prevalence highest in children 3
to 8-years old.
 General susceptibility.
Signs and Symptoms

 First sign- Live

worms are
passed in stool
QuickTime™ and a
(occasionally decompressor
are needed to see this picture.

from mouth,
anus, nose).

Image from http://www.holistic-wellness-basics.com/parasite-cleanse.html

What is its reservoir?

 Humans
 Ascarid eggs in soil.
QuickTime™ and a
decompressor
are needed to see this picture.

Image from http://en.wikipedia.org/wiki/Ascariasis

How are they transmitted?

 Ingestion of:
 Infected eggs from soil contaminated with human feces.
 Uncooked produce contaminated with soil containing
infective eggs.
 Often occurs:
 In vicinity of the home.
 When children eat soil.
 When dirt and dust are tracked into buildings by feet.
Timeline of Ascarasis
 Incubation period- Life cycle takes 4-8 weeks
for completion.
 Period of communicability- As long as
mature, fertilized female worms live in the
intestine.
 Life span ≈ 12 months, max is 24 months.
 Lay 200,000 eggs a day.
Timeline of Ascarasis Cont’d

 Eggs enter soil via

feces and undergo
development.
 Remain infective 2-3
months in favorable QuickTime™ and a
decompressor

soil. are needed to see this picture.

 Ingested eggs hatch in

intestinal lumen and
penetrate gut wall.
Image from
http://www.docstoc.com/docs/22263204/Ascarislumbricoide
s-‐-Life-cycle
Timeline of Ascarasis Cont’d

 9-10 days after infection: Reach lungs via

circulatory system, develop and pass through
alveoli.
 14-20 days after infection: Ascend trachea
and are swallowed, reaching small intestine.
 45-60 days after infection: Grow to maturity,
mate and lay eggs.
Methods of Control- Preventive

 Educate on use of proper toilet facilities and

avoiding contaminated soil.
 Provide adequate facilities for waste disposal.
 Construct latrines in rural areas.
 Encourage children to wash hands,
especially before eating or preparing food.
Methods of Control- Preventive
Cont’d

 Protect food from dirt in endemic areas.

 Dropped food needs to be washed or
reheated.
 “Preventive chemotherapy” per WHO
guidelines. Treatment of high-risk groups at
regular intervals.
Methods of Control-
Control of Patient, Contacts
and Environment

 Determine others who should be treated,

such as family members.
 Treatment with single dose of oral
mebendazole or bendazole. Ivermectin,
pyrantel pamoate and levamisole are also
effective.
Methods of Control- Epidemic

 Survey for prevalence in highly endemic

areas.
 Educate on environmental sanitation and
personal hygiene.
 Provide treatment facilities and resources for
high risk groups- especially children- or whole
populations.
Resources

 Heymann, David L.. Control of

communicable diseases manual . 19th
ed. Washington, DC: American Public
Health Association, 2008. Print.