echinostomids are digenetic trematodes characterized by a collar of spines aroun
d their oral suckers several species infect humans (2 in the Philippines E.ilocanum and Artyfechinost omum malayanum) mode of transmission is ingestion of metacercariae encysted in snails Adults Color: reddish-gray Dimensions: 2.5-6.6mm x 1-1.35mm (lw) Shape: resembles coffee bean; round anteriorly, tapers posteriorly Integument: covered with single spaced spines Reproductive organs: 2 lobed testes arranged in tandem at the third quarter of the body ovary anterior to testes and posterior to ventral sucker; w/ six long unbranched lobes other: vitellaria are follicular in the posterior half of the body tapered at posterior end and has 49- 51 collar spines oral sucker lies in center of circumoral disk ventral sucker situated at the anterior fifth uterine coils found between the ovary and ventral sucker LIFE CYCLE Adults once attached to the wall of the S.I., they mature sexually into adult worms live in the intestines of definitive hosts Definitive host: Man, dogs, cats, rats, pigs Eggs released by adult worms and transported to the environment through the feces matures in water Miracidium hatches from the egg after 6-15 days and infects snail 1st intermediate host: Snail (Gyralus convexiusculus and Hippeutis umbilicalis) Redia - No sporocyst stage - develops from the miracidium inside the snail - mother redia produce daughter redia and cercaria after 42-50 days Cercaria escapes from the snail and swims in water and seeks 2nd intermediate host Metacercaria - Cercaria develops into metacercaria in 2° intermediate host - 2nd intermediate host: snail (Pila luzonica â kuholâ and Vivipara angularis â susong pampangâ ) - once ingested, metacercaria excyst and juvenile flukes attach themselves to th e wall of the small intestine PATHOGENESIS AND CLINICAL MANIFESTATION heavy infections â inflammation develops at site of attachment ulceration and consequently diarrhea (sometimes bloody) and abdominal pain may d evelop general intoxication after absorption of metabolites of worms DIAGNOSIS and TREATMENT detection of eggs in the stool echinostomes, fasciola and buski eggs look very much alike Praziquantel EPIDEMIOLOGY endemic in Northern Luzon, Leyte, Samar and provinces of Mindanao also in SEA and East Asian countries endemicity is related to eating habits of population 2nd intermediate host are abundant in rice fields especially during the wet mont hs Reservoir host : rat PREVENTION AND CONTROL avoiding ingestion of improperly cooked 2nd intermediate hosts