Tentative Schedule

Oct 23 – Trematodes and Cestodes

Oct 30 – Undas Break
Nov 6 – Case Study and Quiz on Trematodes and Cestodes
Nov 13 – Lecture on Nematodes
Nov 20 – Case Study and Quiz on Nematodes
Nov 27 – Group Presentation (Ectoparasites)
Dec 4 - Long Quiz
Dec 11 – Finals

Phylum Platyhelminthes
Phylum Platyhelminthes – Flatworms
Includes:
Flukes – Trematodes
Tapeworms – Cestodes
Bilaterally symmetrical
Possess excretory system but lack circulatory system
Sexual organs are highly elaborated and complicated. Most species hermaphrodites or
monoecious and few are diecious.
May require one or more intermediate hosts

Class Trematoda
Most are hermaphroditic
May require one or two intermediate hosts
Mostly leaf-shaped
Has two suckers: oral and ventral (acetabulum)
Egg is operculated

The Trematodes
Intestinal Flukes
 Fasciolopsis buski
Echinostoma ilocanum
Heterophyes heterophyes
Liver Flukes
Fasciola hepatica
Chlonorchis sinensis
Lung Fluke
Paragonimus westermani
Blood Flukes
Schistosoma species
Schistosoma mansoni
Schistosoma japonicum
Schistosoma haematobium
Fasciolopsis buski
Common Name: giant intestinal fluke
Habitat: duodenum
Pathology
Inflammation and ulceration at the site of attachment – increase mucus secretion,
bleeding, gland abscess
Heavy infection – intestinal obstruction, intoxication, edema

Control and Prevention

Washing, cooking of vegetables, boiling drinking water, elimination of snail
intermediate host

Echinostoma ilocanum
Common Name: Garrison’s fluke
Habitat: small intestine
Intermediate hosts
1st IH - snail (Gyraulus convexiusculus and Hippeutis umbilicalis)
2nd IH – snail (Pila luzonica – “kuhol”)
 Pathology:
Attachment - Inflammation of the intestinal wall
Heavy infections – diarrhea (bloody), abdominal pain, metabolites of the worm can
cause general intoxication

Heterophyes heterophyes
Habitat: small intestine
Morphology
Egg: operculated; ovoid; closely resemble Clonorchis sp.
Adult: elongated, pyriform, small
presence of genital sucker surrounding the genital pore
Integument has scale-like spines
1-2 testes
Pathology:
Inflammation at the site of attachment; chronic - intermittent mucus diarrhea,
nausea, abdominal (colicky) pain
Rare cases: burrow deep into the small intestine – gain access to circulatory system
and other vital organs; Heart – cardiac failure or cardiac beri-beri; Brain – cerebral
hemorrhage; Spinal cord – loss of motor and sensory functions

Fasciola hepatica
Common Name: sheep liver fluke
Habitat: liver
Morphology
Egg: large, ovoid, operculated
Adult: large, broad, flat. Cephalic cone with shoulders; highly branched intestine and
reproductive organs
Pathology
Acute or invasive phase – parasite migration from intestine to liver
Chronic phase – parasite has settled in the bile duct
Pharyngeal fascioliasis - halzoun
Clonorchis sinensis
Common Name: Chinese liver fluke ; Oriental liver fluke
Habitat: liver / bile ducts
Morphology
Egg: operculated, convex, small protuberance at the abopercular end
Adult: flat, transparent, rounded posteriorly and attenuated anteriorly
2 branched testes, uterus in loops and simple intestinal ceca
Pathology: fatigue, weakness, weight loss, enlargement of liver, eosinophilia
May lead to cholangiocarcinoma
Paragonimus westermani
Common Name: Oriental lung fluke
Habitat: lungs
Morphology
Egg – oval, flattened operculum, thick abopercular end
Adult – reddish brown, coffee-bean shaped”
Pathology: hemoptysis, fever, sweating, chest and back pains
Can be seen in extrapulmonary sites and may cause abcess to the organ

Schistosomes
The three species of Schistosoma have different geographic distributions. S.
hematobium is prevalent in Africa, S. mansoni is found in Africa and America and S.
japonicum is common in the far east.
Adult worms are 10 to 20 mm long; they have separate sexes (diecious), has oral and
ventral suckers and presence of gynecophoral canal

Schistosoma japonicum
Common Name: Oriental blood fluke
Habitat: mesenteric veins of small intestine
Morphology
Egg: small knob-like projection on one side
Schistosoma mansoni
Common Name: Manson’s blood fluke
Habitat: mesenteric veins of intestine and rectum
Morphology
Egg: presence of lateral spine

Schistosoma haematobium
Common Name: bladder fluke
Habitat: veins of the urinary bladder
Morphology
Egg: presence of terminal spine

Pathology: “swimmer’s itch”, dermatitis, ulcerations, splenomegaly, abdominal

enlargement, hematuria (S. haematobium)
Prevention
Sanitary disposal of human feces, swimming in contaminated water should be
avoided.
Laboratory Diagnosis
Direct fecal smear
Urinalysis (S. haematobium)

CLASS CESTODA
Medically Important Cestodes
ORDER: Pseudophyllidea
Diphyllobothrium latum (Broad fish tapeworm)

ORDER: Cyclophyllidea
Taenia solium (pork tapeworm)
Taenia saginata (beef tapeworm)
Hymenolepis nana (dwarf tapeworm)
Echinococcus granulosus (hydatid worm)
GENERAL CHARACTERISTICS
Adult worms inhabit the intestinal tract of vertebrates; larvae parasitize the tissues
of vertebrates or invertebrates
Body consists of 3 distinct regions: head or scolex, neck, strobila
Each segment or proglottid is a complete reproductive unit

Life Cycle: 1. egg (hexacanth embryo or oncosphere), 2. larval stage

(cysticercus/cysticercoid or coracidium – procercoid – plerocercoid) 3. adult

All cestodes require an intermediate host in some species the definitive host can
serve as the intermediate host

Diphyllobothrium latum (Broad fish tapeworm)

Scolex: unarmed with dorsal and ventral sucking organ called bothrium
Mature proglottids are broader than long; uterus – rosette

PATHOLOGY DUE TO THE ADULT TAPEWORM

By products can cause systemic toxemia
Large number of worms can cause mechanical obstruction
“bothriocephalus anemia” or tapeworm pernicious anemia
DIAGNOSIS
Recovery of eggs in stools
Sparganosis: surgical removal
PREVENTION AND CONTROL
Thorough cooking of fish, freezing of fish for 24 to 48 hours
Feces should not be discharged into rivers or lakes

T. solium: INTRODUCTION/ MORPHOLOGY

Adult worm: 2-3 meters
Head or scolex: globular with 4 cup shaped suckers; provided with armed rostellum
 Proglottids: 800-1000 segments; gravid proglottid has 5-13 lateral uterine branches

T. saginata: INTRODUCTION/ MORPHOLOGY

Adult worm: 5 to 10 meters
Head or scolex: globular with 4 cup shaped suckers; unarmed rostellum
Proglottids: more segments; gravid proglottid has 15 or more lateral uterine branches

INTRODUCTION/ MORPHOLOGY
Egg: spherical, striated, with an embryo or oncosphere with 6 hooklets
Larval stage: bladder worm or cysticercus cellulosae (T. solium); cysticercus bovis (T.
saginata)

T. solium
Mild intestinal obstruction
Abdominal pains
Pathology by cysticercus:
Cysticercosis – may lodge in vital organs – calcification

T. saginata
Intestinal obstruction
Systemic intoxication
DIAGNOSIS
Recovery of eggs in stools or scotch tape swab
Recovery of gravid proglottid in stools or scotch tape swab (to differentiate)
Cysticercosis: biopsy, x-ray

PREVENTION AND CONTROL

Avoid eating raw insufficiently cooked pork or beef
Proper disposal of stool
Cysticersosis can be prevented by practicing good hygiene
Hymenolepis nana
Adult: small; 0.5-0.9 cm; 96-840 segments; minute scolex with short retracticle armed
(20-30 spine) rostellum
With three ovoidal testes
egg: spherical, hyaline, contains an oncosphere with 2 polar thickenings and 3 pairs of
hooklets

Life Cycle
DIRECT – ingestion or autoinfection
INDIRECT – needs IH
Fleas (Ctenocephalides canis)
Flour beetles (Tenebrio molitor)

PATHOLOGY
Asymptomatic to generalized toxemia – headache, dizziness, anorexia, pruritus,
diarrhea, abdominal distress
DIAGNOSIS
Demonstration of characteristic egg in stools
CONTROL
Personal hygiene – eggs can be acquired from soiled linen, toilet seats or directly
from anus to mouth
Protect food from contamination of feces from rat and mice, fleas and flour beetles

Echinococcus granulosus
Adult: smallest tapeworm of man; scolex, neck and three segments
Scolex – prominent rostellum with 2 rows of hooklets and 4 cup-like suckers
Segments (immature, mature and gravid)
Egg: subspherical, with brown radially striated embryophore
Larva or hydatid cyst – 2 layers; inner layer is where the buds or brood capsules will
arise; freed brood capsules or free scolices – “hydatid sand”
PATHOLOGY
Hydatid cyst – may lodge in vital organs
In bones – osseous hydatid cyst – cause permanent injury
Rupture of cyst – serious allergic or anaphylactic reactions
DIAGNOSIS
Demonstration of egg in stool
X-ray or CT scan of organ in focus
Immunologic tests
CONTROL
Handwashing after handling / fondling dogs
Dogs should be prevented from eating carcasses of sheep, cattle and hogs
Dogs should be dewormed