o Parasitism- Symbiotic relationship where one
organism, the parasite, lives in or on another,
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PURPLE - Mnemonics
INTRODUCTION TO MEDICAL PARASITOLOGY
Dr. L. Velasco
PARASITOLOGY
DEFINITION OF TERMS:
 PARASITOLOGY - Area of biology concerned with the
phenomenon of dependence of one living organism on another
 (Root word: Parasite- lives in or outside a host that sometimes
causes injury)
 MEDICAL PARASITOLOGY - Concerned primarily with the animal
parasites of humans and their medical significance, as well as
their importance in human communities
 TROPICAL MEDICINE - Branch of medicine which deals with
tropical diseases and other special medical problems of tropical
regions.
 TROPICAL DISEASE - Illness indigenous to or endemic
(there’s always a case but not so many) in a tropical area but
may also occur in sporadic (due to fast travel of people who have
brought epidemics . Ex. Dengue brought to America by a carrier
of the virus from Philippines) or epidemic proportions in areas
that are not tropical.
BIOLOGICAL RELATIONSHIPS
 SYMBIOSIS – living together of unlike organisms; may involve
protection or other advantages to one or both partners
o It is an association of two species, perhaps primarily
for food getting on the part of one or both members
of the group
o Commensalism – two species live together and one
species benefits from the relationship without harming
or benefiting the other.
 From the Latin for “eating at the same table”
 e.g. Entamoeba coli (normally seen in
human host) in the intestinal lumen is
supplied with nourishment and is protected
from harm, while it does not cause any
damage to the tissues of its host
 (Entamoeba hystolitica - pathogenic
amoeba)
 (in Microbiology- normal microflora)
o Mutualism- 2 organisms mutually benefit from each
other.
 e.g. Termites (protects the flagellates in
turn) and the flagellates in their digestive
system which synthesize cellulose to aid in
the breakdown of ingested wood
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depending on the latter for its survival and usually at
the expense of the host.
 e.g. Entamoeba histolytica derives nutrition
from the human host and causes Amebic
dysentery.
PARASITE:
 Organism which lives on or in the host, usually a larger organism,
which provides physical protection and nourishment
 Parasites are often described according to their habitat or mode
of development
A. RELATIONSHIP AS TO LOCATION OR HABITAT:
 ENDOPARASITE –living inside the body of the host
(Infection)
 ECTOPARASITE –living outside the body of the host
(Infestation Ex. ticks, lice)
 ERRATIC- parasite found in an organ which is not its
usual habitat
 OBLIGATE- need a host at some stage of their life
cycle to complete their development and to propagate
their species e.g. tapeworms
o cannot survive in any other manner
 FACULTATIVE- parasite may exist in a free living
state and may become parasitic when the need arises
o sometimes applied as“temporary parasite”
B. HOST SPECIFICITY
 ACCIDENTAL/ INCIDENTAL- parasite which
establishes itself in a host where it does not ordinarily
live (w/ similarity to erratic)
 PERMANENT- parasite that remains on or in the body
of the host for its entire life
 TEMPORARY- parasite lives on the host only for a
short period of time
 SPURIOUS/COPROZOIC- free-living organism that
passes through the digestive tract without infecting
the host
HOST
 Any organism which harbours the parasite
 Classified according to their role in the life cycle of the parasite
o DEFINITIVE/ FINAL- host in which parasite attains
sexual maturity (e.g. Taeniasis)
o INTERMEDIATE- host that harbours the asexual or
larval stage of the parasite (e.g. pigs or cattle serve
as intermediate hosts of Taenia spp.)
Snails are intermediate hosts of Schistosoma
spp. (it does not produce the adult parasite)
 First intermediate hosts – those that
harbour the different larval stages of the
parasites
 Second intermediate hosts - those that
harbour the effective larval stage of the
parasites (infective stage)
o PARATENIC- host in which the parasite does not
develop further to later stages.
 Parasite remains alive and is able to
infect another susceptible host.
 e.g. Paragonimus metacercariae in raw
wild boar meatcan pass through the
intestinal wall of humans and complete
its development.
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 wild boar is the paratenic host
transferring the infective stage to
humans
 Paratenic hosts are important because
they widen the parasite distribution
and bridge the ecological gap between
the definitive and intermediate hosts.
o RESERVOIR HOSTS- allow the parasite’s life cycle to
continue and become additional sources of human
infection.
 e.g. Pigs – Balantidium coli
Field rats – Paragonimus westermani
Cats – Brugia malayi
 (Humans become accidental hosts)
 Humans are not always the final host.
 Humans may be the most important host in the spread of the
disease or an incidental host of parasites prevalent in other
animals.
VECTORS
 Responsible for transmitting the parasite from one host to
another
 BIOLOGIC VECTOR – transmits the parasite only
after the latter has completed its development within
the host; essential part of the parasite’s life cycle
 e.g. when an Aedes mosquito sucks blood
from a patient with filariasis, the parasite
undergoes several stages of development
from first stage larva to third stage larva
before the latter (infective stage) is
transmitted to another susceptible host
 MECHANICAL/ PHORETIC VECTOR – only
transports the parasite (e.g. flies and cockroaches that
feed on fecal material may carry enteric organisms and
transfer these to food, which could be eaten by
humans)
MOUTH – most common (Since the most common source of parasitic
infection is contaminated food and water)
EXPOSURE AND INFECTION
 PATHOGENS – parasites which are harmful, frequently cause
mechanical injury to their hosts
 CARRIER- harbours a particular pathogen without manifesting
any signs and symptoms
o Ex. Effective source of infection like Food Handlers that
may transfer amoeba- should have to be negative in
Rectal Swab Exam
 EXPOSURE- process of inoculating an infective agent
 INFECTION- establishment of the infective agent in the host;
presence of an endoparasite in the host
 INFESTATION- presence of an ectoparasite on a host
INCUBATION PERIOD
 Period between infection and evidence of symptoms (CLINICAL
INCUBATION PERIOD / CHRONOLOGIC INCUBATION PERIOD)
 (POST CARRIER-some don’t manifest signs and symptoms)
 BIOLOGIC INCUBATION PERIOD/ PRE-PATENT PERIOD-
period between infection or acquisition of the parasite and
evidence or demonstration of infection
 AUTOINFECTION- infected individual becomes its own direct
source of infection
o e.g. enterobiasis (pinworm infection) – hand-to-
mouth transmission
August 1, 2018/Revision No. 1
PARASITOLOGY
o (mostly in children, a gravida pinworm lay egg in the
anus and becomes pruritic resulting to scratching and
later thumb sucking)
o Can become superinfection
 SUPERINFECTION/ HYPERINFECTION- already infected
individual is further infected with the same species leading to
massive infection with the parasite
SOURCES OF INFECTION
 CONTAMINATED SOIL AND WATER
o Lack of sanitary toilets and use of night soil or human
excreta as fertilizer allow the eggs to get in contact
with the soil and favour the development of Ascaris
lumbricoides, Trichuris trichiura, Strongyloides
stercoralis, and hookworms.
o Water may be contaminated with cysts of amebae or
flagellates as well as cercariae of Schistosoma
o (3rd world countries- toilet problems)
o most common sources of infection
 FOOD may contain the infective stage of the parasite
o intake of undercooked or raw freshwater fish intestinal
and liver fluke infections (crabs – paragonimiasis)
o exemplified by a number of trematode and cestode
infections.
 VECTORS (ARTHROPODS/ DOMESTIC OR WILD
ANIMALS )
o (mosquitoes – malaria, filarial parasites; Triatoma
bugs - Trypanosoma cruzi; sandflies - Leishmaniasis)
o (cats – Toxoplasma; house rats – Hymenolepis nana)
 Another person, his beddings and clothing, immediate
environment he has contaminated (enterobiasis- can be
infected if inhaled)
 ONE’S SELF (AUTOINFECTION)
 ASYMPTOMATIC CARRIERS
MODES OF TRANSMISSION
o Taenia solium (raw pork), Taenia saginata, (raw beef),
Diphyllobothrium latum (raw fish) - eating food
harbouring the infective larval stages.
o Entamoeba histolytica and Giardia lamblia from
drinking water contaminated by cysts; Clonorchis,
Opistorchis, and Haplorchis through ingesting raw or
improperly cooked freshwater fish containing the
parasitic larvae
 SKIN PENETRATION
o Hookworms and Strongyloides enter via exposure of
skin to soil
o Schistosoma species enter skin via water.
 BITES (ARTHROPOD TRANSMISSION)
o Arthropods serve as vectors and transmit parasites
through their bites (agents of malaria, filariasis,
leishmaniasis, trypanosomiasis)
 CONGENITAL TRANSMISSION
o Toxoplasma gondii trophozoites can cross the
placental barrier during pregnancy.
o In transmammary infection with Ancylostoma and
Strongyloides, the parasites may be transmitted
through the mother’s milk
 INHALATION OF AIR-BORNE EGGS
o Enterobius
 SEXUAL INTERCOURSE
o Trichomonas vaginalis
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NOMENCLATURE
 Animal parasites are classified according to the International
Code of Zoological Nomenclature
 PHYLUM → CLASSES → ORDERS → FAMILIES → GENERA
→ SPECIES
 May have SUBORDER, SUPERFAMILY, SUBSPECIES
 Scientific names are Latinized; family names are formed by
adding –idae to the stem of the genus type; generic names
consist of a single word written in initial capital letter;
specific name always begins with a small letter
 The names of the genera and species are italicized or
underlined when written
 Ascaris lumbricoides (handwritten)
 Ascaris lumbricoides (computerized)
LIFE CYCLE
 Important to study because it is necessary to explain the disease
that it cause
 Only PROTOZOANS have similar life cycle except those that have
no cyst
 SIMPLE- ova - larva – adult (sample question: What is the
definitive host?)
 COMPLICATED – 2 or more hosts
o (sample question: 1st intermediate and 2nd
intermediate host; Is this an animal, crustacean, fish,
etc.?)
o In complicate life cycle, the lesser chances for an
individual parasites to survive.
o Most parasitic organisms attain sexual maturity in their
definitive hosts
o Some spend their entire lives within the host with one
generation after another, while others are exposed to
the external environment before taken up by an
appropriate host.
o The larval stage of the parasite may pass through
different stages in the intermediate host before it
reaches a final host
o As the life cycle becomes complicated, the lesser
chances are for individual parasites to survive
o The perpetuation of a species of parasite depends
upon its ability to ensure transmission from one host
to the next. The parasite must, therefore, adapt to
protect itself from the host’s defenses and the external
environment, and it must overcome the attrition in the
species by producing numerous progeny.
August 1, 2018/Revision No. 1
PARASITOLOGY
EPIDEMIOLOGIC MEASURES
 EPIDEMIOLOGY - Study of patterns, distribution and
occurrence of disease
 INCIDENCE - Number of new cases of infection appearing in a
population in a given period of time
 PREVALENCE - Number (usually expressed in percentage) of
individuals in a population estimated to be infected with a
particular parasite species at a given time
 CUMULATIVE PREVALENCE - Percentage of individuals in a
population infected with at least one parasite
 INTENSITY OF INFECTION/ WORM BURDEN - Number of
worms per infected person
o May be measured directly or indirectly.
 MORBIDITY - Clinical consequences of infections or diseases
that affect an individual’s well-being
TREATMENT
 DEWORMING - Use of anti-helminthic drugs in an individual or
a public health program
 CURE RATE - Number (especially expressed as a percentage)
of previously positive subjects found to be egg-negative on
examination of a stool or urine sample using a standard
procedure at a set time after deworming
 EGG REDUCTION RATE (ERR) - Percentage fall in egg counts
after deworming based on examination of a stool or urine sample
using a standard procedure at a set time after treatment
 Cure rate and egg reduction rate are indicators that are
commonly used to measure the reduction in prevalence and
reduction in intensity of infection
 SELECTIVE TREATMENT - Individual-level deworming with
selection for treatment based on a diagnosis of infection or an
intensity of infection, or based on presumptive grounds (private
treatment)
o can be used in whole populations, or in defined risk
groups.
 TARGETED TREATMENT - Group-level deworming where the
(risk) group to be treated (without prior diagnosis) maybe
defined by age, sex or other social characteristics
 UNIVERSAL TREATMENT - Population -level deworming in
which the community is treated irrespective of age, sex, infection
status or other social characteristics
 COVERAGE - Proportion of the target population reached by an
intervention (e.g. Percentage of school-age children treated
during a treatment day) (Actual number covered)
 Efficacy is the effect of a drug against an infective agent in ideal
experimental conditions and isolated from any context.
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 PARASITOLOGY

 Effectiveness is a measure of the effect of a drug against an 11. Example/s of parasite which enter the skin via exposure to soil.
infective agent in a particular host, living in a particular 12. Parasite that can be transmitted via inhalation of air-borne eggs.
environment with specific ecological, immunological, and 13. Treatment using anti-helminthic drugs in an individual or a public
epidemiological determinants.
health program.
 DRUG RESISTANCE - Genetically transmitted loss of
14. Permanent reduction to zero of the worldwide incidence of
susceptibility to a drug in a worm population that was previously
infection.
sensitive to the appropriate therapeutic dose
15. Reduction to zero of the incidence of a specified disease in a
defined geographic area.
PREVENTION & CONTROL 16 – 20. Give 5 sources of infection
 MORBIDITY CONTROL - avoidance of illness caused by
infections; may be achieved by periodically deworming Answers:
individuals or groups, known to be at risk of morbidity 1. Entamoeba histolytica
 INFORMATION-EDUCATION-COMMUNICATION (IEC) - 2. Ectoparasite
health education strategy that aims to encourage people to adapt 3. Obligate Parasite
and maintain healthy life practices 4. Spurious/coprozoic parasite
 ENVIRONMENTAL MANAGEMENT - planning, organization, 5. Wildboar
performance and monitoring of activities for the modification 6. Vectors
and/or manipulation of environmental factors for their interaction 7. Flies and/or Cockroaches
with human beings with a view to preventing or minimizing 8. Clinical incubation period
vector or intermediate host propagation and reducing contact 9. Autoinfection
between humans and the infective agent 10. Food
 ENVIRONMENTAL SANITATION 11. Hookworm and/or Strongyloides
1. interventions to reduce environmental health risks 12. Enterobius
(safe disposal and hygienic management of human 13. Deworming
and animal excreta, refuse and waste water) 14. Disease Eradication
2. involves the control of vectors, intermediate hosts and 15. Disease Elimination
reservoirs of disease 16 – 20. (Any of the ff.)
1. provision of safe drinking water and food safety  CONTAMINATED SOIL AND WATER
2. housing (adequate in terms of location, quality of  FOOD
shelter, indoor living conditions)  VECTORS (ARTHROPODS/ DOMESTIC OR WILD ANIMALS)
3. facilities for personal and domestic hygiene  Another person, his beddings and clothing, immediate
4. Safe and healthy working conditions environment he has contaminated
 SANITATION – provision of access to adequate facilities for the  ONE’S SELF (AUTOINFECTION)
safe disposal of human excreta, usually combined with access to  ASYMPTOMATIC CARRIERS
safe drinking water
 DISEASE ERADICATION – permanent reduction to zero of the
worldwide incidence of infection caused by a specific agent, as a
result of deliberate efforts; once achieved, continued measures
are no longer needed
 DISEASE ELIMINATION – reduction to zero of the incidence
of a specified disease in a defined geographic area as a result of
deliberate efforts; continued intervention or surveillance
measures are still required

SAMPLEX
Identify the following:
1. This organism derives nutrition from human host and causes
Amebic desentery.
2. Parasites living outside the body.
3. Parasites needing host to develop and propagate their species. Transcribed by:
4. Free-living organism that passes through the digestive tract BANKWHOT, Nuhu
ELEDA, Emmanuel C.
without infecting the host.
NJOKU, Chinedu Chukwuemeka
5. Example of paratenic host.
PUSAYEN, Teresito B.
6. Responsible for transmitting the parasite from one host to QUEMI, Juan Paolo C.
another. RABAGO, Khristine Andrea R.
7. Example of phoretic vector.
8. Period between infection and evidence of symptoms.
9. Enterobiasis is transmitted form hand-to-mouth, what kind of
“Don’t watch the clock; do what it does. Keep going.”
infection is it? —Sam Levenson
10. Source of infection that may contains the infective stage of the
parasite.

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