Parasitology Types of Parasite

● study of parasites, their hosts, and the A. Habitat

relationship between them
● deals with the parasites that infect man, the ● Ectoparasite lives outside the body of a
diseases caused by them, clinical feature host; infestation
and the response generated by man ● Endoparasite infects visceral organs e.g.
against them Fasciola hepatica; infection
● concerned with various methods of their
diagnosis, treatment, and prevention and
control Ectoparasite Endoparasite

Parasites any organisms that live in or on Advantage - ease of - ease of

dispersal feeding
the body of another organism for survival - safe from host - protected from
which provide food and shelter for the immune system external
organism environment
- safer from
Hosts any organism that harbors the natural
parasite enemies

Disadvantage - vulnerability - vulnerability to

to natural host immune
Types of Host enemies system
- exposure to - dispersal more
Definitive host harbors the adult or the external difficult
sexually mature stages of parasites environment
- feeding more
Intermediate host harbors asexual or larval difficult
stages of parasite (e.g. snails, mollusks)

Reservoir B. Effect of the parasite on the host

● harbors parasite in nature: acting as
source of infection
● animals carrying the same parasites as
humans
● Pathogenic
● Non-pathogenic
C. Mode of Relationship existing between the
parasite and the host
● Obligatory can not survive without a host
(e.g. Ascaris lumbricoides)
● Facultative can survive without a host (e.g.
Strongyloides stercoralis) and may exist in
a free-living state or may become parasitic
when need arises
● Intermittent only visit the host during
feeding time

Erratic found in an organ which is not its

Paratenic
● harbors the infective stage of parasites,
simply acting as a means of transport so
that the infective stage will reach a final
host
● animal where the parasite stays in an
arrested state of development
● does not develop further to later stages
● remains alive and is able to infect another
susceptible host
usual habitat
Accidental/Incidental establishes itself in a
host where it does not ordinarily live
Permanent remains on or in the body of the
host for its entire life
Temporary lives on the host only for a short
period of time. A
Spurious free-living organism that passes
through the digestive tract without infecting
the host

Infective stage needs to be transmitted to
humans to proceed with the life cycle
Diagnostic stage host/patient needs to be
separated or isolated to identify or diagnose a
parasitic pattern
D. Mode of Transmission
Soil transmitted parasites developed further
in the soil before they become infective (e.g.
Ascaris, Trichuris, and hookworms)
Snail transmitted parasites developed further
in the body of the snail (e.g. Schistosoma,
flukes)
Arthropods e.g. Malarial parasite, Filarial Common Symptoms of Parasites in Humans
worms, Trypanosomes, Leishmania
● Constipation
Food animal transmitted parasite e.g. ● Gas or bloating
Tapeworms (T. solium & T. saginata), ● Diarrhea
Paragonimus, Capillaria ● Pains or aches in the back, joints or
muscles
Contact transmitted parasite e.g. ● Irritable bowel syndrome
Trichomonas vaginalis, Enterobius vermicularis ● Allergies
Portal of Entry ● Increased appetite
● Itchy ears, nose or anus
● Oral ingestion of infective stage Intimate ● Nervousness or grumpiness
oral contact; most common ● Chronic fatigue, lethargy or apathy
● Skin ● Various skin problems
⎯ active larval penetration ● Tooth grinding or clenching
⎯ arthropod vector ● Anemia
● Vector has 2 life cycles (e.g. mosquito and ● Excess weight
human) ● Forgetfulness
● Vision problems
Sexual intimacy or Intercourse sexually ● Problems sleeping
transmitted disease (e.g. Trichomonas
vaginalis, Giardia lamblia)
Transplacental from a pregnant mother to Symbiology
the fetus (e.g. Toxoplasma gondii) ● Mutualism when these non-similar
Intranasal can be deposited in the nasal organisms benefit in the association called
cavities and reach the covering of the brain mutuals
(meninges) e.g. Naegleria, Acanthamoeba ● Commensalism an association when one
organism benefits and the other neither
Airborne inhalation e.g. Enterobius benefits nor is harmed
vermicularis ⎯ Commensal benefits
⎯ Host neither benefits nor is harmed
● Parasitism when one organism harms the
Specimen Examined other, or in some sense lives at the
1. Stool sample expense of the other without killing it
2. Urine immediately
3. Sputum ⎯ In order parasitism to take place, the
4. Blood parasite should exhibit an entry to the
5. Tissue biopsy host.
a. muscle biopsy
b. rectal biopsy Effect of the parasite on the host
6. Tissue aspirate ● most common mechanism is by
a. liver aspirate interference with the vital processes of the
b. duodenal aspirate host through the enzyme system
c. pulmonary aspirate ● invasion and destruction of host tissue
d. lymph node aspirate ● deprive the host of essential nutrients and
e. cerebrospinal fluid substance
f. hydrocele fluid
7. Orifice swab Effects of the Host on the Parasite
a. vaginal swab ● genetic make-up of the host may influence
b. perianal the interaction
● nutritional status of the host Immune
processes play an important role in
host-parasite relationships
Treatment
● Deworming use of antihelmenthic drugs in
Parasite modes of entry ingestion, arthropod
an individual or a public health program
bites, penetration of intact skin or mucous
● Cure rate refers to the number of
membranes
previously positive subjects found to be
egg-negative on examination of a stool or
urine sample using standard procedure
● Selective treatment involves Spread and tropisms
individual-level deworming with selection for ● Some parasites must migrate to certain
treatment based on a diagnosis of infection locations within the host in order to
complete their life cycle.
● Non-human parasites, in humans, often fail
to migrate properly and become “dead-end
infections”.
● Parasites migrate to a predisposing
location.
● Harboring a parasite not in the infective
stage will have no effect.
● Increase in eosinophils indicate
parasitism.
Tissue damage and host response
● direct destruction of tissue
● hypersensitivity reactions
● eosinophilia
⎯ occurs with helminths, not protozoa
⎯ results from tissue migration
Mechanisms for evading the host response
● Antigenic variation trypanosomes
● Intracellular infection plasmodia
● Encystation amoebae, cestodes
● Camouflage schistosomes
Trematodes require a snail as the first
intermediate host. e.g. Echinostoma
● Secondary IH can be snail, snail/snail,
fish/snail, crab/snail, or water vegetation.
● Only helminth that requires snail (fluke
worm)
● For all the IH, the last IH and larva
manifests the infective stage. e.g.
metacercariae

Echinostoma Life Cycle

a. Echinostoma have three hosts in their life cycle: a first intermediate host, a second
intermediate host and a definitive host. Snail species such as Lymnaea spp. are common
intermediate hosts; fish and other bivalve molluscs.
b. A definitive host which is infected with Echinostoma will shed unembryonated Echinostoma
eggs in their feces. When the eggs are in contact with fresh water they may become
embryonated, and will then hatch and release miracidia.
c. The miracidia stage of Echinostoma is free-swimming, and actively penetrates the first
intermediate snail host, which then becomes infected.
d. In the first intermediate host, the miracidium undergoes asexual reproduction for weeks, which
includes sporocyst formation, a few generations of rediae and the production of cercariae. The
cercariae are released from the snail host into water and are also free-swimming.The cercariae
penetrate a second intermediate host, or they remain in the first intermediate host, where
they form metacercariae.
e. Definitive hosts become infected by eating secondary hosts which are infected with
metacercariae. Once the metacercariae have been eaten, they excyst in the intestine of the
definitive host where the parasite then develops into an adult.
f. Echinostoma are hermaphrodites. A single adult individual has both male and female
reproductive organs, and is capable of self-fertilization. Sexual reproduction of adult
Echinostoma in the definitive host leads to the production of unembryonated eggs.The life cycle of
Echinostoma is temperature dependent, and occurs quicker at higher temperatures. Echinostoma
eggs can survive for about 5 months and still have the ability to hatch and develop into the
next life cycle stage.
Strongyloides Life Cycle
Free-living cycle
a. The rhabditiform larvae passed in the stool can either molt twice and become infective filariform
larvae (direct development) or molt four times and become free living adult males and females
that mate and produce eggs from which rhabditiform larvae hatch.
b. The latter in turn can either develop into a new generation of free-living adults, or into infective
filariform larvae. The filariform larvae penetrate the human host skin to initiate the parasitic
cycle.

Parasitic cycle
a. Filariform larvae in contaminated soil penetrate the human skin, and are transported to the
lungs where they penetrate the alveolar spaces; they are carried through the bronchial tree to
the pharynx, are swallowed and then reach the small intestine. In the small intestine they molt
twice and become adult female worms.
b. The females live threaded in the epithelium of the small intestine and by parthenogenesis
produce eggs, which yield rhabditiform larvae. The rhabditiform larvae can either be passed in
the stool, or can cause autoinfection.
c. In autoinfection, the rhabditiform larvae become infective filariform larvae, which can penetrate
either the intestinal mucosa (internal autoinfection) or the skin of the perianal area (external
autoinfection); in either case, the filariform larvae may follow the previously described route, being
carried successively to the lungs, the bronchial tree, the pharynx, and the small intestine where
they mature into adults; or they may disseminate widely in the body.
d. To date, occurrence of autoinfection in humans with helminthic infections is recognized only in
Strongyloides stercoralis and Capillaria philippinensis infections. In the case of Strongyloides,
autoinfection may explain the possibility of persistent infections for many years in persons who
have not been in an endemic area and of hyperinfections in immunodepressed individuals.
Filarial Life Cycle (Wuchereria bancrofti)
1. The infected vector transmits the infective-stage larvae into the human host during a blood meal.
2. The L3-stage larvae mature into adult worms.
3. The parasites develop into adults and then produce microfilariae (MF), which migrate to the
lymphatics and blood for circulation.
4. The vector once again ingests the microfilariae during a blood meal on an infected host.
5. The microfilariae then migrate to the thoracic muscles of the vector through the midgut.
6. The microfilariae develop into the L1 stage and;
7. subsequently into the L3 larvae.
8. The L3 larvae migrate to the vector's proboscis via the hemocel. The infected vector transmits the
infective-stage larvae into the human host during blood meal [1].
Classification of Helminths ● All nematoda have sensory organs/anterior
chemoreceptors (cannot be used to
● Nematodes (roundworms) differentiate) but not all have posterior or
● Platyhelminthes (flatworms) caudal chemoreceptor.
● Trematodes (flukes)
⎯ anterior ends amphids, head/cephalic
● Cestodes (tapeworms) papillae, all nematodes are provided
⎯ posterior ends phasmids, tail/caudal
papillae, selective presence (e.g.
Helminthic diseases aphasmids have caudal chemoreceptor)
Intestinal ● Anterior buccal capsule may contain hooks,
teeth or cutting plates for attachment.
● Strongyloides (autoinfection cycle)
Invasive
● Trichinosis (muscle pain, uncooked
carnivores)
● Filaria (worms in lymphatics or under skin)
● Schistosomiasis (liver or urinary tract
granulomas and fibrosis)
● Cysticercosis (cysts in brain, seizures)
● Echinococcus (massive cysts in liver or
lung)
Transmission of Nematoda
● Ingestion of fully embryonated ova
● Ingestion of encysted larvae
Hookworms ● Larval skin penetration
Human ● Skin inoculation by vectors

● Necator americanus new world

hookworm Characteristics of Phylum Nematoda
● Ancylostoma duodenale old world ● Reproductive system consists of tubular
hookworm organs lying in the pseudocoelom.
Animal
● Ancylostoma braziliense cat hookworm
● Ancylostoma caninum dog hookworm

Filariform Hookworm
● infective stage of hookworm
● capable of skin penetration
● MOT: skin penetration 2nd larval stage

Nemathelminthes (General Characteristics)

● long cylindrical, elongated, covered by a
tough and complex and cuticle and tapered
at both ends
● named as it is round when cut
cross-sectionally
● have a complete digestive system (gut) with
both a mouth and a [subterminal] anus
● dioecious or non-hermaphroditic
● The female is bigger because of two
reproductive systems. Males are smaller
than females.
● bilaterally symmetrical
● unsegmented
● nervous system with a pharyngeal nerve
ring
● no circulatory system, no blood system
● reproduction normally sexual/separate
sexes
Classification according to:
I. Habitat
Intestinal
A. Small intestine
● C[apillaria]. philippinensis
● A[scaris]. lumbricoides
● S[trongyloides]. stercoralis
● Hookworms
B. Large intestine
● E[nterobius]. vermicularis
● T[richuris]. trichiura
Extraintestinal
● lymph glands Filarial
● muscle Trichinella larvae
● meninges Angiostrongylus
II. Caudal Chemoreceptor
A. Phasmid Phasmidia, Secernentea (with
caudal chemoreceptor)
● A[scaris]. lumbricoides
● E[nterobius]. vermicularis
● S[trongyloides]. stercoralis
● Hookworms
B. Aphasmid Aphasmidia, Adenophorea
(without caudal chemoreceptor)
● T[richuris]. trichiura
● T[richinella]. spiralis
● C[apillaria]. philippinensis
III. Manner of Reproduction
A. Oviparous
● egg producing
● not fully developed larva upon oviposition
B. Ovoviparous-Oviviparous eggs
contain fully developed larva
C. Viviparous-Larviparous do not produce
eggs but a fully developed larvae
Helminth/Worm Terminology
● Adults sexually reproductive life cycle
stage
● Larvae developmental or asexually
reproductive life cycle stage
● Eggs stage protective of zygote &/or
embryo
● Cysts usually a larval stage encapsulated
in tissues of an intermediate host
● Hypobiosis worms in temporary
developmental arrest
● Monoecious/hermaphroditic both sexes 1
body
● Dioecious sexes separate; males &
females
● Parthenogenesis ability to produce
offspring without fertilization of eggs
Intestinal Roundworms
Anterior
● presence of any: stichocytes, teeth, cutting
plates (attachment)
● at least one free-living stage (except E.
vermicularis)
Adults
● blood suckers
● extent of larval migration through tissues
Ascaris Lumbricoides
● CN - giant intestinal roundworm
● whitish or pinkish worms
● males (10 to 31 cm)
⎯ curved posterior
⎯ single, long tubule
● females (22 to 35 cm) paired reproductive
organs (posterior two thirds)
● smooth striated cuticles
● terminal mouth - three lips and sensory
papillae
● Adults reside but do not attach to the
mucosa of the small intestine
Ova and Adult
that
Ascaris spp. Life Cycle
1. Infective eggs are swallowed
2. Eggs reach small intestine and hatch
3. L3 larvae migrate to hepatic portal through
intestinal wall (1-2 days post-infection)
4. Larvae enter lungs (5-6 dpi) and alveolar
spaces causing cough
5. Coughed-up Tarvae are swallowed
6. Larvae reach small intestine for a second
time, mature (50-55 dpi) and adult worms
lay eggs
7. Eggs are passed in feces and embryonate
becoming infective in a few weeks
Ascaris Eggs
● fertilized eggs
● unfertilized eggs
● decorticated eggs
● corticated eggs

ID: egg in various aspects: size, color, shape, shell and content.

Fertilized
● broad oval, brown
● average size 60x45 pm
● thicker shell and consists of ascaroside, chitinous layer, fertilizing membrane and mammillated
albuminous coat
● fertilized Ascaris egg, still at the unicellular stage, as they are when passed in stool

● fertilized egg of A. lumbricoides in an unstained wet mount of stool, undergoing early stages of
cleavage at 200x magnification

● fertilized egg of A. lumbricoides in an unstained wet mount of stool

Unfertilized
● longer and slender than a fertilized egg
● chitinous layer and albuminous coat are thinner
● content made of many refractable granules various in size
● unfertilized egg of A. lumbricoides (prominent mammillations on the outer layer)

● unfertilized egg of A. lumbricoides in an unstained wet mount, 200x magnification

● unfertilized egg of A. lumbricoides in a wet mount of stool (lacks mammillated layer, decorticated)

Decorticated
● both fertilized and unfertilized eggs, sometimes may lack their outer albuminous coats and are
colorless
● A. lumbricoides decorticated, fertile eggs in wet mounts, 200x magnification

● larva of A. lumbricoides hatching from an egg

Life Cycle
1. Site of inhabitation: small intestine
2. Infective stage: embryonated eggs
3. Route of infection: by mouth
4. No intermediate and reservoir hosts
5. Lifespan of the adult: about 1 year

Parthenogenesis There are two phase in ascariasis

1. The blood-lung migration phase of the larvae
● pneumonia, low fever, cough, blood, tinged sputum, asthma
● Large numbers of worms - allergic symptoms
● Eosinophilia is generally present.
● These clinical manifestation is also called Loeffler's syndrome.
2. The intestinal phase of the adults
● light infections produces no symptoms, but may give rise to vague abdominal pains
● heavy infections wandering adults may block the appendiceal lumen or the common bile duct and
even perforate the intestinal wall

Epidemiology world wide distribution

Factors favoring the spread of the transmission
● simple life cycle
● enormous egg production (240,000 ova/eggs/day of female)
● eggs are highly resistant to ordinary disinfectants (due to the ascaroside), may remain viable for
several years
● social customs and living habits
● disposal of feces is unsuitable

Prevention and Treatment

● treatment to ascariasis: Mebendazole, Albendazole and Levamisole are effective
● sanitary disposal of feces
● hygienic habits such as cleaning of hands before meals
● health education

Trichuris trichiura/Whipworm (Japanese Lantern Ova)

● narrow anterior esophageal end and shorter and thicker posterior anus
● females are larger than males; approximately 35–50 mm long compared to 30–45 mm
● females have a bluntly round posterior end male counterparts with a coiled posterior end

2 main parts
● posterior part - 2/5 fleshy (thick)
● anterior - 3/5 attenuated (thin), female is larger (2 inches long)
Ova
● bi-polar plug
● barrel-shaped (50-54 u)
● brown with bipolar protuberances.
● barrel or spindle in shape and 50x20um in size
● has a translucent polar plug at either ends
● content of the egg is an undeveloped cell
Trichuris trichiura Life Cycle
1. It starts from the release of trichuris trichiura eggs with feces, the eggs will experience maturation
in the soil. In this process the maturation of worm eggs takes 3 weeks to 5 weeks, the mature
eggs will be infective which can then infect humans.
2. The process can be through mechanical vectors or other objects that have been contaminated.
For example, the soil has been contaminated by human feces (which contain whipworm eggs) or
vegetables that have been sprayed with fecal fertilizer. Infection will occur immediately if the feces
contain eggs that are ready to hatch, it will hatch in the intestines when the eggs are swallowed by
humans.
3. In hatching eggs, the larvae will come out through the egg wall and enter the small intestine. After
adulthood, worms that are in the distal part of the intestine will go to the colon area. The period of
growth of eggs into worms for 30 to 90 days. The female and male worms will copulate.
4. When female worms lay eggs, they will mix with feces in the large intestine and come out with
feces. Eggs will experience maturation for approximately 6 weeks. The ripening process will take
place in moist soil and shady places. The host of trichuris trichiura is humans. The life cycle of
trichuris trichiura is related to what is consumed by humans.

● embryonated ova = has larva within

● embryonating stage = 2-3 weeks in soil
● mamillary coating = corticated
● Ascaris, Trichuris, hookworm = unholy three, soil transmitted
● Strongyloides stercoralis has both free-living stage (facultative) and parasitic cycle
● Taenia solium → pork
● Taenia saginata → beef
● Capillaria philippinensis → fish
● Enterobius vermicularis → perianal
● Trichomonas vaginalis → symptomatic in females