By the end of this course you should be able to:

 Define terminology specific to flukes.

 Identify the geographical distribution of the flukes (local or imported).
 Describe the general morphology of the fluke stages.
 Describe the life cycle of the flukes.
 Outline the epidemiological aspects and mode of transmission.
 Identify the infective stages and diagnostic stages of each fluke.
 Describe the clinical aspects of each fluke.
 Outline and describe the laboratory diagnosis of fluke diseases.
 Outline the ways of control and prevention.

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 Introduction
Helminthology

the family ‫اﻟﺪﻳﺪان اﻟﻤﺴﻄﺤﺔ‬

 Phylum: Platyhelminthes

 Class: Trematoda

 (Flatworms)
Flat and Unsegmented

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 General morphology and
characters:
1- Dorsoventrally flattened, unsegmented, and bilaterally
symmetrical worms.
2- No body cavity and the body covered with cuticles
(cuticular spines).
3-Two suckers: Oral (anterior) and ventral (posterior).
4- Cuticular spines and suckers enable the flukes to
move in the host body.

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 …….General morphology and
characters:
5- Contain digestive system, excretory system, nervous
system and sex organs.
6- Range in length from less than 1 mm to several
centimeters. female and male together
7- Adults are HERMAPHRODITES (but sperms obtained
from other individuals to produce offspring) EXCEPT
in schistosomes the sexes are separate.
8- Eggs are operculated except in schistosomes
9- Flukes do not multiply in humans.
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 Classification based on type of Egg

mature Immature

operclautaed

non opercluted operclautaed

paragonimus westermani
liver fluke

Heterophyes
Schistosoma heterophyes
species and
Clonorchis
sinensis
 Life cycle
- Eggs are excreted in faeces, sputum or urine of the
D. H. (depending on the habitat of the worm) into
water.
- Trematodes require two intermediate hosts except
Schistosoma species.
- In some species the eggs are excreted immature and
require time to develop in water before they hatch to
produce miracidia, then the miracidium penetrates the
proper snail. Examples: Fasciolopsis buski, Fasciola
hepatica, F. gigantica and Paragonimus westermani.
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 ……….Life cycle non opercluted
- In some species the eggs are excreted mature and
hatch when they reach fresh water then the
miracidium penetrates the proper snail. Example:
Schistosoma species. opercluted
- In some species the eggs are excreted mature and
don’t hatch in water, but after being ingested by the
proper snail. Examples: Heterophyes heterophyes
and Clonorchis sinensis.
- Miracidium in snail Sporocyst Redia (except
Schistosoma spp.) cercaria Encysted
metacercaria (except Schistosoma spp.).

The life cycle will be continued as Routs of infection in next page

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 Routes of infection
-Cercarial penetration of the skin, e.g. Schistosoma
species
-Ingestion of encysted metacercaria on aquatic
plants, e.g. Fasciolopsis buski, Fasciola hepatica
and Fasciola gigantica.
-Ingestion of encysted metacercaria in fishes, e.g.
Heterophyes heterophyes and Clonorchis sinensis.
-Ingestion of encysted metacercaria in crabs, e.g.
Paragonimus westermani.

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……….Routs of infection
‫ﻓﻲ ﻛﻴﺲ‬
After ingestion of the encysted larva (metacercaria)
by the D. H., the cyst wall is dissolved in the
intestine and the larva migrates to its habitat and
matures to adult worm.

After cercarial penetration of Schistosoma spp., the

Migrating cercaria is carried out by blood to the
heart then to its habitat to become an adult worm.

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 TREMATODES-INTRODUCTION
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