Professional Documents
Culture Documents
What'S Ahead: Learning Objectives
What'S Ahead: Learning Objectives
1
Introduction
Elizabeth Zeibig
WHAT’S AHEAD
Focusing In Disease Processes and Specimen Processing and
Historical Perspective Symptoms Laboratory Diagnosis
Epidemiology Treatment Parasite Nomenclature and
Parasite-Host Relationships Prevention and Classification
Parasitic Life Cycles Control Looking Back
LEARNING OBJECTIVES
On completion of this chapter, the successful Metazoa
learner will: Micron (abbreviated as µ or µm;
1-1. Define each of the following key terms and pl., microns)
phrases: Mode of transmission (pl., modes of
Accidental or incidental host (pl., hosts) transmission)
Animalia Mutualism
Arthropod (pl., arthropods) Obligatory parasite
Artifact (pl., artifacts) O&P
Carrier (pl., carriers) Parasite (pl., parasites)
Commensal Parasitic
Commensalism Parasitic life cycle
Confuser (pl., confusers) Parasitology
Definitive host Parasitism
Diagnostic stage (pl., stages) Pathogenic
Disease Protozoa
Ectoparasite Reservoir host
Elephantiasis Symbiosis
Endoparasite Transport host
Epidemiology Vector (pl., vectors)
Facultative parasite 1-2. Identify and summarize the key discoveries
Helminth (pl., helminthes or helminths) that have contributed to current knowledge
Host (pl., hosts) about parasites.
Infection 1-3. Select the areas in the world in which
Infective stage parasitic infections are endemic and
Infestation the factors that contribute to their
Intermediate host (pl., hosts) occurrence.
1-4. Identify and describe the main factors 1-17. Summarize, in general terms, the
that account for the increased prevalence components of the ova and parasite (O&P)
of parasites in nonendemic areas of traditional parasite processing technique
the world. performed on a variety of samples including
1-5. Choose populations of people at risk of stool.
contracting a parasitic infection. 1-18. Give examples of newer parasite recovery
1-6. Identify and describe the primary modes of techniques.
parasitic transmission. 1-19. State the name of each of the three
1-7. State the primary function of a host in a major groups of the clinically significant
parasite-host relationship. parasites.
1-8. Explain, in general terms, the parasite-host 1-20. Differentiate Protozoa, Metazoa, and
relationship. Animalia in terms of definition and the
1-9. Give an example of a parasite defense members of each group.
mechanism that serves to protect it from a 1-21. Analyze case studies with information
host’s immune system. pertinent to this chapter, and:
1-10. State the two common phases in the A. Interpret and explain the information,
parasitic life cycle and the significance data and results provided.
of each. B. Define and explain the parasite-
1-11. Identify and describe the key pieces of associated terms and processes
information that may be extracted from associated with the case.
each of the two common phases in the C. Construct a generic parasite life
parasitic life cycle. cycle.
1-12. List the major body areas that may be D. Determine possible parasite-associated
affected as the result of a parasitic epidemiology, generic, symptoms
infection. and disease processes, treatment,
1-13. Name the most commonly observed and prevention and control
symptoms associated with parasitic measures.
infections. E. Explain the parasite-related processes
1-14. Cite examples of available treatment going on in the case.
therapies to combat parasitic F. Propose subsequent actions to
infections. be taken and/or solutions, with
1-15. Outline possible parasite prevention and justification.
control strategies. G. Design an informational brochure that
1-16. Select the most commonly submitted contains generic information about all
specimen type for parasitic study. or select aspects of parasites.
Joe, a third-year medical student, presented to his physi- 2. Indicate where Joe might have come into contact with
cian complaining of severe diarrhea and abdominal pain parasites and identify the factors that likely contributed
and cramping. Patient history revealed that Joe recently to this contact. (Objective 1-21D)
returned home after a 3-month medical missionary trip to 3. Name two other populations that are at risk of contract-
Haiti. Suspecting that Joe might be suffering from a para- ing parasitic infections. (Objective 1-21D)
sitic infection, his physician ordered a battery of tests, 4. Name two other symptoms associated with parasitic
including a stool sample for parasite examination using a infections that individuals like Joe may experience.
traditional O&P technique. (Objective 1-21D)
Questions and Issues for Consideration 5. What are the key components of a traditional O&P
1. What is a parasite? (Objective 1-21B) examination? (Objective 1-21B)
CHAPTER 1 Introduction 3
underdeveloped tropical and subtropical coun- on to an uninfected host, most often via a blood
tries such as Haiti, Guatemala, and Myanmar meal (bite). Still others will drill their way
(Burma) and countries on the African continent. into the body via the skin through an unpro-
Increased population density, poor sanitation, tected bare foot or when an unsuspecting human
marginal water sources, poor public health prac- is swimming in contaminated water. Sexual
tices, and environmental changes affecting vector transmission, mouth-to-mouth contact through
breeding areas account for the prevalence of para- kissing, droplet contamination, and eye contact
sites. The habits and customs of the people living with infected swimming water also serve as
in these regions are also contributing factors. routes for parasite transmission.
The increased prevalence of global travel
likely accounts for parasitic infections being
spread to areas other than where these infections Quick Quiz! 1-2
originated. Individuals who travel to endemic
Which of the following people may be at risk for
areas are at risk of contracting parasitic infec-
contracting a parasitic infection? (Objective 1-5)
tions. Refugees, immigrants, and foreign visitors
A. A toddler who attends an all-day preschool or day
may bring parasites with them when entering a
care center
nonendemic area.
B. A 25-year-old man who lives on his own in an
Representative additional human populations
apartment complex
at risk of contracting a parasitic infection are
C. A 37-year-old South American refugee
listed in Box 1-1. Historically, a dramatic increase
D. More than one of these: _______________
in parasite infection incidence occurred in the
(specify)
homosexual population but it is now also occur-
ring more in the heterosexual population. More
recently, parasitic infections have become more
PARASITE-HOST RELATIONSHIPS
prevalent in underdeveloped countries, regard-
less of a person’s sexual orientation. The study of parasite-host relationships is over
The means whereby a parasite gains entry into 100 years old. The main focus of this research
an unsuspecting host, referred to as mode of has been threefold: (1) recognition of these rela-
transmission, vary by specific parasite species tionships; (2) search for patterns of the relation-
and those associated with the parasites covered ships; and (3) development of methodologies to
in this text are summarized in Box 1-2. Consum- study these patterns. Table 1-1 lists the terms
ing contaminated food or water and hand-to- associated with parasite-host relationships, along
mouth transfer are common ways of transmitting with their definitions.
select parasites. Others require an insect (arthro- There are several types of parasites that may
pod) vector through which a parasite is passed be members of a parasite-host relationship. An
CHAPTER 1 Introduction 5
organism may be an obligatory parasite or a the host’s immune system. Parasites alter their
facultative parasite. It may be an endoparasite or antigenic makeup so that the host will not reco
an ectoparasite. In the same manner, a number gnize the modified parasites as foreign, and thus
of different hosts may be part of this parasite- the initiation of an immune response does not
host relationship. These include accidental or occur. A more in-depth study of parasite-host
incidental hosts, definitive hosts, intermediate relationships is beyond the scope of this chapter.
hosts, reservoir hosts, transport hosts, and Where appropriate, further consideration of this
carriers. topic is discussed on an individual parasite basis.
When a parasite infects a host, symbiosis
results. The primary function of the host is to
carry on the parasite’s life cycle. This newly
formed relationship may develop into commen- Quick Quiz! 1-3
salism, mutualism, or parasitism. Some of these
associations exist as commensal under certain The primary function of a host in a parasite-host
circumstances and pathogenic under others. relationship is to: (Objective 1-7)
Parasites have an amazing capability to adapt A. Carry on the parasite’s life cycle.
to their host surroundings. In addition to a B. Provide immunologic protection for the host.
number of morphologic adaptations, parasites C. Carry on the host’s life cycle.
are capable of protecting themselves from D. Provide a food source for the host.
6 CHAPTER 1 Introduction
Parasites
come in contact
with human
[Infective stage(s)]
e
a
ut
pa
e
a
ra
pa
sit
ra
e
sit
fo
llo
e
fo
ws
llo
in
ws
Parasites come
sid
in
in contact with
e
de
or
Parasites multiply
pe
soil or water,
on
intermediate
hu
en
human for
m
food hosts
to
an
nutritional needs
fa
bo
hu
dy
m
an
Parasites
enter outside
environment Parasites emerge
from human
(diagnostic stages)
Key
Which of the following represent examples of avail- Which of the following are examples of possible
able treatment therapies to combat parasitic infec- parasite prevention and control measures?
tions? (Objective 1-14) (Objective 1-15)
A. Regulated exercise plan A. Avoiding the use of insecticides
B. Change in diet B. Practicing unprotected sex
C. Avoidance of vitamin supplements C. Practicing proper sanitation practices
D. More than one of these: ______________ (specify) D. More than one of these: ________________
(specify)
Class Species
Nematoda See Chapter 7
Phylum
(roundworms)
Nemathelminthes
Class Species
Filariae See Chapter 8
Subkingdom (tissue roundworms)
Metazoa
Class Species
Cestoda See Chapter 9
Phylum (tapeworms)
Platyhelminthes
Class Species
Trematoda See Chapter 10
(flukes)
condition associated with Giardia intestinalis. In amebas (Chapter 3). When appropriate, refer-
some cases, a variation of a scientific genus name ence to the amebas may be written in several
may be used to refer to a genus of parasites. Here ways, such as amebic or ameboid.
is an example of this use of a genus name. There are several different parasite classifica-
Chapter 5 of this text discusses two genera of tion systems, ranging from very basic to complex.
parasites, Leishmania and Trypanosoma. In The system used in this text delineates three
general, reference to infections with these two major groups of clinically significant parasites:
genera is often written as leishmanial infections 1. Single-celled parasites—Protozoa (Fig. 1-2)
and trypanosomal infections. 2. Multicellular worms—Metazoa helminths
Along with specific parasite name variations, (Fig. 1-3)
variations of parasite category names are 3. Arthropods (insects and their allies)—Anima-
common. An example of this terminology is the lia (Fig. 1-4)
CHAPTER 1 Introduction 11
Class
Crustacea
(crabs, crayfish, etc.)
Class
Pentastomida
(tongueworms)
The groups of parasites in each classification of parasites. In addition, parasites are classified
table are organized by kingdom and subking- based on their individual characteristics. Tradi-
dom, phylum and subphylum, and class. The tional as well as new methodologies for parasite
individual species are classified in their respective identification allow for accurate laboratory
chapters. diagnosis.
Parasitology is an interesting and exciting field
Quick Quiz! 1-9 of the clinical laboratory sciences. The continued
development of high-tech, highly sensitive para-
Which of the following correctly represents the three site test methodologies provides the key to the
major groups of clinically significant parasites? (Objec- future of parasitology. Because it is highly
tive 1-20) unlikely that parasites will totally be eradicated
A. Protozoa—worms; Metazoa—single-celled para- in the near future, competent practitioners edu-
sites; Arthropods—insects and their allies cated in the field of parasitology are essential to
B. Protozoa—insects and their allies; Metazoa— ensure proper parasite identification.
worms; Arthropods—single-celled parasites
C. Protozoa—single-celled parasites; Metazoa— TEST YOUR KNOWLEDGE!
worms; Arthropods—insects and their allies
D. Protozoa—single-celled parasites; Metazoa— 1-1. Match each of the key terms (column A)
insects and their allies; Arthropods—worms with its corresponding definition (column
B). (Objective 1-1)
LOOKING BACK Column A Column B
Over the years, parasites once considered com- ___ A. Ectoparasite 1. The form of a
mensal have evolved to become human patho- parasite that
gens. During this time, we have gained tremendous enters a host
knowledge of the epidemiology, parasite-host ___ B. Obligatory 2. Two organisms of
relationships, life cycles, disease processes and parasite different species
symptoms, treatment, and prevention and control living together