MEDICAL PARASITOLOGY

Lecture 1

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 LEARNING OBJECTIVES
➢ BY THE END OF LECTURE STUDENTS WILL BE ABLE TO
• Learn important definitions regarding medical
parasitology
• Enumerate modes of parasitic transmission, avenues of
invasion,and effects of parasites on humans
• Classify parasites
• Discuss medically important protozoans and diseases
caused by them
• Describe general characteristics of class trematodes,
cestodes, nematodes and diseases caused by them

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 Medical Parasitology

• Medical Parasitology focuses on parasites which

cause disease in humans.

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• According to the very broad definition of
parasitology, parasites should include the viruses,
bacteria, fungi, protozoa and metazoa (multi-
celled organisms) which infect their host
species. However, for historical reasons the first
three have been incorporated into the discipline
of Microbiology.

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 Epidemiology
• Although parasitic infections occur globally, the majority
occur in tropical regions
• Often entire communities may be infected with multiple,
different organisms which remain untreated because
treatment is neither accessible nor affordable
• Tropical countries are most favorable places for the
survival, larval development, and transmission of
parasites.
• WHY?????? …….
• Because optimal conditions of temperature and
humidity are present and there is poverty, poor
sanitation and poor personal hygiene

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• Effective prevention and control requires "mass
intervention strategies” and intense community
education. Examples include:
– General improved sanitation: pit latrines,
fresh water wells, piped water
– Vector control: insecticide impregnated bed
nets, spraying of houses with residual insecticides,
drainage, landfill
– Mass screening and drug administrtion
programmes which may need to be repeated at
regular intervals

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 The
Theburden
burdenofofsome
somemajor
majorparasitic
parasiticinfections
infections
Parasite Diseases No. people infected Deaths/yr
Plasmodium malaria 273 million 1.12 million

Soil transmitted helminths: 2 billion 200,000

• Roundworm (Ascaris) Pnemonitis, intestinal

obstruction
• Whipworm (Trichuris)
• Bloody diarrhoea, rectal
• Hookworm (Ancylostoma and prolapse
Necator)
Coughing, wheezing, abdominal
pain and anaemia
Schistosoma Renal tract and intestinal 200 million 15,000
disease

Filariae Lymphatic filariasis and 120 million Not fatal but 40

elephantiasis million
disfigured or
incapacitated
Trypanasoma cruzi Chagas disease 13 million 14,000
(cardiovascular)
African trypanosomes African sleeping sickness 0.3 – 0.5 million 48,000
Leishamania Cutaneous, mucocutaneous 12 million; 2 million 50,000
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 Key Definitions
• Medical parasitology: “the study and medical
implications of parasites that infect humans”
• A parasite: “a living organism that acquires
some of its basic nutritional requirements
through its intimate contact with another living
organism”. Parasites may be simple unicellular
protozoa or complex multicellular metazoa
• An organism that lives and feeds on or in an
organism of a different species and causes harm
to its host.

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• Protozoa: unicellular organisms, e.g. Plasmodium
(malaria)

• Metazoa: multicellular organisms, e.g. helminths

(worms) and arthropods (ticks, lice)

• An endoparasite: “a parasite that lives within

another living organism” – e.g., Giardia

• An ectoparasite: “a parasite that lives on the

external surface of another living organism” – e.g.
lice, ticks

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• Host: “the organism in, or on, which the parasite lives
and causes harm”
• Definitive host: “the organism in which the adult or
sexually mature stage of the parasite lives-”man for
filaria, hookworm, roundworm
• Intermediate host: “the organism in which the
parasite lives during the larval stage of its
development only”,asexual reproduction occurs.
-man for malarial parasite ,hydatid cyst.
• ”infection –when parasite establishes itself within
host
infestation –when it lives superficially on host
• Vector: “a living carrier (e.g.an arthropod) that
transports a pathogenic organism from an infected to
a non-infected host”. A typical example is the female
Anopheles mosquito that transmits malaria
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 Life cycle and its type

• Life cycle : The whole process of parasite

growing and developing.

• The direct life-cycle : Only one host (no

intermediate host).
• The indirect life cycle: Life cycle with
more than one host (intermediate host
and final host).
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 Symbiosis
-The relationship between two organisms
that live together and involve protection
or other advantages to one or both
partners . E.g.,some termites and
flagellates.

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 Commensalism
- Both are able to lead
independent lives,
but one may gain
advantage from the
association when
they are together
and least not
damage to the other. Fig. A female pea crab in
Entamoeba coli in the mantle cavity of its
intestine . mussel host. The crab
does not damage the
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mussel and uses its shell19
purely for protection
 Parasitism

-An association which is beneficial to one

partner and harmful to the other partner. The
former that is beneficial to is called parasite,
the latter that is harmful to is called host. E.g.,
hookworm in humans (endoparasite)
Lice (ectoparasite)

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 EFFECTS OF PARASITES
• Depriving the host of essential substances-
malnutrition
Hookworm –> Sucks blood -> Anemia
• Mechanical effects
Ascaris -> Perforate/Obstruction
• Toxic and allergic effects
E.h-> Proteolytic enzyme-> Necrosis
Parasite antigen -> Immune response- allergy /
hypersensitivity reaction

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 The basic factor of transmission of parasitic
diseases

• The source of infection

• The route of transmission
• The susceptible host
combined effect of these factors determine
the prevalence and the incidence of the disease

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 The source of the infection
• Patient : Persons who have parasites in
their body and show clinical symptoms
• Carrier : Persons who have parasites in
their body& do not show symptoms.
• Reservoir host : Animals that harbor the
same species of parasites as man.
Sometimes, the parasites in animals can
be transmitted to humans.

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 The routes of transmission
• Congenital transmission : From mother to
infant. Toxoplasmosis
• Contact transmission : Direct contact---
Trichomonas vaginalis; Indirect contact---
Ascaris
Food transmission : The infectious stage
of parasites contaminate food / the meat
of the intermediate hosts

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 • Water transmission : Drinking or contact
with the water which is contaminated with
the infectious stage of parasites.
• Soil transmission : Contamination of the
soil by faeces containing the infective stage
of parasites .

• Arthropod transmission :
Insect vectors of certain parasitic diseases.
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 The susceptible host

----In general, most people are susceptible

host (Why?)..

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 The Preventive Measures of
the Parasitic Diseases
• Controlling the source of the infection.
Treatment of the patients, carriers and reservoir hosts.
• Intervention at the routes of transmission
Managing feces and water resource,controlling or
eliminating vectors and intermediate hosts.
• Protecting the susceptible hosts.
Paying attention to personal hygiene, changing bad eating
habits, taking medicine.

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 The avenues of invasion
• Digestive tract : Most common avenue of
entrance. (Food/ Water)
• Skin : Infective larvae perforate skin and
reach the body and establish infection.
(soil/ water transmission)
• Blood : Bloodsucking insects containing
infective parasites bite the skin and inject
parasites into human blood. (Arthropod
transmission---malaria).

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 CLASSIFICATION OF PARASITES
• ENDOPARASITES
PROTOZOA PLATYHELMINTHES NEMATYHELMINTHES

• CLASS RHIZOPODA • CLASS CESTODES • CLASS NEMATODES

• CLASS CILIATA • CLASS TREMATODES
• CLASS
MASTIGOPHORA
• CLASS SPOROZOA

• ECTOPARASITES- ARTHROPODS

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 PHYLUM PROTOZOA—
CLASS RHIZOPODA
• PROTOZOOLOGY- The science that deals with the
study of protozoa
• Rhizopoda:- Move by means of pseudopodia

• NON PATHOGENIC
• Endolimax nana
• Dientamoeba fragilis
• PATHOGENIC
• Entamoeba histolytica

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 ENTAMOEBA HISTOLYTICA
• One of the most important and pathogenic
parasites of humans
• Amoebiasis is the condition of harbouring the
protozoan parasite entamoeba histolytica with or
without clinical manifestations
• Symtomatic disease occur in less than 10 % of
infected individuals
• Symptomatic group has been further divided into
intestinal and extra intestinal amoebiasis

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 • Amoebic colitis
• Fulminant colitis
INTESTINAL • Amoeboma

• Liver
EXTRA • Lung
INTESTINAL • Brain
• Skin

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 PROBLEM STATMENT
• Amoebiasis occurs worldwide; the prevalence is
disproportionately increased in developing
countries because of poor socioeconomic
conditions and sanitation levels
• In industrialized countries, risk groups include male
homosexuals, travelers and recent immigrants, and
institutionalized populations.

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 EPIDEMIOLOGICAL DETERMINANTS
AGENT FACTORS
AGENT: entamoeba histolytica exists in two forms
trophozite and cyst
CYST
• Dormant/resistant stage
• 1-4 nuclei, (4 in mature cysts)
• Cysts are excreted in stool and are infective
• Cysts are susceptible to heat (above 40 °C), freezing
(below –5 °C), and drying.
• Cysts remain viable in moist environment for 1 month.

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 TROPHOZITE
Dwell in colon where they encyst
and multiply
• Short lived outside human
body and do not transmit
disease

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• RESERVOIR OF INFECTION:
• man is only reservoir
• Immediate source of infection is infected faeces
7
• Healthy carriers can discharge upto 15X10 cysts
daily
• Greatest risk is associated with carriers engaged in
preparation and handling of food

• PERIOD OF COMMUNICABILITY:
• as long as cysts are excreted

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 • HOST FACTORS:
• can occur at any age
• No sex or racial difference

• ENVIRONMENTAL FACTORS:
• closely related to poor sanitation and socioeconomic
status
• Use of night soil for agricultural purposes favors
spread of disease
• Epidemic outbreaks are associated with sewage
seepage into water supply
• INCUBATION PERIOD
• About 2-4 weeks or longer
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 MODE OF TRANSMISSION
❖ FECAL ORAL ROUTE:
• Food or drink contaminated with feces containing the
E.histolytica cyst- man ingests- small intestine- excystation- binary
fission- large intestine—portal blood- or feces- cysts and
vegetative forms
• Use of human feces (night soil) for soil fertilizer
• Eating salads, fruits or vegetables which have been washed in
infected water.
• Handling objects which have already been infected or touching an
infected surface.
❖ SEXUAL TRANSMISSION
• Venereal transmission among homosexual males( oral-anal)
❖ VECTORS
• Flies,cockroaches and rodents are capable of carrying cysts and
contaminated food and drink
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 LIFE CYCLE OF ENTAMOEBA
HISTOLYTICA

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 PRIMARY PREVENTION
sanitation • safe disposal of human excreta
• washing hands after defecation and
before eating

• Water filtration by sand filters and boiling

Water supply are more effective than chemical
treatment of water against amoebiasis

• protection of food and drink against

faecal contamination
Food hygiene • disinfected with 5 or 10% acetic acid or
full strength vinegar
• Fruits and vegetable can thoroughly
washed in running water with detergents
to remove cysts
Longterm,reservoirs,carriers
Health education working in food
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industry,hotels,kitchens 40
 SECONDARY PREVENTION
EARLY DIAGNOSIS

• Microscopic examination of fresh stool smears :

• The presence of intracytoplasmic RBCs in trophozoites is
diagnostic of E histolytica infection
• Serology: is often negative in intestinal amoebiais but if
positive provides clue to extraintestinal amoebiasis
• Serum antibodies against amebae are present in 70-90% of
individuals with symptomatic intestinal E histolytica infection
• Indirect hemagglutination assay (IHA) detects antibody
specific for E histolytica and is most sensitive
• ELISA and CIE (counterimmunoelectrophoresis)are newer
techniques
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 TREATMENT
• symptomatic cases
• asymptomatic in non-endemic areas
• asymptomatic if food handlers

Drug
Metronidazole Tinidazole Iodoquinol Diloxanide
furoate
Kills trophozoites in Kills Luminal- Luminal-
Acts intestine & tissue trophozoites in Eradicate cysts Eradicate cysts
on intestine &
tissue

500-750 mg PO tid x 5- 600 mg bd PO x 650 mg PO tid 500 mg PO tid

Dose 10 days 5 days x10days x10days

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 CLASS MASTIGOPHORA
• Move by flagella
• important pathogenic genera
1.Genus trypanosoma hemoflagellates
2.Genus leishmania
3.Genus giardia– intestinal flagellate
4.Genus trichomonas– genital and oral fl

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 TRYPANOSOMA GAMBIENESE
• Human African trypanosomiasis, also known as sleeping
sickness, is a vector-borne parasitic disease,Infection is caused
by the bite of fly called GLOSSINA PALPALIS(TSE TSE FLY)
• Sleeping sickness threatens millions of people in 36 countries in
sub-Saharan Africa.

• TRANSMISSION
• The disease is mostly transmitted through the bite of an
infected fly

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 CLINICAL PICTURE
• haemo-lymphatic stage, which entails bouts of fever,
headaches, joint pains and itching
• neurological or meningo-encephalic stage. changes of
behaviour, confusion, sensory disturbances and poor
coordination. Disturbance of the sleep cycle,
• Without treatment, sleeping sickness is considered fatal
although cases of healthy carriers have been reported.

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 DIAGNOSIS
• Screening for potential infection. This involves using serological tests
(only available for T.b.gambiense) and checking for clinical signs -
especially swollen cervical lymph nodes.
• Diagnosing by establishing whether the parasite is present in body
fluids.
• Staging to determine the state of disease progression. By examining
the cerebrospinal fluid obtained by lumbar puncture.

TREATMENT
FOR FIRST STAGE:
Pentamidine,Suramin

FOR SECOND STAGE

Melarsoprol
Eflornithine:
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Nifurtimox:
 PREVENTION
Aims at destruction of glossina spp.
By methods like
• Trapping and spraying with
insecticide DDT
• Infected individuals should be
treated and further prophylactic
methods should be taken to avoid
bite of fly

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 INTESTINAL ORAL AND GENITAL
FALGELLATES
GENUS GIARDIA
• SOURCE: giardia lamblia found in small intestine and may
appear in faeces of man and animals
• they also thrive in contaminated food, water, and soil.
• MODE OF TRANSMISSION
• FECORAL ROUTE ingestion of cysts
• The cysts can stay infectious for up to three months in cold
water
• Sources of contamination include animal feces, diapers,
and agricultural runoff.
• Unprotected anal sex

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 CLINICAL FEATURES
• Abdominal pain
• vomiting,
• bloating,
• excessive gas, and burping.
• diarrhoea with poor absorption of nutrients
• Loss of appetite
• Symptoms typically develop 9–15 days after
exposure,but may occur as early as one day.

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 DIAGNOSIS
• Detection of antigens on the surface of
organisms in stool specimens
• Microscopic examination of the stool for
motile trophozoites or for the distinctive
oval G.lamblia cysts can be performed.
• Immunologic enzyme-linked immunosorbent
assay (ELISA)

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 TREATMENT
• The WORLD HEALTH ORGANIZATION and
INFECTIOUS DISEASE SOCIETY OF AMERICA
recommend metronidazole as first line therapy
• inidazole often treats giardiasis in a single dose and is as
effective as metronidazole.
• Nitazoxanide is a popular option for children because it’s
available in liquid form.
• Paromomycin has a lower chance of causing birth defects
than other antibiotics, although pregnant women should
wait until after delivery before taking any medication for
giardiasis
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 PREVENTION
• Wash your hands. Wash your hands after using the toilet
or changing diapers and before eating or preparing food.
When soap and water aren't available, alcohol-based
sanitizers are an excellent alternative.
• Purify wilderness water. Avoid drinking untreated water
from shallow wells, lakes, rivers, springs, ponds and
streams unless you filter it or boil it for at least 10 minutes
at 158 F (70 C) first.
• Keep your mouth closed.
• Use bottled water. When traveling to parts of the world
where the water supply is likely to be unsafe, drink and
brush your teeth with bottled water that you open yourself.
Don't use ice, and avoid raw fruits and vegetables, even
those you peel yourself.
• Practice safer sex.
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 TRICHOMONAS VAGINALIS
• Is the etiologic agent of trichomoniasis, and is
a sexually transmitted infection
• INCUBATION PERIOD typically 5 to 28 days
• CLINICAL FEATURES
• Commonly occurs in female genital tract and
present as vaginal discharge with burning and lower
abdominal pain
• In men presents as urethral discharge

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• DIAGNOSIS
– Cell cultures
– Microscopy
– antigen tests (antibodies bind if
the Trichomonas parasite is present, which
causes a color change that indicates infection)
– Detection of DNA of T.vaginalis

– TREATMENT
• Metronidazole 2 g orally in a single dose
OR
• Tinidazole 2 g orally in a single dose
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 CLASS SPOROZA
• Organisms move by amoeboid movement
• Genus Plasmodium
• Main species are
• Plasmodium falciparum
• Plasmodium ovale
• Plasmosium malarie
• Plasmodium vivax

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 TOXOPLASMA GONDII

• It is sporozoan parasite and is a

zoonotic infection in humans
• It causes toxoplasmosis-oocytes in
cat faeces cause occular problems

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 MODE OF TRANSMISSION
• Foodborne
• Eating undercooked, contaminated meat (especially pork, lamb)
• Eating food that was contaminated by knives, utensils, cutting boards, or other
foods that had contact with raw, contaminated meat
• Animal-to-human (zoonotic)----CATS
• Cats play an important role in the spread of toxoplasmosis. They become
infected by eating infected rodents, birds, or other small animals. The
parasite is then passed in the cat's feces in an oocyst form, People can be
infected by:
• Accidental ingestion of oocysts after cleaning a cat's litter box when the cat
has shed Toxoplasma in its faeces
• Accidental ingestion of oocysts in contaminated soil (e.g., not washing
hands after gardening or eating unwashed fruits or vegetables from a
garden)
• Drinking water contaminated with the Toxoplasma parasite
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 • Mother-to-child
(congenital)
• Rare instances
• Organ transplant
recipients can become
infected by receiving an
organ from
a Toxoplasma-positive
donor. Rarely, people
can also become
infected by receiving
infected blood via
transfusion. Laboratory
workers who handle
infected blood can also
acquire infection
through accidental
inoculation.
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 • DEINITIVE HOST: Mainly domestic and wild
cats.
• Cats can become infected by ingesting
sporulated oocyst or infected rodent or a bird.

• INTERMEDIATE HOST: Human, cattle, birds,

rodents, pigs, and sheep.
• Humans get the disease through ingestion of a
cyst, infected raw meat, transplacental, organ
transplatantion or blood transfusion.

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 CLINICAL FEATURES
Asymptomatic in immuno competenent
persons or may present with
• fever
• swollen lymph nodes, especially in the neck
• a headache, muscle aches and pains
• sore throat
The clinical course is benign and self-limited;
symptoms usually resolve within a few
months to a year.
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IN IMMUNOCOMPROMISED INDIVIDUALS
• ENCEPHALITIS, causing headaches, seizures,
confusion and coma.
• PNEUMONITIS, causing cough, fever, and
shortness of breath
• AN EYE INFECTION, causing blurry vision and eye
pain
• In patients with AIDS, toxoplasmic encephalitis is
the most common cause of intracerebral mass
lesions and is thought to be caused by
reactivation of chronic infection.
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 CONGENITAL TOXOPLASMOSIS
Severity of disease depends on maternal
manifestation
• First trimester:15% cases. severe disease
leading to spontaneous abortion
• Third trimester:40% cases leading to subclinical
infections and congenital toxoplasmosis

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 DIAGNOSIS
• Direct microscopy of body fluids
• SEROLOGY: Ig G and Ig M antibodies
• PCR techniques
• Isolation T.gondii from tissues

TREATMENT

• Sulfonamides
• Pyrimethamine(daraprim)
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 PREVENTION
• Pets should be checked and cured.
• Wash hands thoroughly with soap
• Cats should be kept indoors and litter boxes changed
daily.
• Better cook your meat well.
• Cat feces should be flashed down the toilet or burned.
• Raw meat should not be given to cats to prevent
infection and should not be allowed to hunt in
garbage or outside
• Pregnant women should avoid handling cats
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 CLASS CILIATA
• Organisms belonging to this class by
means of cilia
• One important pathogenic
organism of this class is blanitidium
coli or escheria
• B.Coli is found in intestine of
humans
• Occur in cystic( infective) and
trophozite form
• Patient presents with dysentry
• PREVENTION
• Provision of safe water and food
hygiene
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PARASITE DISEASE PORTAL OF COMMAN SITE IN MODE OF
ENTRY HOST INFECTION
E. HISTOLYTICA AMOEBIC DYSENTRY MOUTH COLON INGESTION OF
INFECTED CYST IN
WATER
E.COLI DYSENTRY MOUTH DUODENUM AND INGESTION OF CYST
INTESTINE IN FOOD
GIARDIA LAMBLIA GIARDIASIS MOUTH DUODENUM AND INGESTION OF CYST
INTESTINE IN FOOD
TRICHOMONAS TRICHOMONIASIS GENITAL ORIFICE VAGINA,URETHERA INDIRECT
P.FALCIPARUM MALIGNANAT SKIN INTRACELLULAR BITE OF FEMALE
TERTIAN MALARIA ANOPHELES

P.VIVAX BENINGN TERTIAN SKIN INTRACELLULAR BITE OF FEMALE

MALARIA ANOPHELES

P.MALARIAE QUARTARN SKIN INTRACELLULAR BITE OF FEMALE

MALARIA ANOPHELES

P.OVALE OVALE MALARIA SKIN INTRACELLULAR BITE OF FEMALE

ANOPHELES

LEISHMANIA LEISHMANIASIS SKIN INTRACELLULAR BITE OF SAND FLY

DONOVANI
T.GAMBIENSE
10/7/2021 AFRICAN SLEEPING SKIN BLOOD,LYMPH BITE OF TSETSE
68 FLY
SICKNESS GLANDS,SPINAL
 HELMINTHOLOGY

PLATY
NEMATO HELMINTHES
HELMINTHES

CLASS
CLASS CLASS
CESTODE
NEMATODE Taenia solium TREMATODE
Taenia saginata
Taenia INTESTINAL
INTESTINAL echinococcus BLOOD FLUKES OR LIVER
Trichuris TISSUE
diphylobothru schistosoma FLUKES
Ascaris Trichinella
m Clonorchis
Ancyclostoma dracunculus
sinensis
LUNG
FLUKES
paragonim
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 CLASS TREMATODA OR FLUKES
• General Characteristics:
• Flat, fleshy, leaf-like worms, with 2 sets of muscular
suckers:
• Oral sucker (starts an incomplete digestive system)
• Ventral sucker: for attachment
• SIZE : FEW mm – SEVERAL cm .
• Alimentary system is in form of lateral tubes, no
terminal excretory orifice.
• All are hermaphroditic, except Schistosomes.
• Require intermediate host, a snail (or clam).
• Some require various second intermediate host.
• Egg has an operculum (a lid) at top (except Schistosome)
• No “redia” stage in Schistosomes.
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 Trematodes of medical
importance
• Schistosoma, blood flukes
• Clonorchis & Opistorchis, liver flukes with
metacercaria in fish
• Paragonimus, lung flukes with metacercaria
in crabs
• Fasciolopsis, Fasciola, Dicrocoelium,
intestinal and liver flukes with metacercaria
on plants

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NAME OF DISEASE ADULT MODE OF
TREMATODE HABITAT INFECTION

BLOOD
Schistosoma
haematobium Schistosomiasis,bilharzi Blood,veins of
asis bladder
S. Mansoni Skin, contact with
Schistosomiasis,bilharzi Blood,veins of colon infected water
S.japonicum asis
schistosomal dysentry Blood,veins of colon
Schistosomiasis,bilharzi
asis,katayama disease

LIVER
Clonorchis sinensis Clonorchiasis Liver, bile duct Ingestion of poorly
cooked fish
Fasciola hepatica fascioliasis Liver, bile duct Ingestion of infected
water
INTESTINE
fasciolopsiasis duodenum Ingestion of infected
Fasciolopsis buski water plants

LUNGS
10/7/2021 paragonomiasis lung Ingestion of uncooked crab
72
Paragonimus westermani
 INTESTINAL OR LIVER FLUKES

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 INTESTINAL OR LIVER FLUKES
• Three species affect liver and biliary
passages
✓Fasciola hepatica….metacercaria on
✓Opistorchis plants
metacercaria in
✓Clonorchis sinensis fish

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 CLONORCHIS SINENSIS

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• CLINICAL FEATURES
• Most signs and symptoms are related to inflammation and
intermittent obstruction of the biliary ducts.
• In severe cases, abdominal pain, nausea, and diarrhoea can
occur.
• In long-standing, untreated infections, inflammation of the
biliary system can lead to cancer, which can be fatal
DIAGNOSIS
The detection of eggs in stool is the most common
TREATMENT
Praziquantel or albendazole are the drugs of choice to
eliminate the infection.
PREVENTION
•AVOID eating raw or undercooked freshwater fish.
•Safe water supply and destruction of snail population
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 PREVENTION

Cattle – free of parasites .

Snails – destroy .
Veterenarian importance .

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 LUNG FLUKES OR PARAGONIMUS

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• CLINICAL FEATURES
• Persons with light infections may have no symptoms.
• cough, abdominal pain, discomfort, and low-grade
fever that may occur 2 to 15 days after infection. Symptoms of
long-term infection may mimic bronchitis or tuberculosis, with
coughing up of blood-tinged sputum.
• DIAGNOSIS
• identification of Paragonimus eggs in sputum.
• The eggs are sometimes found in stool samples (coughed-up eggs
are swallowed)
• Tissue biopsy
• PREVENTION
• Metacercaria in crabs
• Proper disinfection of sputum and faeces
• Eradication of snail host
• Avoid eating raw fish
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•
BLOOD FLUKE:
Bilharziasis – cystitis
SCHISTOSOME
• hematuria
• Cause – blockade of urinary tract
• Common in –Africa
• Adult worm – portal vein , vesicle plexus in man .
• Larval stage – snail
• Diagnosis
• Eggs in urine rarely in stools
• Complement fixation text may be helpful
• Pathogenecity – worms causes endophlebitis
,haemmorhage ,papillomata develop into
malignancy ,toxoemia
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 SCHISTOSOMIASIS

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 3

1
2

1, 2, 3 Paragonimus
westermani worm and ova.

4 5 6
4, F. hepatica and 5, F. gigantica egg; have a small, barely distinct operculum.
– The eggs have a thin shell
– They are passed unembryonated. Size range: 120-150 µm by 63-90 µm.
6, Fasciola
10/7/2021hepatica worm 82
 2

1,2,3: male and female Schistosoma worm.

4: Schistosoma hematobium egg. 5: Schistosoma
mansoni egg.

4 3

5 10/7/2021 83
 PREVENTION
• Safe drinking water ,washing ,bathing
• Straining of water through cloth
• Boiling of water
• Chlorination
• Drainage of freshwater swamps and drying of
irrigation canals Copper sulfate in dilution of 5-50
parts/million is effective
• Proper disposal of urine and stools
• Treatment of patients
• Health education
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