Introduction

to Parasitology
apt. Putu Indra Cyntia Dewi, S.Farm., M.Med.Sci
 Parasitology
•Parasitology: the area of biology
concerned with the phenomenon of
dependence of one living organism on
another.
• Parasites: organism that is entirely
dependent on another organism,
referred to as its host, for all or part of
its life cycle and metabolic
requirements.
• Parasite and Parasitism are terms
that define a way of life.
Parasitism - a way of life
• Symbiosis: “Any two organisms living in
close association, commonly one living
in or on the body of the other, are
symbiotic, as contrasted with free living.”

Symbiosis may be:

❖ Commensalism: One partner benefits

but the other is not hurt.

❖ Mutualism: Both partners benefit.

❖ Parasitism: One partner (the parasite)

harms or lives on the expense of the
other (host).
 Parasitism
➢ Facultative parasitism: an organism
can live free or establishes a parasitic
existence depending on a host. (e g.
Naegleria fowleri, Acanthamoeba spp.,
Balamuthia mandrillaris)

➢ Obligatory parasitism: an organism

establishes a permanent parasitic
existence and is completely dependent
on the host. (e g. Taxoplasma gondii)

➢ Accidental or incidental parasitism:

occasionally an organism parasitizes a
species other than its usual host.
On the basis of host, parasites are subdivided into the
following types: Parasitism
•Obligate parasites: Organisms that cannot exist
without a host (e g. Taxoplasma gondii)
•Facultative parasites: Organisms that under
favourable circumstances may live either a parasitic or
free-living existence (e.g. Naegleria fowleri,
Acanthamoeba spp.)
•Accidental parasites: Organisms that attack an
unusual host (e.g. Echinococcus granulosus in man).
•Aberrant parasites: Organisms that attack a host
where they cannot live or develop further (e.g.
Toxocara canis in man).
•Free-living: The term free-living describes the non
parasitic stages of existence which are lived
independently of a host. e.g. hookworms have active
free-living stages in the soil
• Endoparasites: live within the host causing infection. All
protozoan and helminthic parasites of man are
Types of Parasites
endoparasites
• Ectoparasites: live on the external surface of the host
(skin) or temporarily invade the superficial tissues of the
host causing infestation. (lice)

• Temporary parasite: only visits the host to get its meal.

• Permanent parasite: always fixed to the host.
• Opportunistic parasite: produces disease only in
immunodeficient hosts.

•Microparasite : small, unicellular and multiplies within its

vertebrate host, often inside cells. (Viruses, bacteria, and
protozoa)

•Macroparasite : large, multicellular and has no direct

reproduction within its vertebrate host. (helminths)
Taxonomic classification of parasites
• Taxonomic classification groups together animals of similar
structure, function and behavior into distinct groupings
[Kingdom, Phyla, Classes, Orders, Families, Genera & classes].
• Parasites of medical importance are classified into 2 sub-
kingdoms:
PROTOZOA (unicellular) & METAZOA (multicellular)

. Protozoan parasites are Metazoan parasites include:

classified according to . Helminths (worms).
morphology & means of . Arthropods (posses an
locomotion.
external skeleton).
 3 major groups of parasites:

Protozoa Arthropods
Helminths

Hi I am a protozoa I like to present

called One-celled my self as insects
organisms and my allies
Simply called
Worms e.g. Glossina morsitans
e.g. Giardia lamblia
e.g. Ascaris lumbricoides
Scientific Nomenclature
Binomial System of Nomenclature:
• Each parasite belongs to: Phylum,
Class, Order, Family, Genus and
Species.
• Each parasite is written by Generic
name (with 1st letter capital) and
Specific name (1st letter small); and
printed in italics or underlined.
Example: Schistosoma mansoni
or Schistosoma mansoni
 Types of Hosts Host is defined as an organism which harbors the parasite and
provides the nourishment and shelter to the latter.

➢ Definitive host: the host in which sexual reproduction of the parasite takes place or in which the most highly
developed form of a parasite occurs. When the most mature form is not obvious, the definitive host is the
mammalian host.

➢Intermediate host: The host which alternates with the definitive host and in which the larval or asexual stages of
a parasite are found. Some parasites require two intermediate hosts for completion of their life cycle

➢Paratenic host: A host in which larval stage of a parasite survives but does not develop further. It is often not a
necessary part of the life cycle.

➢Reservoir host: an animal harboring the same stage of the parasite like in human. Reservoir hosts represent a
potential source of infection to man.

➢ Vector “usually an arthropod”: transmits parasites (or other pathogens) from infected organisms to other hosts.
A host which harbors the parasite and serves as an important source of infection to other susceptible hosts.
Epidemiologically, reservoir host are important in the control of parasitic disease.
 Habitat
The habitat is where the parasite lives and
multiplies in the body of the definitive or
intermediate host, like:

▪ Small intestine
▪ Large intestine
▪ Blood vessels
▪ Organs; liver, lung, heart, brain, etc
▪ Muscles
▪ Lymphatics
▪ Reticuloendothelial system
▪ Cells as red blood cells
 Sources of
parasitic
infections
• Water
• Soil
• Raw vegetables & fruits
• Animals
• Fish
• Vector [Arthropods]
• Blood
Sources of parasitic infections
Contaminated soil and water;
Soil polluted with human excreta acts as a source
of infection with
- Ascaris lumbricoides,
- Trichuris trichiura,
- Ancylostoma duodenale,
- Necator americanus and
- Strongyloides stercoralis
Before acquiring infectivity for man, eggs of these
parasites undergo certain development in the soil.
→ These are known as soil transmitted helminths
Sources of parasitic infections
• Water polluted
with human excreta may contain viable cysts of
• Entamoeba histolytica,
• Giardia lamblia,
• Balantidium coli,
eggs of
- Taenia solium,
- Hymenolepis nana,
and the infective cercarial stage of
- Schistosoma haematobium,
- S. mansoni
- S. japonicurn.
Sources of parasitic infections
Freshwater fishes
constitute the source of Diphylobothrium latum
and Clonorchis sinensis.

Crab and crayfishes (Kepiting, udang karang)

are the sources of Paragonimus westermani.
Raw or undercooked pork
is the source of Trichinella spiralis, T. solium,
Fasciola hepatica, T. saginata, and S.
suihominis.
Raw or undercooked beef
is the source of T. saginata, Toxoplasma gondii,
and S. hominis.
Sources of parasitic infections
Watercress is the source of Fasciola hepatica.
Blood-sucking insects transmit Plasmodium
spp., Wuchereria bancrofti, Brugia malayi,
Onchocerca volvulus, T. brucei, T. cruzi,
Leishmania spp. and Babesia spp.
Housefly (mechanical carrier) is the source of E.
histolytica.
Dog is the source of Echinococcus granulosus
and Toxocara canis (visceral larva migrans).
Cat is the source of T. gondii,
Man is the source of E. histolytica, Enterobius
vermicularis, and H. nana.
Autoinfection may occur with E. vermicularis
and S. stercoralis, leading to hyperinfection,
Modes of infection
• Ingestion
• Inhalation
• Penetration of skin & mucous membrane
• Bite of vector
• Direct contact
• Congenital transmission
• Blood transfusion
• Sexual
• Trans-mamary
 PORTAL OF ENTRY INTO THE BODY
Mouth
The commonest portal of entry of parasites is
oral, through contaminated food, water, soiled
fingers or fomites.
This mode of transmission is referred to as
faecal-oral route.

• E. histolytica, • G. lamblia, • B. coli.

• E. vermicularis, • T. trichiura, • A. lumbricoides,
• T. spiralis, • T. solium, • T. saginata,
• D. latum, • F. hepatica, • C. sinensis
• Fasciolopsis buski, • P. westermani
PORTAL OF ENTRY INTO THE BODY
Skin
• Infection with A. duodenale, N. americanus and S.
stercolaris is acquired when filariform larvae of
these nematodes penetrate the unbroken skin of
an individual walking over faecally contaminated
soil.
• Schistosomiasis caused by S. haematabium, S.
mansoni and S. japonicum is acquired when the
cercarial larvae, in water, penetrate the skin.

• A large number of parasites e.g, Plasmodium spp.,

W. bancrofti, B. malayi, O. volvulus, T. brucei, T.
cruzi, Leishmania spp. and Babesia spp. are
introduced percutaneoursly when blood-sucking
arthropods puncture the skin lo feed.
PORTAL OF ENTRY INTO THE BODY
Sexual contact
Trichomonas vaginalis is transmitted by
sexual contact, E. histolytica and G. lamblia
may also be transmitted by anal-oral sexual
practices among male homosexual
Kissing
E. gingivalis is transmitted from person-to-
person by kissing or from contaminated
drinking utensils.
Congenital
Infection with T. gondii and Plasmodium
spp. may be transmitted from mother to
foetus transplacentally
PORTAL OF ENTRY INTO THE BODY
Inhalation
Airborne eggs of E. vermicularis may be inhaled into
posterior pharynx leading to infection.

Iatrogenic infection

- Malaria parasites → transmitted by transfusion of

blood from the donor with malaria containing
asexual forms of erythrocytic schizogony → This is
known as trophozoite-induced malaria or transfusion
malaria.
- Malaria parasites may also be transmitted by the
use of contaminated syringes and needles → This
may occur in drug addicts.
Pathogenesis: Dangerous
effects of parasitic infection
• 1- Parasitic toxic products: produce allergy or necrosis.
• 2- Anaemia: Malarial parasite & Ancylostoma.
• 3- Loss of weight.
• 4- Fever & eosinophilia.
• 5- Mechanical obstruction: Ascaris.
• 6- Mechanical pressure: Hydatid cyst.
• 8- Abortion or Congenital anomalies: T. gondii.
• A parasite may live in or on the tissues of PATHOGENICITY
its host
- without causing evident harm.
- However, in majority of cases the
parasite has the capacity to produce
damage.
• With the advent of AIDS, there is an
increase in the incidence of newer
parasitic infections caused by
Cryptosporidium parvum, Isospora belli,
and other hitherto unheard of parasites.
• These parasites also cause infections in
patients who are immunocompromised e.g,
patients receiving cytotoxic drugs or organ
transplant.
Traumatic damage
Relatively slight physical damage is produced
by entry of
- filariform larvae of S. stercoralis, A. duodenale and
N. americanus and
- cercarial larvae of the Schistosoma spp. into the
skin.
Migration of several helminthic larvae
through the lung produces traumatic damage
of pulmonary capillaries leading to
extravasation of blood into the lung.
Similar damage in cerebral, retinal or renal
capillaries may lead to serious injury.
Eggs of S. haematobium and S. mansoni cause
extensive damage with haemorrhage as they
escape from vesicle and mesenteric venules,
respectively, into the lumen of the urinary
bladder and the intestinal canal
 Attachment of hookworms (A. duodenale and N.
americanus to the intestinal wall results in
traumatic damage of the villi and oozing of blood at
the site of attachment
Large worms, such as A. lumbricoides and T.
saginata may produce intestinal obstruction.
Ascaris, in addition, may occlude lumen of the
appendix or common bile duct, may cause
perforation of the intestinal wall, or may penetrate
into the parenchyma of the liver and the lungs.
Lytic necrosis
E. histolytica secretes lytic enzyme which lyses
tissues for its nutritional needs and helps it to
penetrate into the tissue of the colon and
extraintestinal viscera.
Obligate intracellular parasites e.g. Plasmodium
spp., Leishmania spp., Trypanosoma cruzi and
T.gondii cause necrosis of parasitized host cells
during their growth and multiplication
Inflammatory reaction
• Most of the parasites provoke cellular
proliferation and infiltration at the site of their
location.
• In many instances the host reaction walls off
the parasite by fibrous encapsulation.
• In metazoan and in some protozoan
parasitoses, there is a moderate-to-notable
eosinophilia.
• Iron-deficiency, pernicious and haemolytic
anaemia develop in patients with hookworm
disease, diphyllobothriasis and malaria,
particularly blackwater fever, respectively.
• E. histolytica may produce inflammation of the
large intestine leading to the formation of
amoebic granuloma or amoeboma.
• Parasitization of fixed macrophages in the
spleen, bone marrow, and lymph nodes by L.
donovani causes proliferation of
reticuloendothelial cells.
Competition for specific nutrients
Diphyliohothrium latum competes with the host for vitamin
B12 leading to parasite-induced pernicious anaemia.

Allergic manifestations
The normal secretions and excretions of the growing
larvae of some helminthes and the products liberated
from dead parasites may give rise to various allergic
manifestations
e.g,
• Schistosomes cause cercarial dermatitis and
eosinophilia
• D. medinensis and T. spiralis infections cause urticaria
and eosinophillia,
• rupture of hydatid cyst may precipitate anaphylaxis.
Neoplasia
• Clonorchis sinensis and Opisthorchis
viverrini have been associated with
cholangiocarcinoma
• S. haematobiumn with vesical carcinoma
• E. histolytica with sigmoid granuloma /
amoeboma.
Secondary Infection
• Strongyloidiasis, trichinosis and
ascariasis, the migrating larvae may carry
bacteria and viruses from the intestine to
the blood and tissues leading to
secondary infection.
• Leismaniasis→ Pasca Kala Azar