Symbiosis
Mutualism- benefit each other
Commensalism- one benefits
and the other one is unharmed
Parasitism- the other benefits
and causes harm to the host
Classification
Obligate- cannot exist without
host
Facultative- parasite/ free-living
Spurious- pass through human
development
Incidental- lives on a host other
than its natural host
-Accidentally live on human
beings
Reproduction
Oviparous- lays unembryonated
egg
Ovoviviparous/oviviparouslays embryonated or segmented
egg
Viviparous/larviparous- lays
larva
Types of Host
Final/Definitive- harbors
sexual/adult stage
Intermediate- asexual/larval
stage
Vector- an insect which carries the
infective stage of the organism and
transmit it to man
Biological
Mechanical- carry the parasite
and introduce it to the organism
Fly-> poop ->food
Carriers- no signs and symptoms of an
infectious disease but harbors and
eliminates the organism thus spreading
the disease
Classification of Animal Parasites
Animal Kingdom
-
Subkingdom Metazoa
Subkingdom Protozoa
Subkingdom Metazoa
1st IH- harbors early larval stage
2nd IH- harbors the larval stage
infective to final host
Reservoir Host- an animal that
harbors the same species as
man
-Not the natural host of the
parasite
Phylum Nemathelminthes or
Nematoda (roundworms)
-Class Phasmidia (with caudal
chemoreceptors or phasmids)
-Class Aphasmidia (no caudal
chemoreceptors or phasmids)
Phylum
Platyhelminthes(flatworms)
-Class Trematoda (flukes)
-Class Cestoda (tapeworms)
Phylum Arthropoda
-Class Miriapoda (millipede)
-Class Chilopoda (centipede)
-Class Crustacea (crabs and
crayfishes
-Class Arachnida (spiders,
scorpions, mites, ticks)
-Class Insecta/Hexapoda
(insects)
Modes of Transmission
Nematoda
General characteristics
non-segmented
elongated
cylindrical in shape
complete digestive system
o -mouth (w/ spines, hooks,
cutting plates used for
attachment or penetration)
o -buccal cavity
o -esophagus
o -intestines
o -rectum
o -anus
pseudocoel (body cavity)
Chitinous- like cuticle
Separate sexes
Free living and parasitic forms
exist
Life cycle:
Egg Stage(ova) > (3 or 4) larval
stage > adult stage
Males- smaller and have curved
posterior end
Females- larger and tapering end
- Can be oviparous, larviparous,
ovoviviparous, or
parthenogenetic
Ingestion
Eggs (A. lumbricoides, T.
trichiura, E. vermicularis)
Skin Penetration
(N. americanus, A.
duodenale, S. stercoralis)
Arthropod vectors
Inhalation
(E. vermicularis)
Transmammary
(S. Stercoralis)
Infective Stage
a. Embryonated egg
(A. lumbricoides, T. trichiura, E.
vermicularis)
b. Filariform larva
(N. americanus, A. duodenale, S.
stercoralis)
Habitats
Small intestine
Large intestine
Subcutaneous tissue
Lymphatic glands
Skeletal muscle
General Laboratory Diagnosis
Fecal concentration technique
Muscle Biopsy
Serological Test
Blood Examination
Direct fecal smear
Phylum Nemathelminthes/Nematoda
Class Aphasmidia
-Trichinella spiralis
-Capillaria philippinensis
-Trichuris trichiura
Class Phasmidia
-Ascaris lumbricoides
-Necator americanus
-Ancylostoma duodenale
-Enterobius vermicularis
-Wuchereria malayi
-Wuchereria bancrofti
Unfertilized and fertilized ova
Infective Stage
-
Embryonated ova (ingestion thru
contaminated food and drinks)
Embryonation in soil
Unfertilized egg
- 88-94 um by 44 um
- ovoidal
Ascaris lumbricoides
- has a Tri-radiate lips (opening
triangular shape)
Fertilized egg
Common name
Embryonated
Small intestine
Ova
-
Color
-
Whitish or pinkish (alive)
STH
-
Soil transmitted helminth
Size
1.
2.
3.
4.
Male seldom over 30 cm, coapulatory
spicule
Female 25-35 cm, vulva, lays 200,000
ova/day
Cuticle
-
45-75 um by 35-50 um
round
Giant intestinal roundworm
Habitat
-
Fine striations
Diagnostic Stage
narrow, long, thin-shelled,
unorganized refractile granules,
found in all female infection
thick transparent hyaline shell
>develops into larva in 14 days
Egg shell layers
Lipoidal vitteline membrane
Glycogen layer
Coarse mammillated
albuminous layer
Pathogenesis
Ascariasis
-causes varying degrees of
pathology
-tissue reaction to larvae
-intestinal irritation to adults
-complications due to intestinal
migration
Laboratory Diagnosis
Direct Fecal Smear
Kato technique or Cellophane
Thick Smear Method
Kato-Katz technique
-quantitative test
-intensity of infection
-per gram of feces
Treatment
Albendazole
-drug of choice
-400 mg single dose
-200 mg for children under 2 yrs
old
Mebendazole
-500 mg single dose
Pyrantel Pamoate
-10 mg/kg body weight (max of
1g)
Hookworms
Necator americanus
Ancylostoma duodenale
-
Soil transmitted helminths
Blood-sucking
Attach to the intestinal mucosa
Animal Hookworms:
Necator americanus
- New world hookwowm
- Small, cylindrical, fusiform,
whitish worm
- Caudal bursa for coapulation
S- shaped body curvature
Semilunar cutting plates
Ancylostoma duodenale
-
Old world hookworm
Slightly larger
C- shaped body curvature
Buccal cavity (pair of true ventral
teeth)
Coapulatory bursa
Animal hookworms:
Ancylostoma braziliense
-
Cat hookworm
Ancylostoma caninum
-
Dog hookworm
Rhabditiform Larva
-
Short, stout
Open-mouthed
Feeding stage
Diagnostic stage
Filariform Larva
-
Long, slender
Close-mouthed
Thin-needle like
Infective stage
Hookworm ova
-
Single, thin transparent hyaline
shell
Unsegmented during oviposition
2-8 cell stage in fresh feces
Pathogenesis
Skin
Lungs
Small intestine
Skin penetration -filariform larva
Maculopapular lesions ground itch or
dew itch
Papulovesicular eruption lasting for 2
weeks (itching, edema, erythema)
Lungs- larval migration (ex. Bronchitis,
Pneumonitis)
Small intestine- abdominal pain,
steatorrhea, diarrhea with blood and
mucus, and eosinophilia (30% to 60%)
Epidemiology
-
Over 900 million people infected
Associated anemia causes 50,
000 deaths annually
Prevention and Control
Sanitary disposal of human feces
Wearing of footwear
Health education
Treatment of infected individuals
Diagnosis
Zinc Sulfate Centrifugation
Formalin Ether Concentration
Harada-Mori
-allows hatching of larvae from
eggs on strips of filter paper with
one end immersed in water
Treatment
Albendazole
-drug of choice
-ovicidal and larvicidal
-400mg single dose in adults and
children over 2 yrs old
-available in chewable tablets or
suspension
-not recommended for pregnant
women
Mebendazole
-500mg single dose in adults and
children
-not recommended for children
below 2 yrs old
Trichuris trichiura
- Whipworm
- Soil transmitted helminth
- Similar with ascaris due to same
transmission and mode of
distribution
- Infective and diagnostic stage is
embryonated ova
- Anterior is 3/5 long and whip-like
- Posterior is 2/5 and is thick and
fleshy
- Inhabit the large intestine
(cecum, ascending colon)
- Insert into the intestinal wall of
the cecum in a pin-fashion
- Adult stages resemble a whip or
latigo whose thin anterior
portion is the one responsible for
intestinal penetration.
Male
-
30-45 mm
Coiled posterior end
Single spicule
Refractile sheath
Female
-
Ova
-
35-50 mm
bluntly rounded posterior end
can produce over 60 million eggs
in an average life span of 2 yrs.
(5,000 7,000 eggs/day)
50-54 um x 22-23 um
Embryonation in the soil (2-3
weeks)
Protuberant bipolar mucus plugs
Football or barrel-shape
Treatment
Mebendazole
Albendazole
Enterobius vermicularis
-
Pinworm/seatworm
Large intestine (lower ileum and
cecum)
Cuticular alar expansions:
cephalic alae
Prominent, posterior esophageal
bulb
Male
Pathogenesis
Rectal prolapse during heavy
infection due to constipation
2-5 mm by 0.1-0.2mm
Curved tail with a single spicule
Dies after fertilizing the female
Female
Diagnosis
Direct fecal smear
Kato Thick smear
Kato katz
Concentration Techniques (acidether)
Epidemiology
Distributed in warm moist areas
20-30% prevalence in temperate
countries
60% to 85% in tropical countries
Children 5 to 15 yrs of age are
frequently infected
Ova
-
8-13 mm by 0.4 mm
Long pointed tail
Uteri of gravid females are
distended with eggs
Gravid females lays 4,672-16,888
eggs/day
Dies after deposition
Assymetrical
D-shaped
Plano-convex
Can be transmitted thru ingestion
and inhalation
Retroinfection is also possible if
eggs in the perianal opening
continue to develop and larva
hatches out and travel back the
intestinal tract.
Embryonated when laid
Viable in 13 days in moist
condition
Translucent shell
early in the morning before one
defecates or takes a bath.
Treatment
Pathogenesis
Enterobiasis or Oxyuriasis
Familial disease
Perianal pruritus
Appendicitis, vaginitis,
endometriosis, salpingitis,
peritonitis
Prevention
Personal cleanliness and hygiene
Chemotheraphy for familial cases
Use of showers rather than bath
tubs
Boiling of bed sheets, night wear,
blankets
Diagnosis
-
Finding the adult worm
Finding ova in stool (only in 5% of
infected individuals)
Finding ove in scotch tape swabs
Grahams Scotch Adhesive Tape
Technique
Cellulose Tape Technique
-this parasite is best diagnosed through
scotch tape swabbing preferably done
Pyrantel pamoate
-drug of choice
-10 mg/kg with a second dose 24 weeks late
Albendazole
-alternative drug
-400 mg single dose
-chewable tablets
Mebendazole
-500 mg single dose
-chewable tablets
Strongyloides stercoralis
- Threadworm
- Smallest nematode of man
- Large intestine
- Thru skin penetration
- Fecally transmitted or STH
- Facultative parasites
- Only parasite capable of
perpetuation in man by producing
infective larvae from
parthenogenetic females
3 life cycles
Direct/parasitic/homogonic
Indrect/Free-living/heterogonic
Autoinfection (internal
development can happen within
the host)
Infective Stage: filariform larva
Diagnostic Stage: rhabditiform larva
Morphology
Adult
-
Cylindrical shape, creamy white
or pinkish in color
Male
-
650 to 950 um long
Exclusively free-living
Has a spicule at the posterior end
Female
-
~2.0 mm long
Parasitic adults or free-living
Contains row of eggs
Larvae
Rhabditiform larva
-
250 x 20 um
Filariform larva
-
600 x 20 um
Esophagus to intestine ratio 1:1
Can repeatedly invade the
intestinal mucosa and leads into
its honeycomb appearance
S. stercoralis eggs
-
Clinical Manifestations
Comparison of Rhabditiform larvae
Comparison of Filariform larvae
similar to the hookworm egg
Chinese lantern shape
Embryonated
Most are asymptomatic
Ground itch
-occurs when infective larvae
from the soil penetrate the skin
Pneumonitis
-can result from larval invasion in
the lung
Cochin China diarrhea
3 Clinical Forms
1. Chronic and
asymptomatic with
occasional exacerbations
2. Acute, with urticarial,
abdominal pains and
diarrhea
3. Disseminated formoccurs in persons
receiving
immunosuppressive drugs
Diagnosis
Demonstration of rhabditiform
larva in stool
Harada-Mori culture:
-Strongyloides:examine after 5d
-Hooworm: examine after 10d
Larva seen on stool examination
of freshly passed specimens
suggest that the larvae are those
of S. stercoralis
