METAZOA/NS

HUMAN PARASITES OF MEDICAL IMPORTANCE

CHARACTERISTICS:
• Are multicellular parasites
• Are cosmopolitan in all climates and habitats
• Their primary ecological role is that of consumer
 Classified into three types
• Predator – consumes other organism / something
another organism produced: carnivores and herbivores
• Parasite – lives on or in and obtain nourishment from LARVAL STAGES:
a living host  Maybe:
• Detrivore – feeds on dead or decaying organic matter • Larval stage
(recyclers) • Immature egg
• Embryonated egg
DIVISION: or…..
• Phylum Nemathelminthes (roundworms) • Rhabditiform larva
• Phylum Platyhelminthes (flatworms) • Filariform larva
 Trematodes ( flukes)
• Liver flukes
• Intestinal flukes
• Lung fluke
• Blood flukes
 Cestodes (tapeworms)

CLASS NEMATODA/THE ROUNDWORMS

• INTESTINAL ROUNDWORMS PATHOGENECITY:
 Ascaris lumbricoides • Extent of larval migration thru tissues
 Enterobius vermicularis • Skin penetration of intestinal wall
 Trichuris trichiura • Blood sucking activities of adult worms
• Hookworms • Allergic reactions to substances secreted by adult and
 Ancylostoma duodenale larval worms
 Necatur americanus
 Ancylostoma braziliense
 Ancytostoma caninum
 TISSUE ROUNDWORMS
 Wuchereria bancrofti
 Brugia malayi
 Loa-loa
 Onchocerca volvulus
 Mansonellamozzardi
 Tricynella spiralis
 Dracunculus medinensis
ASCARIS LUMBRICOIDES
INTESTINAL ROUNDWORMS Giant Intestinal Roundworms
 CHARACTERISTICS • Largest intestinal roundworm
• Size: maybe from few mm. – more than 1 m. • Buccal capsule: 3 papillae with finely toothed lips (Tri-
• Buccal capsule: may have teeth, cutting plates or lobed anterior end)
hooks for attachment • Life Cycle: Environment and Man
• Have separate sexes • Environment: immature egg to fully-embryonated egg
 Male adult: smaller than female adult • Man: embryonated egg (infected stage to human host thru
 Male adult has dorsally curved posterior while female 6 Fs)
is not  SI- hatch →larva (larval migration (blood vessels) →
 Man serves as a definitive host liver→lungs→pharynx→ SI→ mature into adult
worms
 ENTEROBIUS VERMICULARIS
Pinworms
• Most common helminth infection in the world
• Has greater prevalence in cool and temperate climate an in
crowded or over-crowded conditions (dorms) / door-knob
infection
• Habitates the colon (SI)
• Life Cycle
 Embryonated egg (infected stage to man: 4-6 hours
 Thru ingestion or inhalation→ SI →larva→adult
worms
 Gravid female worm migrates to the peri-anal skin to
deposits embryonated eggs
 ADULT
o Ivory white with a body that resembles a
SYMPTOMS AND PATHOLOGY:
“question mark” or looks like a “pin” /
• Intestinal Obstruction (heavy infection)
• Larval migration can/ may cause…
 vomiting
 Abdominal pain
 Pneumonia
 Cough
 Fever
 eosinophilia
 Intestinal perforation if adults are irritated by therapy
or by spicy food

LABORATORY DIAGNOSIS:
• Direct Fecal Smear (DFS) – eggs of parasite
• Concentration Techniques

LABORATORY DIAGNOSIS:
• Peri-anal swab
• Scotch-tape Method
• Microscopic X

EMBYONATED EGG:
• “D”-shaped egg
• Lopsided egg with U-shaped embryo

SIGNS AND SYMPTOMS

• Same as other round worm infection
• Intense anal itchiness → pruritus ani

TRICHURIS TRICHUIRA
Whipworm
• 30 – 50 mm
• Habitates the colon
• Adult worm resembles a whip:
  Posterior end is thick and fleshy with slender and SYMPTOMS AND PATHOLOGY:
threadlike anterior end • Ground itch - site of penetration
LIFECYCLE: TT - allergic reaction with severe itching
• Man passes immature eggs thru feces • Wakana Disease - a lung pathology characterized by
• Eggs embryonate in 3 weeks in warm moist soil pneumonia, alveolar hemorrhage and bloody sputum
• Ingestion thru 6 Fs to another host (larval migration)
• Eggs hatch in SI- penetrates and develop in the villi ( ant • Diarrhea
ends are delicately but firmly threaded into the mucosa of • Weight loss
the cecum)→adult • Weakness
• Bloody stool
PARASITIC SPECIES
• Ancylostoma duodenale
• Necatur americanus
LABORATORY DIAGNOSIS
• DFS – occasionaly with rhabditiorm larvae
- Egg is oval, thin-shelled with clear space between shell
and contains embryo in 2 – 8 cell stage of cleavage
SYMPTOMS AND PATHOLOGY
• Concentration Technique- Brine’s Floatation Method
• Same as in ascariasis and enterobiasis
• Harada-Mori Test Tube Filter Paper Technique
• Causes “rectal prolapse” particularly in children due to
weight of worms
BLOOAD AND TISSUE ROUNDWORMS
TYPES:
LABORATORY DIAGNOSIS
• Those whose adult worms are found in tissue and larvae
• DFS
are found in lymph and blood
• Microscopic X
 Wuchereria bancrofti / Brugia malayi
 Barrel-shaped/ foot-ball shaped / lemon-shaped or
• Those whose adult worms are found in the intestines and
Japanese lantern appearance with bi-polar hyaline
larvae are found in muscle
plugs
 Trichenella spiralis
HOOKWORMS
2 SPECIES OF MEDICAL IMPORTANCE:
CHARACTERISTICS:
Wuchereria bancrofti
• An intestinal parasite
• Common name: Bancroftian filarial worm
• Habitat: Small Intestine
• Disease: Bancroftian filariasis / Filariasis bancrofti/
• Adult worms: pinkish – cream gray in color (living state)
Bancroftian elephantiasis
• Fairly stout: * 8mm – 10 mm L
Brugia malayi
* 0.30 mm W
• Common name: Malayan Filarial worm
• Life Cycle
• Disease: Malayan filariasis / Malayan elephantiasis
• Egg → develops rapidly →rhabditiform larva (feeding
and non infective stage) hatch in soil 24 – 48 hours then
undergo 2 molting stages→ filariform larva (free-living
stage)→ adult
• Adult – parasitic stage (infective stage)
• Filariform larva – skin penetration→ larval migration (blood
and lymph) → lungs ( alveoli →bronchiole)→pharynx →
SI → Adult
• Note: Ancylostoma – thru ingestion

HOSTS:
• Definitive Host : Man
• Intermediate Hosts: Mosquito
W. bancrofti
1. Urban Type: Aedes sp.
 most prevalent in abaca and banana raising areas
 Breeds in accumulated water in axils
2. Rural Type: Anopheles minimus flavirostris
 Found in hills and mountains away from houses
 Breeds in clear, running mountain streams
B. Malayi
1. Mansonia bonnae – breeds in freshwater swamps
2. Mansonia uniformis – breeds in ricefields
ENDEMIC AREAS IN THE PHILIPPINES: W.BANCROFTI LABORATORY DIAGNOSIS
• Albay 1.Thick Blood Smear
• Bohol  Time to collect blood sample – between 8 pm – 4 am
• Camarines Sur / Norte  Best time collection – 10 pm to 2 am
• Leyte • Microfilaria are mostly present in the peripheral blood
• Masbate • Mosquito vectors have nocturnal periodicity
• Mindanao 2. Knott’s Concentration Technique for light infection
• Mindoro
• Mt. Province PREVENTION
• Palawan • Same as in Dengue Fever
• Quezon
• Romblon
• Samar
• Sorsogon
• Sulu
ENDEIC AREAS IN THE PHILIPPINES: B. MALAYI
• Agusan
• Eastern Samar
• Palawan – Municipality of Quezon
• Sulu – Municipality of Bongao in Tawi- Tawi

LIFE CYCLE
• Man – Definitive Host
• Mosquito – Intermediate Host
• Infective stage to man – 3rd larval stage
 Blood Meal (mosquito bite) → take in microfilaria in
blood→ development of microfilaria into 1st, 2nd and 3rd
larval stages in mosquitoes→ 3rd larval stage migrate
to proboscis in mosquitoes→ blood meal of infected
mosquito in another host;→ cycle is repeated.
• Adult worm of W. bancrofti matures 12- 18 months→ 5
years
• B. malayi – 3 to 9 months maturation