Parasitology study of parasites. Three Categories of Organisms under Parasitology. 1. Parasitic protozoa 2. Helminthes 3.

Arthropods Parasitism a symbiotic relationship that is of benefit to one party (parasite) at the expense of the other party (the host ). Parasites- are defined as organisms that live on or in other living organisms (host) 1. Ectoparasites- parasites that live outside the host s body. 2. Endoparasite parasite that live inside the host s body Facultative parasite is an organism that can be parasitic but does not have to live as a parasite. Obligate Parasite- must be a parasite to survive . Examples of facultative parasites Acathamoeba spp. and Naegleri fowleri are examples of facultative parasites, they are free living amoebas that normally reside in soil or water , but can cause serious disease when they gain entrance to the eyes or nasal mucosa. From nasal mucosa, they travel via the olfactory nerve, into the brain and can cause disease affecting the central nervous system ( CNS ) The life cycle of a particular parasite may involved one or more hosts, If more than one host is involved , thus ; A. definitive host is the one that harbors the adult or sexual stage of the parasite on the sexual phase of the cycle, and B. intermediate host harbors the larval or asexual of the parasite in the asexual phase of the cycle. Accidental host is a living organisms that can serve as a host on a particular parasite s life cycle , but is not a usual host in that life cycle.  Parasitic Infections are diagnosed by observing and recognizing various parasite s life cycle in stages in clinical specimens How Parasite Cause Diseases The manner in which parasite cause damage to their host varies from one species of parasite to another and often depends to the number of parasite that are present. Some parasites produce toxins , some produce harmful enzymes , some invasive and migratory parasites cause physical damage to tissues and organs, some cause the destruction of individual cells , and some cause occlusion of blood vessels and other tubular structures. Some parasites interfere with vital processes of the host , whereas others deprive their host of essential nutrients. PROTOZOA Protozoa are classified taxonomically by their mode of locomotion. 1. Amoebas ( amebae ) move by pseudopodia. 2. Flagellate move by means of whiplike flagella. 3. Ciliates move by means of hairlike cilia. 4. Sporozoa - exhibit no motility. Protozoal Infection are most often diagnose by microscopic examination of body fluids, tissue specimens, or feces. Most parasitic protozoal infections are diagnose by observing trophozoites , cysts , oocysts , or spores in the specimen. 1. trophozoite is the motile , feeding , dividing stage in a protozoan s life cycle. 2. cysts , oocysts and spores are dormant stages. Protozoal infections are primarily acquired by ingestion or inhalation of cysts , oocysts or spores. Trophozoites rarely serve as an infective stage because of their fragile nature. Protozoal Infections of the Skin Leishmaniasis- is caused by various species of flagellated protozoa and is usually transmitted via the bite of an infected sand fly. Leishmania Protozoal infections of the eyes include conjunctivitis and keratoconjunctivitis ( inflamation of the cornea and conjunctiva, caused by amebas in the genus Acanthamoeba and toxoplasmosis caused by the sporozoan , Toxoplasma gondii. Transmission The amebas enter the eye from amoeba contaminated waters. [1] Toxoplasma gondii is a species of parasitic protozoa in the genus Toxoplasma. The definitive host of T. gondii is the cat, but the parasite can be carried by many warm-blooded animals. Toxoplasmosis, the

disease of which T. gondii is the causative agent, is usually minor and self-limiting but can have serious or even fatal effects on a fetus whose mother first contracts the disease during pregnancy or on an immunocompromised human or cat. Protozoal infections of the gastrointestinal tract: Amebiasis cause by Entamoeba histolytica, with two stages , cyst stage which is the most dormant and infective stage and the trophozoite, the motile and metabolically active stage. Transmission a. via ingestion of fecally contaminated food or water. b. by flies transporting cysts from feces to food. c. via the fecally soiled hands of food handlers. d. oral-anal sexual contact. Balantidiasis is caused by Balantidium coli and a gastrointestinal infection of the colon causing diarrhea, or dysentery. Transmission via ingestion of the cyst in fecally contaminated food or water. Cryptosporidiosis is caused by Cryptosporidiums parvum that may cause diarrhea, cramping, and abdominal pain. Transmission fecal-oral transmission, ingestion of contaminated food or water. Giardiasis caused by Giardia lamblia, a protozoal infection of the upper most portion of the intestine (duodenum) Transmission-ingestion of infective cysts (direct contact, water borne, venereal) Cyclosporiasis - caused by Cyclospora cayetanensis, causing watery diarrhea, nausea, anorexia, adominal cramping, fatigue and weight loss. Transmission ingestion of fecally contaminated food and water Protozoal Infection of the Circulatory System: African Trypanosomiasis (African Sleeping Sickness) Trypanosoma brucei Trypanosoma brucei spp. gambiense a systemic disease caused by flagellated protozoa in the blood stream, known as hemoflagellates . early stage of the disease include a painful chancre, at the site of tsetse fly bite, fever, intense headache, insomnia and local edema. latter stages of disease includes body wasting, falling asleep, coma and death if untreated. Transmission human becomes infected when mature trypanosomes are injected into the blood stream as the infected tsetse flies take blood meals. American Trypanosomiasis ( Chagas Disease ) caused by Trypanosoma cruzii , patient may present with an inflammatory response to the site of the bug bite, fever, malaise hepatomegaly and splenomegaly. Transmission the person becomes infected by rubbing the insects feces into the bite wound or eye, transmission by blood transfusion and organ transplantation also occurs. Malaria caused by four species; 1. Plasmodium vivax most common species 2. Plasmodium malariae 3. Plasma ovale 4. Plasmodium falciparum Malaria is a systemic sporozoan infection with malaise, fever, chills, sweating, headache, and nausea. Transmission infection occurs as a result of injection of sporozoites into the bloodstream by an infected Anopheles mosquito while taking a blood meal, may also occur as a result of blood transfusion. HELMINTHES parasitic worms , they infect humans ,other animals and plants. the helminthes that infect humans are always endoparasites. Helminthes are multicellular, eucaryotic organism. Two major divisions of Helminthes Roundworms ( Nematodes ) Flatworms tapeworms (cestodes) fluke( trematodes ) the typical helminthes life cycle includes three stages, the egg , the larvae , and the adult worm. the adult produces eggs, from which larvae emerge and larvae mature into adult worm.

adult nematodes are either male or female. cestodes and many trematodes are hermaphroditic, meaning the adult worms contain both male and female reproductive organs, thus it takes only one worm to produce fertile eggs. helminthic infections are primarily acquired by ingesting the larval stage , although some larvae are injected into the body via the bite of infected insect and other enter the body by penetrating the skin. Skin helminthic infection; Onchocerciasis caused by a nematode Onchocerca volvulus ; microfilariae ( tiny prelarval stage) are found in the skin. Helminthic infection muscle and subcutaneous tissues; Trichinosis- caused by a nematode Trichinella spiralis. Dracunculiasis- caused by a nematode Dracunculus medinensis, also known as guinea worm. Helminthic infection: EYES; Loiasis- caused by nematode Loa loa, also known as the African eyeworm Helminthic infection: RESPIRATORY SYSTEM; Paragonimiasis- Paragonimus westermani (T) ; the lung fluke Helminthic infection: gastrointestinal tract; Ascariasis Ascaris lumbricoides ( N ) ; the large intestinal roundworms of humans. Pinworm (Enterobiasis) - Enterobius vermicularis ( N Hookworm Ancylostoma duodenale ( N ) or Necator americanus ( N ) Whipworm ( Trichuriasis ) Trichuris trichiura Strongyloidiasis Strongyloides stercoralis Beef Tapeworm Taenia saginata Dog Tapeworm Dipylidium caninum Dwarf Tapeworm Hymenolepsis nana Fish Tapeworm Diphyllobothrium latum Pork Tapeworm Taenia solium Rat Tapeworm Hymenolepsis diminuta Fasciolopsiasis- Fasciola buski ( T ) ; an intestinal fluke Fascioliasis Fasciola hepatica ( T ); liver flukes Clonorchiasis Clonorchis sinensis ( T ) ; Chinese or Oriental liver fluke Helminthic infection: circulatory system; Filariasis Wucheria bancrofti ( N ) and Brugia malayi ( N ); microflariae are found in the blood stream Schistosomiasis Trematodes in the genus Schistosoma Helminthic infection: central nervous system; Cysticercosis cysts of the pork tapeworm Taenia solium , are found in the brain. Hydatid cyst disease Echinoccocus granulosis ( C ) or Echinoccocus multilocularis ( C ) ; in addition to the brain , can also form in many other location of the body.

Ways in which Arthropods May be involved in Human Diseases.: The Arthropod may actually be the cause of the disease. Ex. scabies , a disease in which microscopic mites live in subcutaneous tunnels and cause intense itching. The Arthropod may serve as the intermediate host in the life cycle of a parasite. Ex. Flea in the life cycle of the dog tapeworm, Beetle in rat tapeworm, Cyclops in the fish tapeworm, Tsetse fly in African trypanosomiasis and etc. The Arthropod may serve as the definitive host n the lifecycle of parasite. Ex. Female Anopheles mosquito in the life cycle of malarial parasite. The Arthropod may serve as a vector in the transmission of an infectious disease. Ex. Oriental rat flea in the transmission of plague. Tick in Rocky Mountain spotted fever and Lyme disease. Louse in epidemic typhus.

******HAND HYGIENE: NHMRC; Hand washing is generally considered to be the most important measure in preventing the spread of infection. Hands should be washed before significant contact with any patient and after activities likely to cause contamination. Do Staff Wash Enough? ; No  Wards 16 48%  NICU 29%  ICU 30 81% Why Don t Staff Wash their Hands (Compliance estimated at less than 50%);  Skin irritation  Inaccessible hand washing facilities  Wearing gloves  Too busy  Lack of appropriate staff  Being a physician ( Improving Compliance with Hand Hygiene in Hospitals Didier Pittet. Infection Control and Hospital Epidemiology. Vol. 21 No. 6 Page 381)  Working in high-risk areas  Lack of hand hygiene promotion  Lack of role model  Lack of institutional priority  Lack of sanction of non-compliers  Lack of rewarding of compliers Successful Promotion 5;  Education  Routine observation & feedback  Engineering controls Location of hand basins Possible, easy & convenient Alcohol-based hand rubs available  Patient education (Improving Compliance with Hand Hygiene in Hospitals. Didier Pittet. Infection Control and Hospital Epidemiology. Vol. 21 No. 6 Page 381)  Reminders in the workplace  Administrative sanctions ??  Change in hygiene agent (not in Winter)  Promote and facilitate skin care  Avoid understaffing and excessive workload

Hand Hygiene; Easy, timely access to both hand hygiene and skin protection is necessary for satisfactory hand hygiene. A study by Pittet showed a 20% increase in compliance by using feedback and encouraging the use of alcohol hand rubs Hand Hygiene Techniques; 1. Alcohol hand rub 2. Routine hand wash 10-15 seconds 3. Aseptic procedures 1 minute 4. Surgical wash 3-5 minutes Alcohol Hand Rubs;  Require less time  Can be strategically placed

 Readily accessible  Multiple sites  All patient care areas  Acts faster  Excellent bactericidal activity  Less irritating (??)  Sustained improvement Choose agent carefully: Adequate antimicrobial efficacy Compatibility with other hand hygiene products Visible soiling; Hands that are visibly soiled or potentially grossly contaminated with dirt or organic material MUST by washed with liquid soap and water Hand Care;  Nails  Rings  Hand creams  Cuts & abrasions  Chapping  Skin Problems

Streak plate: Streaking a clinical sample onto a media plate how specific bacteria are isolated so that the causative agent of a bacterial disease can be identified This technique will need be repeated, possibly several times, in order to obtain a pure sample Pour plate: The pour plate technique can be used to determine the number of microbes/mL or microbes/gram in a specimen It has the advantage of not requiring previously prepared plates, and is often used to assay bacterial contamination of foodstuffs disadvantage of pour plates is that embedded colonies will be much smaller than those which happen to be on the surface, must be carefully scored so that none are overlooked. Also, obligate aerobes may grow poorly if deeply imbedded in the agar Spread plate: spread-plate technique is to grow and isolate colonies of bacteria The bacteria sample is applied to the agar plate which a special streaking technique that dilutes the amount of bacteria in each section of the agar plate continuously Bacteria can also be quantified using the spread plate technique Agar slant: Surface area - by making the tube at a slant, you increase the surface area as opposed to just a flat surface; Moisture - plates, when stored, tend to dehydrate very quickly. A capped tube will retain moisture much longer; Bacterial staining: Methylene blue used for direct staining Dorner s nigrosin solution for negative staining of bacteria. The shapes and sizes of the organisms are seen as color-free outlines against the dark background An advantage of using this method, rather than regular positive stains like methylene blue or carbol fuchsin, is that prior fixation by heat or alcohol is not needed organisms are seen in more life-like shapes negative staining with nigrosin can reveal some microorganisms that cannot be stained by regular methods Ziehl-Neelsen staining is used to stain species of Mycobacterium tuberculosis that do not stain with the standard laboratory staining procedures like Gram staining. The stains used are the red coloured Carbol fuchsin that stains the bacteria and a counter stain like Methylene blue or Malachite green. Gram staining to differentiate between gram positive and gram negative bacteria Malachite green (also known as diamond green B or victoria green B) can be used as a blue-green counterstain to safranin in the Gimenez staining technique for bacteria It also can be used to directly stain spores