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