Medical Parasitology

Deals with the study of animal parasites, which infect and produce diseases in human beings.

TAXONOMY OF PARASITES

According to the binomial nomenclature as suggested by Linnaeus, each parasite has two names:

a) a genus

b) a species name.

These names are either derived from: names of their discoverers, Greek or Latin words of the
geographical area where they are found, habitat of the parasite, or hosts in which parasites are found
and its size and shape. All parasites are classified under the following taxonomic units—the kingdom,
subkingdom, phylum, subphylum, super class, class, subclass, order, suborder, super family, family,
genus and species. The generic name of the parasite always begins with an initial capital letter and
species name with an initial small letter e.g. Entamoeba histolytica.

PARASITE

Parasite is a living organism, which lives in or upon another organism (host) and derives nutrients
directly from it, without giving any benefit to the host.

Protozoa and helminths (animal parasites) are studied in Medical Parasitology.

Classification of parasites

1.Ectoparasite

They inhabit the surface of the body of the host without penetrating into the tissues.

They are important vectors transmitting the pathogenic microbes.

The infection by these parasites is called as infestation, e.g ., fleas or ticks

2. Endoparasite

They live within the body of the host (e.g., Leishmania).

Invasion by the endoparasite is called as infection.

General Introduction: Parasitology

• Taxonomy of parasites

• Parasite

• Host

• Host-parasite relationship

• Transmission of parasites

• Life cycle of the parasites

• Immunology of parasitic diseases

• Laboratory diagnosis of parasitic diseases

• Treatment of parasitic diseases

Introduction

Endoparasites

Are of following types:

1.Obligate parasite

They cannot exist without a parasitic life in the host (e.g., Plasmodium species)

2. Facultative parasite

They can live a parasitic life or free-living life, when the opportunity arises (e.g., Acanthamoeba)

3.Accidental parasite

They infect an unusual host (e.g., Echinococcus granulosus infect humans accidentally)

4.Aberrant parasite or wandering parasite

They infect a host where they cannot live or develop further (e.g., Toxocara in humans).

HOST

Host is defined as an organism, which harbors the parasite and provides nourishment and shelter.

Hosts may be of the following types

1.Definitive host

The host in which the adult parasites replicate sexually (e.g., anopheles species), is called as definitive
host.

The definitive hosts may be human or nonhuman living things

2.Intermediate host

The host in which the parasite undergoes asexual multiplication is called as intermediate host. (e.g., in
malaria parasite life cycle, humans are the intermediate hosts)

Intermediate hosts are essential for the completion of the life cycle for some parasites

Some parasites require two inter- mediate hosts to complete their different larval stages. These are
known as the first and second intermediate hosts respectively (e.g., Amphibian snails are the first
intermediate host and aquatic plants are the second inter mediate host for Fasciola hepatica)
3. Reservoir host

It is a host, which harbours the parasites and serves as an important source of infection to other
susceptible hosts. (e.g., dog is the reservoir host for cystic echinococcosis)

4 Paratenic host

It is the host, in which the parasite lives but it cannot develop further and not essential for its life cycle is
known as paratenic host (e.g., fresh water prawn for Angiostrongylus cantonensis, big suitable fish for
plerocercoid larva of Diphyllobothrium latum and freshwater fishes for Gnathostoma spinigerum). It
functions as a transport or carrier host

5. Amplifier host

It is the host, in which the parasite lives and multiplies exponentially.

HOST-PARASITE RELATIONSHIP

The relationship between the parasite and the host, may be divided into the following types:

1.Symbiosis

It is the close association between the host and the parasite. Both are interdependent upon each other
that one cannot live without the help of the other. None of them suffer any harm from each other
2.Commensalism

It is an association in which the parasite only derives the benefit without causing any injury to the host.
A commensal is capable of living an independent life

3.Parasitism

It is an association in which the parasite derives benefit from the host and always causes some injury to
the host. The host gets no benefit in return.

Disease

The disease is the clinical manifestation of the infection, which shows the active presence, and
replication of the parasite causing damage to the host.

It may be mild, severe and fulminant and in some cases may even cause death of the host.

Carrier

The person who is infected with the parasite without any clinical or sub clinical disease is referred to as a
carrier. He can transmit the parasites to others.

TRANSMISSION OF PARASITES

It depends upon:

a) Source or reservoir of infection

b)Mode of transmission.
c)Sources of Infection

1.Man

is the source or reservoir for a majority of parasitic infections (e.g., amoebiasis, enterobiasis, etc.) The
infection transmitted from one infected man to another man is called as anthroponoses

2.Animal

The infection which is transmitted from infected animals to humans is called as zoonoses.The infection
can be transmitted to humans either directly or indirectly via vectors. (e.g., cystic echinococcosis from
dogs and toxoplasmosis from cats)

3. Vectors

Vector is an agent, usually an arthropod that transmits the infection from one infected human being to
another.Vector can be biological or mechanical. An infected blood sucking insect can transmit the
parasite directly into the blood during its blood meal.

4 .Contaminated soil and water

5.Soil polluted with human excreta containing eggs of the parasites can act as an important source of
infection, e.g., hookworm, Ascaris species, Strongyloides species and Trichuris species.

6.Water contaminated with human excreta containing cysts of E. histolytica or Giardia lamblia, can act
as source of infection

7.Raw or under cooked meat: Raw beef containing the larvae of Cysticercus bovis and pork containing
Cysticercus cellulosae are some of the examples where undercooked meat acts as source of infection

Other sources of infection: Fish, crab or aquatic plants, etc.

Modes of Transmission

The infective stages of various parasites may be transmitted from one host to another in the following
ways:

1.Oral or feco-oral route:

It is the most common mode of transmission of the parasites. Infection is transmitted orally by ingestion
of food, water or vegetables contaminated with feces containing the infective stages of the parasite.
(e.g., cysts of E. histolytica, and ova of Ascaris lumbricoides)

2.Penetration of the skin and mucous membranes

Infection is transmitted by the penetration of the larval forms of the parasite through unbroken skin
(e.g., filariform larva of Strongyloides stercoralis and hookworm can penetrate through the skin of an
individual walking barefooted over fecally contaminated soil), or by introduction of the parasites
through bloodsucking insect vectors. (e.g., Plasmodium species, Leishmania species and Wuchereria
bancrofti)
3.Sexual contact:

Trichomonas vaginalis is the most frequent parasite to be transmitted by sexual contact. However,
Entamoeba, Giardia and Enterobius are also transmitted rarely by sexual contact among homosexuals

4.Bite of vectors:

Many parasitic diseases are transmitted by insect bite (such as: malaria (female anopheles mosquito),
filariasis (Culex), leishmaniasis (sandfly), Chagas’ disease (reduviid bug) and African sleeping sickness
(tsetse fly)

5. Vertical transmission

Mother to fetus transmission is important for few parasitic infections like Toxoplasma gondii,
Plasmodium spp. and Trypanosoma cruzi

6. Blood transfusion

Certain parasites like Plasmodium species, Babesia species, Toxoplasma species, Leishmania species and
Trypanosoma species can be transmitted through transfusion of blood or blood products

7. Autoinfection

Few intestinal parasites may be transmitted to the same person by contaminated hand (external
autoinfection) or by reverse peristalsis (internal autoinfection). It is observed in Crypto- sporidium
parvum, Taenia solium, Enterobius vermicularis, Strongyloides stercoralis and Hymenolepis nana.

LIFE CYCLE OF THE PARASITES

The life cycle of the parasite may be direct (simple) or indirect (complex).

1.Direct/simple life cycle

When a parasite requires only one host to complete its development, it is referred as direct/simple life
cycle

2.Indirect/complex life cycle

When a parasite requires two hosts (one definitive host and another intermediate host) to complete its
development, it is referred as indirect/complex life cycle

Some of the helminths require three hosts (one definitive host and two intermediate hosts)