Medical Parasitology

(2)
For Medical Laboratories

New vision

Produced by
Dr/Faiz Al-khawlani
Dr/ Faiz Alkhawlani Medical Helminthology Introduction

MEDICAL HELMINTHOLOGY

INTRODUCTION

□ Medical helminthology is concerned with the study of helminthes or

parasitic worms.
□ Helminthes are trophoblastic metazoa (multi-cellular organisms).
□ Helminthes are among the common parasitic causes of human suffering
and they are the cause of high morbidity and mortality of people
worldwide.
□ They cause different diseases in humans, but few helminthic infections
cause life- threatening diseases.
□ They are well developed and most of helminthes possess digestive
tract, reproductive organs, muscular tissue, nervous cells and sensory
cells.
□ They well adapted to live within their hosts and can survive several
environmental conditions.
□ Helminthes that have encountered in our country and the neighboring
regional areas are what we will discuss them through this textbook.
□ Other helminthes that distributed for instance, in America, South-east
Asia dose not involved in our lectures.
Humans may act as a host of various patterns for helminthic parasites:
�Definitive host

�Intermediate host

�Carrier host

Reservoirs of parasites

Many parasites can survive in different organisms, on non-living objects,

or in the environment. Some can only persist and multiply inside human

1
Dr/ Faiz Alkhawlani Medical Helminthology Introduction

beings, whereas others can survive in other animals, or for example in soil

or water.

Reservoir

The place where the parasitic stage is normally present before infecting a

new human is called a reservoir. Without reservoirs, parasitic stage could

not survive and hence could not be transmitted to other people. The most

common parasites reservoirs are:

□ Human
□ Water
□ Soil
□ Animals

Soil-transmitted helminthiasis

Parasitic diseases that can be transmitted from contaminated soil to humans

are called, Soil-transmitted helminthiasis and the involved helminthes are

called, Soil-transmitted helminthes. Therefore, soil can acts as parasitic

reservoir.

Zoonosis

Several animal species can serve as a parasitic reservoir. Parasitic

diseases such as taeniasis, where one of the parasitic stages can be

transmitted from animal host to susceptible humans, are called zoonoses

(singular, zoonosis).

2
Dr/ Faiz Alkhawlani Medical Helminthology Introduction

Transmission
Transmission is a process in which several events happen one after the

other in the form of a chain. Hence, this process is known as a chain of

transmission

Chain of transmission

Transmission chain includes the following terms as described with the

figure below:

The The
susceptible infectious
host agent

The route of The route of

entry exit

Mode of
The reservoir
transmission

3
Dr/ Faiz Alkhawlani Medical Helminthology Introduction

Mode of transmission

□ Mode of transmission refers to the manner by which a parasitic

infective stage is transmitted to human host (e.g. by ingestion or

penetration of the infective stage).

□ Ingestion of the infective parasitic stage is the most common mode of

transmission that is through mouth.

□ However, penetration the infective stage of human skin is also involved

in several helminthic parasites.

□ From epidemiological view of point, mode of transmission should

include certain indicative terms to be informed.

Important notes

 For example, mode of transmission of ascariasis is through ingestion of

contaminated fresh eatable vegetables containing the infective stage
(embryonated eggs).
 In fact, this indicates that vegetables must be described as contaminated,
fresh not canned and containing the infective stage.
 Because the term ascaris egg has the probability, which means non-
embryonated egg (non-infective) or embryonated egg (infective), the latter
is the valid term, used to describe the mode of transmission.
 If one said that, mode of transmission is through ingestion of vegetable,
the answer is far from the fact and does not carries any indicative terms.

Source of helminthic infections

1. Contaminated soil (Soil-transmitted helminthes)

2. Contaminated Water (cercaria of blood flukes)

4
Dr/ Faiz Alkhawlani Medical Helminthology Introduction

3. Contaminated meat (Taenia in raw meat).

The route of entry

The site through which an infectious stage enters the host is called the route

of entry. The infective stage of parasitic helminthes can enter the host body

through different routes including:

1. Mouth (ingestion of infective eggs)

2. Skin (penetration of infective larvae)

3. Respiratory tract (inhalation of airborne eggs)

Sources of helminthic infections

Sources of helminthic infections

Egg of Ascaris
1.Soil Contaminated With Human Excreta
Larva of Ancylostoma

Egg of Ascaris
2-Water Polluted With Human Excreta
Larva of Schistomoma

Raw vegetables or fruits

3-Foods Contaminated With Parasitic Infective Stage Egg of Ascaris

Meat & fish (undercooked)
Tapeworms
4- Blood sucking insects or arthropods filarial worms

5- Domestic or wild animals, harboring the parasite (Echinococcus granulosus in

dogs)
6- Infected human (Enterobius vermicularis and
Hymenolopis nana).

5
Dr/ Faiz Alkhawlani Medical Helminthology Introduction

Effects of the parasite on the host

Effects of the parasite on the host

Mechanical injury Skin, Bladder, Intestine

Feeding on host cells and Epithelial cells & R.B.C

tissues
Deprive the host essential Iron, Vitamins (A, B
substances complex)

Toxic effects Nervous system

Allergic effect Rash, Urticaria, Pruritus

Obstruction of vital Gall bladder obstruction

organs Intestinal obstruction
Mechanical pressure on Liver, Lungs
vital organs

Indirect effects Mental & physical growth

Secondary infection
Effect on productivity

Parasitic life cycle

Helminthic parasites life cycle can be classified into:
1. Direct simple life cycle

The parasite is transmitted from one person to person without need to a

host or further development outside human body (e.g; Enterobius

vermicularis and Hymenolopis nana). The egg stage in such parasites is

immediately infective.

6
Dr/ Faiz Alkhawlani Medical Helminthology Introduction

2. Direct complex life cycle

The parasite can be transmitted from one person to other person without

need to an intermediate host but further necessary development occurs

outside human body (e.g.; Ascaris and Ancylostoma). The egg stage in such

parasites is not immediately infective and the non-embryonated egg must

remain under favorable conditions for a variable period to become infective

(embryonated) egg.

3. Indirect simple life cycle

The parasite life cycle involves two hosts; the first is human and the second

is non-human host. In contrast, direct life cycle involves only one host

(human). Schistosoma spp life cycle is for instance that involves human as

a definitive host and the snail as an intermediate host.

4. Indirect complex life cycle

In this type, the parasite life cycle occurs in more than two hosts. For

example, three hosts are required for completing the life cycle of

Diphyllobothrium latum (fish tapeworm). In this case, human, water

Cyclop and fish are involved in the life cycle.

Generally, parasitic life cycles range from simple to complex and there are

three common components that life cycle describe:

 A mode of transmission
 An infective stage
 A diagnostic stage

7
Dr/ Faiz Alkhawlani Medical Helminthology Introduction

A parasitic life cycle consists of two common phases:

1. The route that a parasite follows inside the body

 Site of infection
 Clinical symptoms and pathology
 Proper diagnostic technique
 Determining the appropriate medication
2. The route that a parasite follow outside the body:

 Epidemiology
 Prevention
 Control
Classification

In contrast to the protozoan parasites that have already studied, the

metazoan parasites are helminthes can be classified into two groups:

1. Nemathelminthes or Aschelminthes: include one classe; Nematodes

(Roundworms).

2. Platyhelminthes: include two classes; Cestodes (Tapeworms) and

Trematodes (flatworms).

8
Dr/ Faiz Alkhawlani Medical Helminthology Introduction

Diagram (1) Classification of medically important helminthes

9
Dr/ Faiz Alkhawlani Medical Helminthology Introduction

Diagram (2)Classification of medically important Nematodes

10