1 - INTRODUCTION TO MEDICAL PARASITOLOGY Flashcards
- Branch of biology focused on the animal parasites of human and their significance to public health
- From the Greek word, “parasitos” meaning food at the expense of others
Medical Parasitology
Living together for food and shelter
Symbiosis
Types of Symbiosis
- Commensalism
- Mutualism
- Parasitism
1 benefits while the other is unharmed
Commensalism
both organisms benefit for each other
Mutualism
1 benefits while the other is harmed
Parasitism
Organism that provides physical protection and nourishment to the parasite
Host
Types of Host
- Definitive/Final Host
- Intermediate Host
- Paratenic Host
- Reservoir Host
harbors the adult or sexually mature stage of parasite
Definitive/Final Host
harbors the larval stage or asexual/immature forms of the parasite
Intermediate Host
early larval stage
1st Intermediate Host
infective/more mature larval stage; does not reach adult stage
2nd Intermediate Host
harbors underdeveloped stage / arrested stage of development
Paratenic Host
alternative host to a parasite that is harbored normally by humans
Reservoir Host
Caused by Filarial worms
Intermediate Host: insect
Final Host: human
Filariasis
Class of parasite
All infect snails as first intermediate host
Intermediate Host: snail
Trematodes (zombie snail)
Caused by Paragonimus westermani
2nd Intermediate Host: snail, crab, human
Paratenic Host: wild boar
Continues life cycle through ingestion
Paragonimiasis
Reservoir Host: pigs
Balantidium coli
Organism that depends on the host for survival
Parasite
a vector (arthropod) that serves as a vehicle to transfer a parasite to a host but is not essential in its life cycle
Mechanical Vector
arthropod that is essential to the life cycle
Biological Vector
Types of Parasites According to Relationship
- Obligate
- Facultative
- Temporary
- Intermittent
c
Obligate
free-living/commensal but have the tendency to become parasitic
Facultative
obligatory to 1 stage cycle but free-living in another
Temporary
visits the host only during feeding time
Intermittent
Types of Parasites According to Habitat
- Endoparasite
- Ectoparasite
- Erratic
- Coprophilic
- Hematozoic
- Cytozoic
- Coelozoic
- Enterozoic
within the host = infection (ex. Helminthic worms)
Endoparasite
outside the host = infestation (ex. ticks, fleas)
Ectoparasite
unusual place or habitat
Erratic
usually protozoans, able to multiple in fecal matter outside of the human body
Coprophilic
lives inside red blood cells
Hematozoic
lives in cells/tissues
Cytozoic
lives in body cavities
Coelozoic
parasite residing in intestines
Enterozoic
Adaptations to Parasitism
- Physiologic Adaptation
- Morphologic Adaptation
- Biochemical Changes
loss of enzymes
Physiologic Adaptation
c
Morphologic Adaptation
alteration of metabolic pathways and development of specialized mechanisms
Biochemical Changes
Effects of Parasites on Host (Mechanisms of Parasite Infection)
- Damage and obstruction to intestinal wall
- Destruction of tissues in intestinal wall
- Destruction of RBC, causing ischemia
- Perforation of bowel wall and invasion of nearby organs
- Competition against essential nutrients
Damage and obstruction to intestinal wall
Fasciolopsis buski (suckers)
Destruction of tissues in intestinal wall
Entamoeba histolytica (proteolytic enzymes)
Destruction of RBC, causing ischemia
Plasmodium falciparum
Perforation of bowel wall and invasion of nearby organs
Ascaris lumbricoides
Competition against essential nutrients
- Human hookworms (N. americanus and A. duodanale)
- Dibothriocephalus latus (deprives nutrients)
Human hookworms (N. americanus and A. duodanale)
Iron: Microcytic hypochromic anemia
Vit B12: Megaloblastic anemia
Dibothriocephalus latus (deprives nutrients)
Effects of Host on the Parasite
- Genetic Constitution
- Nutritional Status
- Immune Mechanisms
Genetic Constitution
- Duffy null phenotype
- Sickle cell trait
resistant to P. vivax
Duffy null phenotype
resistant to P. falciparum
Sickle cell trait
Nutritional Status
- High-protein diet
- Low-protein diet
- Rich-carbohydrate diet
High-protein diet
unfavorable for development of intestinal protozoa
Low-protein diet
appearance of amoebiasis symptoms
Rich-carbohydrate diet
favors development of tapeworms
Immune Mechanisms
may be natural or acquired
- Exist as motile trophozoite stage and the nonmotile infective cyst
- Locomotor apparatus serves as one of the bases of classification
Protozoan
- Sarcodina: amoebae: equipped with pseudopods or false feet
- Mastigophora: flagellates: equipped with flagellum, a whip-like structure
Phylum Sarcomastigophora
- Ciliata: ciliates: equipped with cilia, hair-like structures
- Some ciliates are multinucleate, while others contain but two nuclei, a large macronucleus, and a small micronucleus
Phylum Ciliophora
only ciliate parasite of humans
Balantidium coli
- Parasites that are not equipped with definite locomotor apparatus
- Demonstrates 2 cycles:
- Schizogony – asexual cycle
- Sporogony – sexual cycle
- Contains apical complex that is composed of the ff: micronemes, subpellicular tubules, polar rings, conoids, rhoptries
Phylum Apicomplexa
causative agent of malaria
Plasmodium spp.
causative agent of Nantucket fever
Babesia microti
causative agent of Toxoplasmosis
Toxoplasma gondii
- Flatworms
- Characterized by a flat, bilaterally symmetrical body
- Most are hermaphroditic; having both male and female reproductive organs in the same individual
- Except schistosomes
- Adults may be less than 1 mm long or they may reach a length of many meters
- Most are parasites, living on or in the body of their hosts
Phylum Platyhelminthes
- Mostly existing as free-living forms inhabiting terrestrial, freshwater, and marine environments
- Ciliated epithelium envelops the body of the adult worm
- With or without suckers
- Direct development without metamorphosis
- Commensals or parasites of invertebrates especially of echinoderms and molluscs
Class Turbellaria
- “Flukes”
- Leaf-shaped or elongated, slender organisms
- Possess attachment organs in the form of cup-shaped muscular depressions called suckers
- An incomplete digestive tract is present
- Of the three orders of the
- Trematoda, the order Digenea contains all the species that are parasitic in humans
- Members of this order have complex life histories, with at least one intermediate molluscan host
- Included in the digenetic trematodes of humans are forms that inhabit: small intestine, liver, lungs, pancreas, and blood vessels
Class Trematoda
- Elongated, ribbon-like, segmented body that bears a specialized anterior attachment organ called the scolex
- A digestive tract is absent
- Adult cestodes or tapeworms inhabit the small intestine
- Cestode larvae require an intermediate host for development
- Hymenolepis nana or the dwarf tapeworm may or may not require an intermediate host; autoinfection is also observed in its life cycle
- Humans may be host to either adult or larval stages depending on the species of cestode
Class Cestoda
- Nematodes or roundworms
- Elongated, cylindrical worms frequently attenuated at both ends
- They possess a stiff cuticle which may be smooth or may be extended to form a variety of structures, particularly at the anterior and posterior ends
- The sexes are separate
- Males are frequently smaller than the female and possess copulatory structures like spicule or bursa
- A complete digestive tract is present
- A large number of species are parasitic
- Intermediate hosts are necessary for the larval development of some forms
- Parasites of humans include intestinal and tissue-inhabiting species
Phylum Nemathelminthes
- Formerly classified with the Sporozoa
- Minute intracellular parasites of many kinds of vertebrates and invertebrates
- Differ significantly in structure from the Apicomplexa
- Rarely cause disease in immunocompetent persons, but may do so with greater frequency in immunosuppressed persons
- Fungi-related microorganisms
- Most human infections are caused by the ff genera: Enterocytozoon and Encephalitozoon
Phylum Microsporidia
Life Cycle
- Mode of Transmission
- Infective Stage
- Diagnostic Stage
means whereby a parasite gains entry into an unsuspecting host
Mode of Transmission
morphologic forms which invades humans
Infective Stage
forms that can be detected in laboratory retrieval methods (nag-iiba based on lab test)
Diagnostic Stage
Multicellular
aMetazoan
Unicellular
Protozoan
Life Stages of a Protozoan Parasite
- Cyst
- Trophozoite
nonmotile, resting/nonfeeding form
Cyst
motile, active/feeding form
Trophozoite
transformation from trophozoite to cyst stage
Encystation
transformation from cyst to trophozoite stage
Excystation
Life Stages of a Metazoan Parasite
- Ova/Egg
- Larva
- Adult
Modes of Reproduction
- Sexual
- Asexual
release unembryonated/immature eggs; is not infective right away
Oviparous
release embryonated eggs; already infective (autoinfection)
Ovoviviparous
release larva directly/immediately
Larviparous
like mitosis
Binary Fission
Parasite Transmission Based on Transmission
- Soil-transmitted
- Vector-transmitted
- Food-borne
- Water-borne
- Direct Contact
Through ingestion
Ascaris lumbricoides
Trichuris trichiura
Through skin penetration
Hookworm
Strongyloides stercoralis
Unholy Three
- Most common parasites
- Can be present simultaneously
- Ascaris lumbricoides
- Trichuris trichiura
- Strongyloides stercoralis
Any agent which carries and transmits an infectious organism into another living organism
Vector-transmitted
such as mosquitoes and ticks may carry pathogens that can multiply within their bodies and be delivered to new hosts, usually by biting
Biological Vector
such as flies can pick up infectious agents on the outside of their bodies and transmit them through physical contact
Mechanical Vector
Examples of Vectors
- mosquito
- tsetse fly
- reduviid bug
- sand-fly
- ticks
- snails
- black fly
- fruitfly
causative agent of malaria
Plasmodium spp.
causative agent of filariasis
Wuchereria bancrofti
causative agent of sleeping sickness
Trypanosoma brucei
causative agent of chagas disease
Trypanosoma cruzi
causative agent of leishmaniasis
Leishmania spp
causative agent of babesiosis
Babesia microti
Snails
Schistosoma spp
Black Fly
Onchocerca volvulus
Fruit Fly
Loa loa
Copepods
Dracunculus medinensis
From raw pork meat
Taenia solium
Trichinella spiralis
Toxoplasma gondii
From raw beef
Taenia saginata (beef tapeworm)
From raw fish
Heterophyes heterophyes
Clonorchis sinensis
Opistorchis spp
From crabs/crustaceans
Paragonimus westermani
From vegetables
Fasciola spp
Fasciolopsis buski
Water-borne protozoans
Intestinal Amoeba
Intestinal Flagellates
Intestinal Coccidian
Direct Contact
Trichomonas vaginalis
Enterobius vermiculari
Portals of Entry
- mouth
- skin
- intranasal
- transmamary
- sexual
Embryonated egg
Ascaris, Trichuris
Cyst
Entamoeba histolytica
Metacercaria
Fasciola spp
Trophozoite
Entamoeba gingivalis
Filariform Larvae
Hookworm & Strongyloides stercoralis
Cercaria
Schistosoma japonicum
Sporozoites
Plasmodium spp
Trypomastigotes
Trypanosoma spp
Intranasal
Naegleria fowleri trophozoite
Transmammary
Ancylostoma duodenale (hookworm)
Sexual
Trichomonas vaginalis
Infected individual becomes his own direct source of infection
Autoinfection
- Already infected individual is further infected with the same species leading to massive infection with the parasite
- Also known as hyperinfection
Superinfection
Portals of Exit
- Stool
- Blood
- Sputum
- Urine
Stool
Ascaris lumbricoides
Trichuris
Hookworm
Taenia
Entamoeba
Blood
Plasmodium spp
Wuchereria
Trypanosoma
Sputum
Paragonimus
Ascaris
Urine
Schistosoma haematobium
Trichomonas vaginalis
Study of occurrence and distribution of disease in human population and communities
Epidemiology
No. of cases of a disease that are present in the population at a given time
Prevalence
No. of new cases that developed
Incidence
The act of occurring again
Recurrence
Clinical consequences of infections or diseases
Morbidity
No. of deaths within a particular society and period of time
Mortality
No. of worms per infected persons
Intensity of Infection
When a disease in a population maintains a relatively steady, moderate level
Endemic
When an outbreak of considerable intensity/sharp rise occur
Epidemic
If the prevalence of a disease is high
Hyperendemic
If it appears only occasionally in one or few members of the community
Sporadic
The disease covers extensive area of the world
Pandemic