Introduction to parasites Flashcards
What is a definitive host?
Either habours sexual stage of parasite or adult stage. Majority of human parasitic infections.
What is an intermediate host?
- Harbours the larval or asexual stages of the parasite
- Some parasites require two intermediate hosts in which to complete their life cycle
What is a parantetic host?
Host where the parasite remains viable without further development.
What is a direct lifecycle?
Only one host (definitive).
What is a simple indirect lifecycle?
One definitive host and one intermediate host.
What is a complex indirect lifecycle?
More than one intermediate host.
What is Ascaris?
Intestinal roundworm
What is the route of infection for Ascaris?
Faeco-oral - ingestion of eggs from contaminated water.
What kind of lifecycle does Ascaris have?
Direct - Human sheds eggs in faeces
What is the lung phase of Ascaris?
Loefflers syndrome - dry cough, dyspnea, wheeze, haemoptysis, eosinophilic pneumonitis
Larvae migrate from intestines to alveolae where they are then coughed up and swallowed.
What is the intestinal phase of Ascaris?
Malnutrition
Migration – into hepatobiliary tree and pancreas
Intestinal obstruction
Worm burden
Adult worm
What is the treatment/control of Ascaris?
Treatment
- Albendazole
- Benzimidazole
- Prevents glucose absorption by worm
- Worm starves-detaches-passed PR
Control
- WHO “Action Against Worms”
- Improve sanitation
- Education
- Community targeted deworming
What is the intermediate host of Schistosomiasis?
Freshwater snail
What is the clinical progression of schistosomiasis?
- Swimmers itch
- Katayama fever
- Chronic Schistosomiasis
What is Katamaya fever?
Acute schistosomiasis
What are the signs/symptoms of chronic schistosomiasis?
- Haematuria
- Bladder fibrosis and dysfunction
- Squamous cell CA bladder
- Portal hypertension
- Cirrhosis
How is schistosomiasis diagnosed?
Urinary
- Terminal Stream Microscopy
- Serology
Hepatic/Intestinal
- Stool Microscopy
- Rectal Snip Microscopy
- Serology
What is the treatment of schistosomiasis?
- Praziquantel (parazinoisoquinoline derivative)
40-60 mg/kg with food 3 doses 8-hourly - Mechanism unknown- increased ionic permeability tetanic contraction, detachment, death
- Well absorbed, extensive 1st pass metabolism, inactive metabolites excreted in urine
Treatment of long term complications
How can schistosomiasis be controlled?
- Chemical treatment to kill snail intermediate hosts
- Chemoprophylaxis
- Avoidance of snail infested waters
- Community targeted treatment, education and improved sanitation
What kind of disease is caused by Echinococcus?
Hydatid disease
E. multilocularis - alveolar
E. granulosus - cystic
What are the usual hosts of Echinococcus?
Sheep and dogs
Humans are accidental hosts
What kind of lifecycle does Echinococcus have?
Simple indirect. Sheep is definitive host, dog is intermediate.
What are the clinical features of hydatid disease?
- Cysts: 70% liver, 20% lungs
- May remain asymptomatic for years
- Mass effect
- Secondary bacterial infection
- Cyst rupture- hypersensitivity
How may hydatid disease be controlled?
- Regularly worm dogs to reduce egg production
- Hand hygiene
- Safe disposal of animal carcasses/products of conception