Introduction to Parasitology

OLFU CLINICAL PARASITOLOGY LEC 1 2021 – 2022

1st Semester
RMT 2023 Instructor: Prof. Sherlyn Joy P. Isip, RMT, MSMT
Date: September 14, 2021 TRANS 1 PARA311
LEC

 Tropical Disease
At the end of the session, the student must be able to learn:  An illness, which is indigenous to or endemic in tropical area
I. Parasitology but may also occur in sporadic or epidemic portions in areas
A. Divisions of Parasitology that are not tropical.
II. Host Parasite Relationship  Parasite
A. Symbiosis  Lives on or in the host usually on a larger organism, which
B. Parasites according to the Mode of Living provides physical protection and nourishment.
C. Parasites according to Duration of Parasitism  Host
D. Parasites according to Pathologic Conditions  Harbours parasite and gives nourishment.
III. Types of Host
IV. Sources of Exposure to Infection II. HOST PARASITE RELATIONSHIP
A. Contaminated soil and water
B. Food containing immature infective stage of parasite  The organisms may develop unique relationship due to their
C. Arthropods, blood sucking insects and other wild or habitual and long associations with each other.
domesticated animals
D. Another Person A. Symbiosis
E. One’s self
V. Types of Vectors  Living together of unlike organisms, protection or other advantages
VI. Modes of Transmission to one or both partners.
VII. Portal of Entry  Mutualism
VIII. Portal of Exit  Relationship is beneficial to both organisms.
IX. Nomenclature  Termites
X. Types of Life Cycle  Commensalism
A. Life stage of a parasite  Parasite derives benefit without reciprocating and without
XI. Mode of Reproduction injury to the host or both.
XII. Epidemiologic Measures  Entamoeba coli can be found in intestinal lumen
XIII. Distribution of Diseases and is being supplied with nourishment without
XIV. Pathophysiology and Symptomology of Parasitic causing any damage to the tissue of the host.
Infections  Parasitism
XV. Factors that determine the Intensity of Parasitic  Relationship where one organism, the parasite, lives in or
Infection another, depending on the latter for its survival and usually at
XVI. Treatment the expense of the host.
XVII. Prevention and Control
 Entamoeba histolytica derives nutrition from
XVIII. Eradication and Elimination
human host at the same time it causes amoebic
dysentery.

I. PARASITOLOGY B. Parasites according to the Mode of Living

 An area of science, which deals with the study of organisms living  Ectoparasites
permanently or temporarily on or within another organism.  Living outside the body of the host.
 The branch of biology or medicine concerned with the study of  Infestation
parasitic organisms  Endoparasites
 It is the study of parasites, their hosts, and the relationship between  Living inside the body of the host.
them.  Infection
 Concerned with the phenomena of dependence of one living  Facultative parasites
organism on another.  Able to live outside or inside the host and lead both to a free
and parasitic existence.
A. Divisions of Parasitology  Obligate parasite
 Completely dependent to the host for its existence throughout
 Protozoology its life.
 Protozoans: small, unicellular organisms, which contain  Accidental/Incidental parasite
nucleus and functional organelles.  Establishes itself in the host in which it does not ordinarily live.
 Helminthology  Occasional/Periodic
 Worms: larger, multicellular organisms normally visible to the  Seeks its host intermittently to obtain nourishment.
naked eye in their adult form.  Saprophytes
 Medical Entomology  Live in organic substances in state of decomposition.
 Insects and arthropods  Erratic
 Those that live in an organ different from the one it usually
parasitize.
OTHER TERMINOLOGIES  Zoonotic
 Animal parasites, non-human parasites that may cause
 Medical Parasitology human infections.
 Concerned primarily with the parasite that affects humans and
their medical significance, as well as their importance in
human communities.
 Tropical Medicine
 Branch of medicine, which deals with tropical diseases and
other special medical problems of tropical regions.

Gurrea, A.N, Ortiz, M.J - TRANSCRIBER

[PARA311] 1.01 Introduction to Parasitology I Prof. Sherlyn Joy P. Isip, RMT, MSMT
C. Parasites according to Duration of Parasitism  Autoinfection
 Infected individual becomes his own direct source of infection.
 Temporary parasites  Enterobius vermicularis
 Free living during part of existence, larval stage has different  Superinfection or Hyperinfection
host from its adult stage.  already affected individual is further infected with the same
 Permanent parasites species leading to the massive infection with the parasite
 Remain on the body of the host in all stages of its life cycle.  Co-infection
 simultaneous infection of a host by two or more parasite
 Presence of Ascaris lumbricoides and Trichuris
D. Parasites according to Pathologic Conditions
trichiura in the stool sample.
 Spurious/Coprozoic parasite
 Passes digestive tract of humans without infecting them. A. Contaminated soil and water
 Coprophilic parasite
 Parasite multiply in fecal matter outside the human body.  lack of sanitary toilets and use of night soil
 Hematozoic parasite  Soil: Ascaris lumbricoides, Trichuris trichiura, Hookworm,
 Lives inside the red blood cells Strongyloides stercoralis
 Cytozoic parasite  Water: Amoeba, Flagellates, Blood flukes
 Lives inside the cells or tissues
 Coelozoic parasite
 Lives in the body cavities B. Food containing immature ineffective stage of parasite
 Enterozoic parasite
 Lives in the intestine  consumption of undercooked or raw freshwater fish, crab,
snail, beef and pork

III. TYPES OF HOST

C. Arthropods, blood sucking insects and other wild or
domesticated animals
 Definitive host
 final host, harbours the adult and sexually mature form
 If infected with Taenia saginata and Taenia solium,  Mosquitoes (Filaria and Malaria)
humas are considered as definitive host.  Triatoma bugs ( Trypanosoma cruzi)
 These helminths develop into adult form inside the  Sandflies (Leishmania)
human body.  Cats, dogs and house rats
 Intermediate host
 harbours the larvae or asexual stage of the parasite
D. Another Person
 In some Helminths, their first intermediate host can
be plants. While their second intermediate host can
be snail or fish.  Beddings and clothing
 Reservoir host  Immediate environment he has contaminated
 Animal that harbours the same parasite of man
 Pigs are reservoir of Balantidium coli E. One’s self
 Paratenic host
 harbours a stage of the parasite where in no further
development in parasite takes place.  Autoinfection: self is the source of infection
 Angiostrongylus cantonensis is in larva form when  Enterobius vermicularis, Hymenolepis nana, and
resided in the human body and will not develop into Strongyloides stercoralis
adult form. Their definitive host is the house rats
while humans are considered as their paratenic
host. V. TYPES OF VECTORS

 Vector is responsible for transmitting the parasite from one host to

IV. SOURCES OF EXPOSURE TO INFECTION another.

 Pathogens A. Biological vector

 can be animal parasites that are harmful and frequently cause
mechanical injury to their host  the parasite is seen inside the body of this organism and the
 Carrier parasite needs this organism for its development. Ex:
 harbours a particular pathogen without manifesting signs and mosquitoes, tsetse flies
symptoms
 Exposure
 process of inoculating an infective agent B. Mechanical vector
 Infection
 establishment of the infective agent in the host  Responsible only for transporting the parasite, the parasite is
 Incubation period only seen on the surface of this organism and there will be no
 period between infection and evidence of symptoms development on the parasite. Ex: cockroaches, house flies
 Pre-patent period
 Biological incubation period, period between infection and
acquisition of the parasite and evidence or demonstration of VI. MODES OF TRANSMISSION
infection.
 Soil transmitted
 Arthropod/ Vector transmitted

 Food-borne

Gurrea, A.N, Ortiz, M.J - TRANSCRIBER

[PARA311] 1.01 Introduction to Parasitology I Prof. Sherlyn Joy P. Isip, RMT, MSMT
 Water-borne
 Skin penetration A. Sexual
 Congenital transmission
 Direct contact  Oviparous: "egg birth", give birth to eggs that must develop before
hatching
 Ovoviviparous: ones that produce eggs but retain them inside the
female body until hatching occurs, so that "live" offspring are born
VII. PORTAL OF ENTRY
 Larviparous/ Viviparous: being born alive without eggs
 By mouth: most common area of invasion, entrance for intestinal
protozoa B. Asexual
 Skin penetration
 Intranasal: inhalation of eggs  Binary fission: division in half
 Transplacental infection  Parthenogenesis: unfertilized ovum develops directly into a new
 Transmammary individual, natural form of asexual reproduction in which growth and
 Sexual intercourse development of embryos occur without fertilization by male sex cell

VIII. PORTAL OF EXIT XII. EPIDEMIOLOGIC MEASURES

 Stool  Epidemiology
 Urine  science concern with the propagation of the disease,
 Sputum study of patterns, distribution and occurrence of
 Blood disease
 Tissue aspirates and biopsy
 Orifice swab  Incidence
 Discharge  number of new cases of infection appearing in a
population in a given period of time
 Absolute number
IX. NOMENCLATURE
 Prevalence
 usually expressed in percentage, number of
 Classified according to the International Code of Zoological
individuals in a population estimated to be infected
Nomenclature with a particular parasite at a certain time
 Scientific name are Latinized
 Names of genera and species are italicized or underlined when  Cumulative prevalence
written.  percentage of individuals in the population infected with
 Generic names consist of a single word written in initial at least one parasite
capital letter, the specific name always begins with a
small letter.  Intensity of infection
Kingdom: Animalia  number of worm per infected person (worm burden)
 Direct: counting expelled worms during treatment
Phylum: Nematoda  Indirect: counting helminth egg excreted in feces,
Class: Secernentea expressed in egg per gram

Order: Ascaridida
Family: Ascarididae XIII. DISTRIBUTION OF DISEASES

Genus: Ascaris  Sporadic

 appears only occasionally in one or at most a few members of
Species: Ascaris lumbricoides the community
 eg. Tetanus and rabies
 Endemic
X. TYPES OF LIFE CYCLE  there is a steady moderate level of disease in human
population
 Simple or complicated  eg. Malaria in Palawan
 Most parasitic organisms attain sexual maturity at the  Epidemic
definitive host.  there is a sudden outbreak or rise of incidence in human
 Larval stage of parasite may pass through different population
stages in an intermediate host.
 SARS-CoV and MERS-CoV
 As life cycle becomes complicated, the lesser chances
are for the individual parasite to survive.  Pandemic
 when the disease have been disseminated in extensive area
of the world
A. Life Stage of a Parasite
 COVID-19, AIDS and HIV
1. Ova
2. Egg
3. Larva XIV. PATHOPHYSIOLOGY AND SYMPTHOMOLOGY OF
4. Trophozoite PARASITIC INFECTIONS
5. Cyst
6. Adult  Traumatic or physical damage
 when parasites invade the skin and other tissues causing
destruction

XI. MODE OF REPRODUCTION

Gurrea, A.N, Ortiz, M.J - TRANSCRIBER
[PARA311] 1.01 Introduction to Parasitology I Prof. Sherlyn Joy P. Isip, RMT, MSMT
 the parasite competes with its host for the available supple of
vitamin.
 Diphyllobothrium latum competes on vitamin b12

Creeping eruption, a skin infection caused by hookworms

 Lytic necrosis
 secretory and excretory products elaborated by many
parasites allow them to metabolize nutrients obtained from the
host and store these for energy production.
 Entamoeba histolytica secretes enzyme cysteine proteinase
to digest cellular materials and degrade epithelial basement Hookworms
membrane facilitating tissue invasion.

XV. FACTORS THAT DETERMINE THE INTENSITY OF

PARASITIC INFECTION

 Topography of locality
 Social condition
 Age
 Hygienic measure
 Sewage disposal
 Water supply

Entamoeba histolytica in rectal biopsy XVI. TREATMENT

 Tissue reactions  There are several options for treating parasitic infections. Many of
 Cellular proliferation, white cell infiltration at the side of the these drugs are toxic to the host and care should be exercised
parasite when selecting the proper course of treatment.
 Antiparasitic medications
 Change in diet
 Vitamin supplements
 Fluid replacement
 Blood transfusion bed rest

 Deworming
 Use of anti-helminthic drugs in an individual or public health
program.
 Cure rate: usually expressed in percentage,
Filarial larvae of Strongyloides stercoralis
number of previously positive subjects found to be
 Toxic allergic phenomena egg-negative in examination of a stool or urine
 When proteins or other metabolites of the parasites are sample using a standard procedure at a set time
introduced into the body, there is sensation to the foreign after deworming.
substance, which may produce hypersensitization to  Egg reduction rate: percentage fall in egg counts
anaphylactic shock. after deworming based on examination of a stool or
urine sample using a standard procedure at a set
time after deworming

 Selective Treatment
 Individual-level deworming with selection of treatment based
on a diagnosis of an infection or based on presumptive
grounds

 Targeted Treatment
 Group-level deworming where the risk group to be treated
(with or without prior diagnosis) may be defined by age,
gender or other social characteristics irrespective of infection
Punctuate keratitis status.

 Universal treatment
 Population-level deworming in which the community is
treated irrespective of age, gender, infection status or other
social characteristics.

 Coverage
 Proportion of target population reached by an intervention.

 Deprivation of the host’s essential nutrients and substances  Drug resistance

Gurrea, A.N, Ortiz, M.J - TRANSCRIBER
[PARA311] 1.01 Introduction to Parasitology I Prof. Sherlyn Joy P. Isip, RMT, MSMT
 Genetically transmitted loss of susceptibility to a drug in a
worm population that was previously sensitive to the
appropriate therapeutic dose.

 Efficacy
 Effect of a drug against an infective agent in deal experimental
conditions and isolated form of any context.
 Performance of intervention under ideal or control
circumstances mostly used in research or in trial.
 Is the drug working or not?

 Effectiveness
 Measure of the effect of a drug against infective agent in a
particular host, living in a particular environment with specific
ecological, immunological, and epidemiological determinants.
 Is the drug working or not? Is it effective or safe?

XVII. PREVENTION AND CONTROL

 Morbidity Control
 Avoidance of illness caused by infections, may be achieved
by periodically deworming individuals or groups, known to be
at risk of morbidity.
 Targeted treatment may be given

 Information-education-communication (IEC)
 health education strategy that aims to encourage people to
adapt and maintain healthy life practices

 Environmental management
 planning, organization, performance and monitoring of
activities for the modification and/or manipulation of
environmental factors or their interaction with human beings
 preventing or minimizing vector and intermediate
host propagation
 reducing contact between humans and the infective
agent

 Environmental sanitation
 intervention to reduce environmental health risk
 safe disposal and hygienic management of human
and animal excreta, refuse and waste water
 control of vectors, intermediate host and reservoir
of diseases
 provision of safe drinking water and food safety
 housing that is adequate in terms of location,
quality of shelter and indoor living conditions
 facilities for personal and domestic hygiene
 safe and healthy working conditions

 Sanitation
 provision to access to adequate facilities for safe disposal of
human excreta, usually combined with access to safe
drinking water

XVIII. ERADICATION AND ELIMINATION

 Disease eradication
 Permanent reduction to zero of the worldwide incidence of
infection caused by a specific agent, as a result of deliberate
effort. Once this is achieved, continued measures are no
longer needed.
 Small pox
 Disease elimination
 Disease elimination: reduction to zero of the incidence of a
specified disease in a defined geographical area as a result
of deliberate effort. Continued intervention and surveillance
are still required.

Gurrea, A.N, Ortiz, M.J - TRANSCRIBER