MEDICAL PARASITOLOGY 

SY 2020-2021 
2ND SEMESTER 
| LECTURE & LABORATORY 

OUTLINE

I. INTRODUCTION TO PARASITOLOGY
A. Overview
B. Epidemiology
C. Parasitic Disease Characteristics
D. Parasitic Disease Risk Factors
E. Specimen Collection and Processing
F. Types of Parasites
G. Life Cycle of Parasites
H. Classification of Parasites
II. NEMATODES
A. General Characteristics
B. Intestinal Nematodes ● Symbiosis
C. Intestinal-Tissue Nematodes - “living together” positive relationship between members
D. Hookworms of different species

UNIT I: INTRODUCTION TO PARASITOLOGY ○ Parasitism - one benefits and the other is harmed
○ Commensalism - one benefits and the other neither
What is Parasitology? benefits nor is harmed
○ Mutualism - both organisms benefit from each other
● Parasitology is the study of parasites, their hosts, and the
relationship between them
○ Parasitus (Latin), Parasitos (Greek) EPIDEMIOLOGY
○ Para​ (beside, by) - ​sitos​ (wheat, grain, food) - ​logos
● Parasites are distributed worldwide
● Parasitology is traditionally limited to ​parasitic protozoa ● Most parasitic infections are found in underdeveloped tropical
(single-celled eukaryotes)​, ​helminths (parasitic worms), and and subtropical countries
arthropods​ ​(invertebrate with exoskeleton) ○ often affected by temperature, poverty, poor sanitation,
● A parasite is an organism that lives on or in its host low educational level, inadequate healthcare facilities
for prevention and mitigation
● The increasing prevalence of world travel may account for
PARASITISM vs. PREDATION parasitic infections being spread
- Host: ALIVE - Host: DEATH
- weak/ exposed to disease - Hunting, scavenging
Neglected Tropical Diseases
→ do not cause instant death so it lacks support from the government

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Neglected Tropical Diseases: PARASITIC DISEASE RISK FACTORS

1. Unsanitary food handling and preparation

○ i.e., contaminated meat and vegetables
2. Contaminated water for drinking or recreational use
3. Poor nutrition
4. Blood transfusion and organ transplantation
5. Foreign travel to endemic regions of the world

SPECIMEN COLLECTION AND PROCESSING

1. Specimen collection
○ Stool (most common)
○ Tissue biopsies
Type I Type II Type III ○ Urine
○ Sputum
Rich and poor Majority in poor Overwhelmingly/
○ Cerebrospinal fluid analysis (CSF)
Prevalence countries countries exclusive in poor
○ Genital material
countries
○ Blood
Hepatitis B HIV/AIDS Sleeping sickness
Measles TB River blindness 2. Recovery Techniques
CVD Buruli ulcer ○ Cellophane (scotch) tape preparations
Examples tobacco-related Chagas ○ EnteroTest (string test)
Leprosy ○ Enzyme immunoassay techniques
Dengue ○ Serology testing
Leishmaniasis ○ Immunofluorescence
Guinea worm
○ Electrophoresis
○ DNA hybridization
○ Polymerase Chain Reaction (PCR)
PARASITIC DISEASE CHARACTERISTICS
TYPES OF PARASITES
1. Diarrhea ​is the most frequent symptom, along with abdominal
cramping seen in gastrointestinal tract infections ● Ectoparasite
2. Other Symptoms depend on the parasite and the site of - ​lives on the surface/ outside the host (infestation)
infection ● Endoparasite
○ Intestinal obstruction, weight loss, and bloating - lives within the host (infection)
○ Organ involvement with ulcers, lesions, and abscesses
○ Blood and tissue parasites can cause anemia, fever, ○ Obligate parasites
chills, bleeding, encephalitis, and meningitis - completely dependent on the host to complete
its life cycle (e.g., viruses)

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○ Facultative parasites - Harbors sexually immature parasite but not

- “free-living” necessarily for development of parasite
- only becomes parasitic when they are ingested ○ Reservoir Host
- e.g., fungi - Where parasite naturally lives and reproduces
○ Accidental parasites
○ Intracellular parasite ● A ​Vector is an organism responsible for transmitting the
- Lives within the cell of the host parasite from one host to another; (frequently arthropods)
- Plasmodium
○ Permanent parasite ○ Biological Vectors
- Lives on its host until maturity or spends their - Carries pathogen that can multiply within their
entire life on its host bodies and be delivered to new hosts, usually
○ Temporary parasite by biting
- Lives on the host only at a few/particular stage - Mosquitoes and ticks
of its life cycle ○ Mechanical Vectors
○ Spurious parasite - Carries a pathogen or infectious agents on the
- digestive tract that causes infection outside of their bodies and transmit them
through physical contact, not as an infection
LIFE CYCLE OF PARASITES - Flies

● A ​host​ is a larger organism that harbors a smaller organism ● A Carrier is an asymptomatic host that harbors a parasite and
is capable of transmitting it to others, usually ​humans​.
○ Definitive Host
- Primary or final host
- harbors the adult phase of a parasite Parasitic Life Cycles
- where the parasite reproduces sexually
○ Intermediate Host ● Simple Life Cycle
- Secondary - all the developmental stages are completed in a single host
- Harbors the larval stage or asexual forms of the ● Complex Life Cycle
parasite
○ Incidental Host ❖ 3 COMPONENTS
- Does not allow transmission to the definitive a. Mode of Transmission
host b. Infective Stage
○ Accidental Host c. Diagnostic Stage
- not normally infected/infested by a particular
parasite ❖ 2 COMMON PHASES
○ Permissive Host a. Route inside
- Allos a parasite to circumvent its defenses and - Provide information in the symptoms,
replicate/develop diagnosis, and treatment
○ Paratenic Host b. Route outside
- Intermediate host - Epidemiology, prevention, etc.

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Transmission
● Anti-parasitic medication
Treatment ● Therapies
1. Oral Route - Change in diet
- Ingestion on contaminated food and water - Vitamin supplements
- Oral-fecal - Fluid replacement
- Paragonimus westermani​ or Japanese lung fluke - Blood transfusion
2. Skin Penetration - Bed rest
- (mucous membrane)
- hookworms ● Education programs
3. Vector-borne ● Proper water treatment
- Inoculation by arthropod vectors ● Good personal hygiene
- Malaria (​Anopheles​) ● Proper sanitation practices
4. Sexual Contact Prevention and Control ● Proper handling of food
- Trichomonas vaginalis ● Use of insecticides
- Entamoeba histolytica ● Protective clothing
5. Inhalation of eggs ● Avoidance of unprotected
6. Blood Transfusion sexual relations
Zoonosis
- Transmission to humans of parasites normally found in wild
and domestic animals CLASSIFICATION OF PARASITES
- An animal infection or disease that humans accidentally aquire
- E.g., ​Trichinella,​ Trichinosis 1. Protozoa​ - unicellular eukaryotic microorganisms
- Humans become infected when they enter the life cycle a. Phylum Nemathelminthes
(eating undercooked meat) - Class Nematoda (roundworms)
b. Phylum Platyhelminthes
- Class Cestoda (tapeworms)
- Class Trematoda (flukes)
OTHERS
2. Metazoan helminths​ - wormlike invertebrates
● Gastrointestinal tract
a. Phylum Sarcomastigophora
● Urogenital tract
b. Phylum Ciliophora
● Blood
c. Phylum Apicomplexa
● Tissue
Major Areas Affected ● Liver
3. Arthropods ​- possess hard exoskeleton; jointed appendages
● Lung
a. Phylum Arthropoda
● CNS
- Class Insecta (fleas)
● Eye
- Class Arachnida (ticks, mites)
● Skin
- Class Crustacea (crabs, crayfish)
● Extermities
- Class Myriapoda (centipedes, millipedes)

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UNIT II: NEMATODES INTESTINAL NEMATODES

Nematodes ● Enterobius vermicularis

● Nematodes (roundworms) are a class of helminths and are ● Trichuris trichiura
among the most abundant animals on Earth. ● Ascaris lumbricoides
○ Bilaterally symmetrical, worm-like organisms ● Capillaria philippinensis
● Strongyloides stercoralis
GENERAL CHARACTERISTICS
● Simple Nervous system INTESTINAL - TISSUE NEMATODES
- includes sensory organs (​plasmids​)
● Complete digestive system ● Trichinella spiralis
● Wuchereria bancrofti
● Brugia malayi
Simple, Pseudocoelomate
● Dracunculus medinensis
BODY PLAN - Fluid-filled cavity that forms hydrostatic
skeleton
HOOKWORMS
OUTER COVERING Cuticle (thin)
● Necator americanus
● Egg ● Ancylostoma duodenale
● Larva ● Ancylostoma braziliense/ ceylanicum
- Larval stages are free-living ● Ancylostoma caninum
- Undergoes several molts
LIFE CYCLE (increasing in size in each molt)
- 4 stages of development
- L3 are usually infective and gets into
the definitive host
● Adult
- Have tapered, cylindrical body with an
esophagus and longitudinal muscles

- Undulating motion (​wave-like​)

- Due to high internal pressure, they
LOCOMOTION move by contraction of the
longitudinal muscles
- No cilia or flagella present

- Dioecious
REPRODUCTION - Nematode sperm lack flagella:
move by pseudopodia
- Males use special copulatory spines

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REVIEW QUESTIONS d. Vector

7. Which species of malaria parasite usually has ameboid trophozoites

1. Enterobius vermicularis ​infection is usually diagnosed by finding
and produces small reddish dots in the red blood cell cytoplasm?
a. Eggs in perianal specimens
a. Plasmodium knowlesi
b. Larvae in perianal specimens b. Plasmodium falciparum
c. Larvae in feces c. Plasmodium malariae
d. Eggs in the feces d. Plasmodium vivax

2. The best direct diagnosis of Echinococcus granulosus infection in 8. A 22-year-old male presents to his family physician complaining of
humans is made by identification of fatigue, muscle pain, periorbital edema, and fever. He denies travel
a. Adult worms in the intestine outside the U.S. The physician suspects infectious mononucle- osis;
b. Adult worms in tissues however, serologic tests for infec- tious mononucleosis are negative.
c. Eggs in feces The complete blood count revealed a slightly elevated white blood
d. Hydatid cysts in tissues count, and there were 10% eosinophils on the differential. Which of
the following should be considered part of the differential diagnosis?
3. Which statement is correct for specimen collection and processing? a. Ascaris lumbricoides
a. Stool samples can contain urine b. Taenia solium
b. Stools can be frozen without affecting parasitic structure c. Trichinella spiralis
c. Liquid stools are best for detecting ameba and flagellated d. Trypanosoma cruzi
trophozoites
d. Unpreserved stools can remain at room temperature for up 9. Which Schistosoma species has a large terminal spine?
to 72 hours a. S. haematobium
b. S. japonicum
4. Cysts are the infective stage of this intestinal flagellate c. S. mansoni
a. Balantidium coli d. S. mekongi
b. Dientamoeba fragilis
c. Entamoeba coli
10. Elephantiasis is a complication associated with which of the
d. Giardia lamblia
following?
5. Eggs or larvae recovered in the stool are ​not routinely used to a. Cysticercosis
diagnose infections caused by which one of the following helminths? b. Guinea worm
a. Trichinella spiralis c. Hydatid cyst disease
b. Strongyloides stercoralis d. Filariae
c. Necator americanus
d. Ascaris lumbricoides
11. A 55-year-old female presents to her physician complaining of a
6. Many parasites have different stages of growth within different hosts. fever that "comes and goes" and fatigue. A complete blood count
The host where the sexual reproductive stage of the parasites exists reveals decreased red blood cell count and hemoglobin. History
is called the reveals the patient recently traveled through Europe and Africa. You
a. Commensal should suspect
b. Definitive host a. Cutaneous larval migrans
c. Intermediate host b. Filariasis

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c. Malaria 17. Which of the following nematode parasites is acquired from eating
d. Trichinella inadequately cooked, infected pork?
a. Strongyloides stercoralis
12. Which of the following helminths produces an elongate, b. Taenia saginata
barrel-shaped egg (50 X 22 |xm) with a colorless polar plug at each c. Taenia solium
end? d. Trichinella spiralis
a. Ascaris lumbricoides
b. Hymenolepsis nana 18. Which of the following pairs of helminths cannot be reliably
c. Necator americanus differentiated by the appearance of their eggs?
d. Trichuris trichiura a. Ascaris lumbricoides ​and​ Necator americanus
b. Hymenolepis nana ​and​ H. diminuta
13. Decontamination of drinking water, fruits, and vegetables before c. Necator americanus a ​ nd​ Ancylostoma duodenale
consumption is necessary in countries without well- developed public d. Diphyllobothrium latum ​and​ Fasciola hepatica
sanitation. Which of the following diseases would probably be least
affected by that kind of precaution? 19. Which of the following is the preferred anticoagulant for preparing
a. Amebiasis blood smears or diagnosing malaria?
b. Ascariasis a. EDTA
c. Filariasis b. Heparin
d. Giardiasis c. Sodium citrate
d. Sodium fluoride
14. Which stage of Trichuris trichiura is infectious for humans?
a. Proglottid ​
20. Which of the following is the vector for ​Babesia?
b. Filariform larva a. Fleas
c. Rhabditiform larva b. Lice
d. Embryonated ovum c. Ticks
d. Mosquitoes
15. Sanitary disposal of human feces is the most important factor in
decreasing the incidence of most infections caused by intestinal
parasites. Which of the following diseases would ​not be affected​ by
that kind of sanitation?
a. Ascariasis
b. Taeniasis
c. Trichinosis
d. Hookworm infection

16. The rhabditiform larvae of ​Strongyloides stercoralis

a. Mate and produce ova
b. Are infective for humans
c. Are the diagnostic form found in feces
d. Are found in the blood of infected humans

QUIZON 7