University of St.

La Salle
Bacolod City

In Partial Fulfillment

of the Requirements in

MC3_B2 Microbiology and Parasitology

“What Symbiote are you?”

Submitted by:

Cerveza, Andrea

Lopez, Neil

Pacheco, Alexandra

Perdigueros, Julia Marie

BSN-1B

Submitted to:

Dr. Joval N. Martinez

Ms. Djohannah Garbanzos

 1. Entamoeba histolytica

Identify the : Description

Common name Amoebiasis

Geographical Entamoeba histolytica is predominantly found in primates (including

distribution in humans) and occasionally in dogs, cats, cattle and pigs. The parasite has
the Philippines a worldwide distribution and is prevalent in tropical and subtropical
countries.

Morphologic The trophozoites are 20-30 µm in diameter and contain a vesicular

Features nucleus with a central endosome, peripheral chromatin and radial
achromatic fibrils (imparting a 'cart-wheel' appearance).

Mode of E histolytica is transmitted primarily through the fecal-oral route.

Transmission Infective cysts can be found in fecally contaminated food and water
supplies and contaminated hands of food handlers. Sexual transmission
is possible, especially in the setting of oral-anal practices (anilingus).

Laboratory Microscopic identification of cysts and trophozoites in the stool is the

diagnosis common method for diagnosing E. histolytica. This can be
accomplished using: Fresh stool: wet mounts and permanently stained
preparations (e.g., trichrome)E. histolytica trophozoites can also be
identified in aspirates or biopsy samples obtained during colonoscopy or
surgery.

Treatment If you have no symptoms but are found to have E. histolytica in a stool
(faeces) specimen, it is usually advised that you should be treated with
medication to kill the parasite. The medicine diloxanide furoate is
commonly used. Treatment is advised because you can still pass on the
infection to others even if you have no symptoms. The amoebae will
still pass out in your stools. Also, you may still develop symptoms at a
later stage. The treatment of symptomatic amoebiasis then depends on
your symptoms.

Prevention and It is possible to prevent amebiasis by avoiding contaminated food and/or

control water, good sanitation techniques, and avoidance of contaminated food
handlers and other carriers of the parasite. There is a vaccine available
for animals, and researchers are working on a vaccine for humans.
Life cycle
 2. Giardia Lamblia
Identify the : Description

Common name Giardia intestinalis; Giardia duodenalis; Gardiasis or Beaver Fever

Geographical Giardia was most prevalent in Mindanao (3.6%) while Cryptosporidium

distribution in was most prevalent in Luzon (3.1%). The prevalence of Giardia (2.0%)
the Philippines
among pediatric patients (0-18 years) did not significantly differ from that
(1.9%) among adults (>18 years old).

Morphologic G. lamblia exists in two morphological form- trophozoite and cyst

Features
Trophozoite:

● It is the active feeding stage of parasites which are responsible for

colonization in the intestine
● The shape of trophozoite is pear shape or tennis racket shape with
broad round anterior end and a tapering posterior end
● It measures 9-21 µm in length and 5-5µm in breadth.
● The dorsal surface is convex while ventral surface is concave with a
sucking disc which acts as an organ for attachment
● Behind the adhesive disc lies a pair of large curved and transverse
median bodies, unique to
● It is bilaterally symmetrical and all organs of the body are paired.
They have two median bodies, two axostyle, two nuclei, and four
pairs of flagella
● Each nucleus consists of large central karyosome giving a
characteristic face like appearance to the parasite in stained
preparation
● Cytoplasm is uniform and finely granulated
● Motility shown typical ‘falling leaf type’ motility.

Cyst:

● It is an infective stage of parasites

● A fully mature cyst is oval or ellipsoidal in shape and measures
8-12µm in length and 7-10 µm in breadth
● Cyst is surrounded by a thick cyst wall. Cytoplasm is granulated
 and is separated from the cyst wall by clear space
● The axostyle lies more or less diagonally
● A cyst contains 4 nuclei
● The remaining of flagella and the margins of sucking disc may be
seen inside the cytoplasm

Mode of Man is the main reservoir of Giardia. Infection is acquired due to:
Transmission ● Ingestion of contaminated food and water
● Person to person transmission due to poor hygiene in day care
centers, nursing homes and mental asylums
● Sexual transmission -oral-anal and genital-oral sex

Laboratory Giardiasis is diagnosed by the identification of cysts or trophozoites in the

diagnosis feces, using direct mounts as well as concentration procedures. Cysts are
typically seen in wet mount preparations, while trophozoites are seen in
permanent mounts (i.e. trichrome). Repeated samplings may be necessary.

Treatment Metronidazole (Flagyl). Metronidazole is the most commonly used

antibiotic for giardia infection. Side effects may include nausea and a
metallic taste in the mouth. Don't drink alcohol while taking this
medication.

Tinidazole (Tindamax). Tinidazole works as well as metronidazole and

has many of the same side effects, but it can be given in a single dose.

Nitazoxanide (Alinia). Because it comes in a liquid form, nitazoxanide

may be easier for children to swallow. Side effects may include nausea,
gas, yellow eyes and brightly colored yellow urine.

There are no consistently recommended medications for giardia infection

in pregnancy because of the potential for harmful drug effects to the fetus.
If your symptoms are mild, your doctor may recommend delaying
treatment until after the first trimester or longer. If treatment is necessary,
discuss the best available treatment option with your doctor.

Prevention and Do not eat fruits and vegetables washed in water that might be
control contaminated. Avoid eating uncooked foods when traveling in countries
where the food supply might be unsafe. Do not use or drink inadequately
treated water or use ice when traveling in countries where the water might
be unsafe

Life cycle
 3. Trichomonas vaginalis

Identify the : Description

Common name Trich; Vaginitis; Ureitis

Geographical Trichomonas vaginalis infection rate in the Philippines, 280 women were
distribution in examined, by either wet mount or stained smear methods, in the greater
the Philippines
Manilla area. G. The T. vaginalis prevalence in this study (12%) is
consistent with previous reports of increasing T. vaginalis infection in the
country. In 2002, T. vaginalis was detected through wet mount/culture
method in 3.18% of 2267 women, without vaginal bleeding, attending
 selected health facilities across the Philippines.25 In 2008, T. vaginalis was
detected by PCR in 6.81% of 969 sex workers attending social hygiene
clinics across the Philippines.26 In 2010, the prevalence rate of
trichomoniasis detected by PCR among 377 FSWs in Angeles City was
9.55%.24 (Rivera, 2015)

Morphologic
Features T vaginalis trichomonas are approximately the size of white blood cells
(about 10-20 μm long and 2-14 μm wide), although this may vary.
Trichomonads have 4 flagellates. The posterior flagellum is part of the
center axostyle, and has a barbed wire-like structure. This structure allows
the protist to attach to and tear the urethra or vaginal walls, which causes
inflammation and aids in speeding and intensifying infection. T. vaginalis
has a cell membrane, but lacks a cell wall. Half of the cell body also has an
undulating membrane, which helps sweep nutrients into the protist's
mouth-like structure, called the cytostome. A visible nucleus is located at
the organism's center. Trichomonads have 4 flagella that project from the
organism’s anterior and 1 flagellum that extends backward across the
middle of the organism, forming an undulating membrane. An axostyle, a
rigid structure, extends from the organism’s posterior.

Mode of
Transmission
● Trichomonas vaginalis is typically transmitted through vaginal, oral,
or anal sex with an infected individual.
● It can also be passed from a mother to her baby at birth, as
evidenced by the discovery of the parasite in the newborn's lungs.
● You cannot contract trichomoniasis from toilet seats, kissing, or
sharing utensils.

The protozoa can survive on moist, warm surfaces outside the human body
for some time. So it can spread through:

● Infected Jacuzzis
● Public bath tubs
● Infected toilet seats
● Used towels, in hotels, swimming pools etc.

Laboratory
diagnosis Trichomonas vaginalis has an oval or pear‐shaped form, rarely round. At
this magnification, it is possible to visualize clearly the flagella. Ideally, for
 a more specific diagnosis, examination at this magnification is always
following the 100× magnification. Laboratory conclusions based on results
using wet mount microscopy.

Treatment ● An antibiotic course is all that is required.

● The drug of choice is metronidazole or tinidazole (Tindamax). In
some cases, your doctor might recommend a lower dose of
metronidazole two times a day for seven days. Avoid taking alcohol
with this drug as it interacts adversely with it.
● Both you and your partner need treatment. And you need to avoid
sexual intercourse until the infection is cured, which takes about a
week.

Prevention and To prevent infection or reinfection, any sexual partners should also receive
control treatment.

Ways of preventing the risk of infection or reinfection include:

● limiting the number of sexual partners

● avoiding sex for 7–10 days after treatment for trich
● not using a douche, as this can affect the healthy bacteria in the
vagina
● limiting or avoiding the use of recreational drugs and alcohol, as
these increase the risk of unsafe sex
● using a condom for protection during sex
● A condom can prevent transmission to some extent, but it is not
fully reliable because the parasite can pass from person to person on
areas of the body that it does not cover.
● Anyone who has symptoms or thinks that they have been exposed to
trich should speak to a doctor.
Life cycle
 4. Ascaris lumbricoides

Identify the : Description

Common name: "large roundworm"

Geographical
distribution in School-aged children (5–19 years) are most at risk of A. lumbricoides
the Philippines: and T. trichiura co-infections and of moderate/high infection intensity
compared to other age groups. We identified target provinces where the
likelihood of STH-associated morbidity was highest: Luzon (Bulacan,
Benguet, Cavite, Sorsogon, Metropolitan Manila, Pampanga and Rizal),
the Visayas (Cebu, Iloilo, Leyte and Negros Occidental), and in
Mindanao (Agusan Del Norte, Davao Del Sur, Davao Oriental, Lanao
Del Sur, Maguindanao, Misamis Oriental, Sulu and Zamboanga Del
Sur). Luzon had the highest estimated number of school-aged children
with A. lumbricoides and T. trichiura co-infections (estimated total
 89,400), followed by the Visayas (38,300) and Mindanao (20,200).

1. Shape and size

Morphologic - It is elongated, cylindrical, and gradually tapering at both ends,

Features the anterior end being slender than the posterior.
- It is the largest size of nematodes.
- It shows sexual dimorphism. i.e., sexes are separate.
- The female measures 20 to 40 cm in length and 4-6 mm in
diameter with a straight tail.
- The male is smaller, measures 15-31 cm in length and 2-4 mm in
diameter with a ventrally curved tail.
- The cuticle covering the body surface bears a minute transverse
striation, giving a worm’s pseudo segmented appearance.
- Generally, the nematodes have no color.
- The freshly secreted worm is yellowish pink in color, which
gradually changes to white.

3. Longitudinal streaks or lines

● The cylindrical body has 4 longitudinal lines -1 narrow
mid-dorsal, 1 mid-ventral, and 2 thick ones are lateral.
● The lines are visible externally.
● The dorsal and ventral lines appear pure white, while lateral
lines appear brown.
● These lines are thickened all over the body and are simply
impressions of the syncytial epidermis.
● The excretory pore is situated mid-ventrally, a little behind
the lips.
● The genital pore and anus open separately in the female; the
genital pore is situated mid-ventrally at about 1/3rd from the
anterior end.

4. Anterior End
● Both the sexes have the same anterior end structures.
● Ascaris have no eyes.
● It is rounded, bearing a small terminal triradiate mouth
 aperture guarded by 3 broad lips or labia.
● One lip is mid-dorsal and broadly elliptical, and 2 are
sub-ventral or latero-ventral and oval.
● Of these, one is on the upper side, and the other two on the
two sides of the mouth cavity.
● Dorsal and anterior extension of labial parenchyma bears
minute denticles.
● The outer surface of each lip bears minute sensory papillae/
labial.
● Labial papillae are hair-like structures used for tactile
reception and are very sensitive to vibrations and touch.
● The dorsal lip has 2 sensory papillae, one on each side.
● Each latero-ventral lip has 1 double sensory papillae in its
ventral position.
● These four papillae form an outer labial circle, but nematodes
have 6 papillae in the outer labial circle.
● The papillae of the inner labial circles are absent in Ascaris,
but other nematodes have 6 papillae in its inner labial circle.
● The latero-ventral lip has lateral papilla, each in lateral and
cuticular excavation called amphid.
● Amphids are reduced in parasitic nematodes.
● Just behind the latero-ventral, there is a pair of cervical
papillae, one on each side close to the nerve ring.
● Papillae are tangoreceptors (sensory) while amphids are
olfactory chemoreceptors.
● The lips bear a fine tooth.

5. Posterior End
● The posterior end of the body shows clear sexual
dimorphism.
● In females, the posterior extremity is conical and
straight—the midventral transverse apertures, or anus,
guarded by one pair of postanal papillae.
● Only the digestive tubes open to the outside through the anus.
● In males, the tail end is curved ventrally in the form of a
hook with a conical tip.
● In male anus is replaced by cloaca. It is the common aperture
for the rectum and genital tubes.
● Two copulatory setae protrude from the aperture. They are
called penial setae or spicules.
● The setae serve to transfer-sperm into the female vagina
 during copulation.
● The male tail is characterized by numerous genital papillae
ventrally, about 50 pairs of pre-anal papillae, and 5 pairs of
postanal papillae.
● Genital papillae of male help in copulation.
● 2 anterior pairs of postanal papillae are double, while the rest
are single.

6. Excretory pore
● Excretory pore lies mid-ventrally and near the anterior end.

7. Female gonopore
● At about one-third of the entire length from the anterior end,
the body is narrower in female s, and this region is known as
the vulvar waist.
● The female genital aperture called vulva or gonopore is
situated on the ventral surface of the vulvar waist.
● But the genital pore on the male opens into the cloaca.

Mode of - Ascaris parasites live in the intestine.

Transmission
- Ascaris eggs are passed in the feces (poop) of infected people.
- Fecal-oral route, by contaminated vegetables or water

Laboratory
diagnosis - The standard method for diagnosing ascariasis is by identifying
Ascaris eggs in a stool sample using a microscope. Because eggs
may be difficult to find in light infections, a concentration
procedure is recommended.
- Diagnosis is usually made by identifying eggs in a stool sample.
- FBC may reveal eosinophilia or anaemia.
- LFTs may reveal liver damage or low protein state.
- Specific investigations such as ultrasound, X-ray, amylase level,
lung function tests and exploratory surgery may be required
depending on the site of infestation.
- Endoscopic retrograde cholangiopancreatography may be useful
 if biliary tree involvement is suspected.

Treatment
Anthelmintic medications (drugs that remove parasitic worms from the
body)
- Albendazole
- Mebendazole
- Pyrantel pamoate: single dose of 1omg/kg weight
- Piperazine citrate

These are the drugs of choice for treatment of Ascaris infections,

regardless of the species of worm. Infections are generally treated for
1–3 days. The drugs are effective and appear to have few side effects.

Prevention and
control ● Avoid ingesting soil that may be contaminated with human or pig
feces, including where human fecal matter (“night soil”),
wastewater, or pig manure is used to fertilize crops.
● Wash your hands with soap and water before handling food.
● Wash your hands with soap and water after touching or handling
pigs, cleaning pig pens, or handling pig manure.
● Teach children the importance of washing hands to prevent
infection.
● Supervise children around pigs, ensuring that they do not put
unwashed hands in their mouths.
● Wash, peel, or cook all raw vegetables and fruits before eating,
particularly those that have been grown in soil that has been
fertilized with manure.

Transmission of Ascaris lumbricoides infection to others in a community

setting can be prevented by:

● Not defecating outdoors.

● Effective sewage disposal systems.
Life cycle
 5. Trichuris trichiura
Identify the: Description

Common name “Whipworm” or “Human Whipworm”

Geographical
Distribution in Luzon - (Bulacan, Benguet, Cavite, Sorsogon, Metropolitan Manila,
the Phil. Pampanga and Rizal) estimated total 89,400 infections

Visayas - (Cebu, Iloilo, Leyte and Negros Occidental) estimated total of

38,300 infections

Mindanao - (Agusan Del Norte, Davao Del Sur, Davao Oriental, Lanao
Del Sur, Maguindanao, Misamis Oriental, Sulu and Zamboanga Del Sur)
estimated total of 20,200 infections

Morphological Morphology of adult worm

Features The worm is oviparous. Pinkish in color.

Male:
It measures 3-4 cm in length.
Its caudal extremity is coiled ventrally .

Female:
It measures 4—6 cm in length .
The caudal extremity is either shaped like a “comma” or an arc.

Morphology of egg:
Size about 50μm in length by 25μm in breath .
color , brown (bile–stained ) , has a double shell, the outer one is
bile-stained. Barrel-shaped with a mucus plug at each pole .
contains an unsegmented ovum when the egg leaves the human host.
Floats in a saturated solution of common salt. The eggs when freshly
passed are not infectious to man.
Mode of Portal of entry : Mouth, ingestion
Transmission
1. The food, water and soil contaminated with embryonated
eggs are the chief sources of infection.
2. Ingestion of embryonated eggs in the contaminated food
and water
3. Contaminated fingers during soil works

Occurs when the embryonated whipworm eggs are ingested. The eggs
are the infective stage Trichuris trichiura.

Laboratory
Diagnosis Adult worms may occasionally be present in the stool. The degree of
infection can be determined by egg count. Proctoscopy examination
shows worm on the rectal mucosa in diarrhoea caused by parasites.

Microscopic examination of stool

- The characteristic lemon-shaped eggs with clear operculum at both

ends are readily apparent. When anoscopy, proctoscopy, or colonoscopy
is done for other indications, wiggling adult worms may be seen
protruding into the bowel lumen.

Direct Method
- Laboratory diagnosis can be made by demonstration of characteristic
eggs in the feces by microscopy and concentration method.

Microscopy: Smear preparation and eggs are observed under the

microscope.

Treatment Thiabendazole and Mebendazole (100 mg twice daily for 3 days )

Albendazole (400 mg daily for 3 days)

Ivermectin (200μgm/kg ) in combination with Albendazole (400 mg)

Prevention and The best way to prevent whipworm infection is to always:
Control
● Avoid ingesting soil that may be contaminated with human feces,
including where human fecal matter (“night soil”) or wastewater
is used to fertilize crops.
● Wash your hands with soap and warm water before handling
food.
● Teach children the importance of washing hands to prevent
infection.
● Wash, peel, or cook all raw vegetables and fruits before eating,
particularly those that have been grown in soil that has been
fertilized with manure.

In Handwashing:

Transmission of infection to others can be prevented by:

● Not defecating outdoors.

● Effective sewage disposal systems.

Life Cycle
 6. Enterobius vermicularis

Identify their: Description

Common name The nematode (roundworm) Enterobius vermicularis is widely known

as the human pinworm due to the female’s long, pointed tail.

Geographical
Distribution in According to the World Health Organization (WHO), the estimated
the Phil. number of individuals who are infected with intestinal parasites reaches
about 3.5 million last 2010 and most of them are children. Also, the
number of individuals who are ill due to infection of intestinal parasites
reaches about 450 million people around the world.

Morphology:

Morphological - The adult worm is small, white in color, more or less spindle
Features shaped and resembles a short piece of thread.
- They are visible to the naked eye.
- True buccal capsule is absent.
 - A pair of cervical alae (wing like expansions) is present as the
anterior extremity.
- The posterior end of the oesophagus is dilated into a conspicuous
globular bulb/ a double- bulb oesophagus which is a
characteristic feature of this nematode.
- The oral end has three lips with a dorso-ventral bladder like
expansion of the cuticle.

Male worm:
- An adult male measures 2-4mm in length and 0.1-0.2mm
breadth.
- The posterior third of the body is curved, sharply shortened and
possesses an exposed terminal copulatory spicule.
- The male worm dies immediately after fertilizing the females,
therefore are rarely seen.

Female worm:
- Adult females are longer, 8-12mm in length and 0.3-0.5 mm in
breadth.
- The posterior end is extremely straight and drawn out into a
long, tapering and finely pointed tail, which is 1/3rd the length of
the worm.
- The female reproductive organs are paired and T-shaped.
- A large number of eggs with an average of 11,105 eggs are
present in the uterus of the gravid female that fill up the entire
body of the female worm.
- The gravid female dies within 2-3 weeks after laying eggs.

Eggs:
- The embryonated eggs are infectious to humans.
- The eggs are colorless, measuring 50-60 µm in length and
20-32µ m in breadth.
- They are typically plane convex, with one flattened side and one
convex side.
- The eggs are surrounded by a thin, hyaline, transparent shell
composed of 2 layers of chitin.
- Egg contains a coiled tadpole like larva.
- Egg can float in a saturated salt solution.
- The egg becomes infective after exposure to atmospheric oxygen
 for 6 hours and is more resistant to antiseptics.

- Infected human beings are the only source of infection. No extra

Mode of
Transmission human reservoir is known.
- It is primarily a disease of children and intra-family transmission
is very common.
- Ingestion of eggs due to contaminated fingers, commonly seen in
children.
- Handling contaminated night clothes of the children.
- Inhalation of air-borne eggs present in the dust.
- Retro infection, occasionally seen mainly in adults.

- Eggs are rarely found in faeces, so conventional stool sample

Laboratory examination techniques are not useful.
Diagnosis - Infections are best diagnosed by microscope detection of adult
worms or microscopic detection of eggs on the perineum.
● Detection of adult worms
- Motile worms may be seen perianal skin shining under bright
light when close visual examinations are conducted during night
or early in the morning.
- Adult worms may sometimes be observed on the surface of fresh
stool samples, during garments, perianal folds.
● Detection of eggs
- Microscopic demonstration of characteristic eggs in the perianal
scrapings is the method of choice for the diagnosis of
enterobiasis
- Anal or perianal specimens can be collected by NIH swab,
cellophane swab or scotch tape swab method.
- At least 3 scotch tape swabs should be collected for 3
consecutive days to rule out E. vermicularis infection.
- Since anal itching is a common symptom of pinworm, the third
option for diagnosis is analyzing samples from under fingernails
under microscope.
Treatment ● Pyrantel pamoate is the drug of choice
- Single dose
- Oral administration
- 5 mg/kg single dose
-
● Mebendazole - single dose of 100mg
● Albendazole- single dose of 400 mg
● Piperazine - 7 day course of 65 mg per kg of body weight
● Pyminium pamoate - Single dose 11 mg per kg of body
weight ( max. 1 gm)

Prevention and
Control - Improving personal hygiene
- Proper washing of bed cloths.
- Hand washing.
- Keeping fingernails short
- Treatment of infected case and all other members in the family
or institution
- Fingers should not be put in mouth as habit
- Washing the bed liners and night dress daily
Life Cycle
 7. Trichiella spiralis

Identify their: Description

Common name Trichina worm ; Tissue nematode

Geographical
Distribution in The incidence of Trichinella spiralis, mainly in North America, is
the Phil. reviewed and it is established that it was absent from pigs in the
Philippines in 1932. A recent examination of 1, 072 pigs throughout the
Philippines has shown a continued absence of T. spiralis. Most imported
pigs are used for breeding rather than meat production and are from
areas where public health standards are high. Climatic factors may also
militate against this parasite but it is possible that the wild fauna may
serve as a reservoir of infection. P.S.G.

Morphological
Features - Smallest known nematode parasite in humans
- Adult worms live in the intestine for up to two months
- The body of the worm is more slender at the anterior then at the
posterior end.
- This nematode has a cuticle with three or more main outer layers
made of collagen and other compounds.
- The outer layers are non-cellular and are secreted by epidermis.
The cuticle layer protects the nematode so they can invade the
 digestive tracts of animals.
- Nematodes have longitudinal muscles along the body wall. The
muscles are obliquely arranged in bands. Dorsal, ventral and
longitudinal nerve cords are connected to the main body of the
muscles.

Male:
- Male measures 1–1.5 mm
- Tail is curved at 360 degrees

Female:

- Females produce larvae which migrate to skeletal muscle where

they invade, develop and encrypt.
- Female worms measure 2–4 mm
- In females, the uterus is contained in the posterior portion of the
worm and is filled with developing eggs.
- The anterior end of the female contains hatching veniles
- Female is longer and bigger

Mode of
Transmission - Undercooked meat, often pork or bear
- Factors that contribute to T. spiralis transmission to humans
include improper management practices in swine operations,
food handling (preparation) or both.

Laboratory
Diagnosis Nonspecific testing
- CBC – eosinophilia
- Muscle enzymes (creatine kinase, aldolase) – elevated during
muscle inflammation stage

- Trichinella antibody testing by enzyme-linked immunosorbent

assay (ELISA) or indirect fluorescent antibody (IFA)

● Detectable 2-4 weeks after infection (may be >1,000/mL)

● Cross reacts with other parasitic infections
● Rarely positive in early disease
Treatment Trichinosis usually isn't serious and often gets better on its own, usually
within a few months. However, fatigue, mild pain, weakness and
diarrhea may linger for months or years. Your doctor may prescribe
medications depending on your symptoms and the severity of infection.

● Anti-parasitic medication. Anti-parasitic medication is

the first line of treatment for trichinosis. If the trichinella
parasite is discovered early, albendazole (Albenza) or
mebendazole (Emverm) can be effective in eliminating the
worms and larvae in the intestine. You may have mild
gastrointestinal side effects during the course of treatment.

● Pain relievers. After muscle invasion, your doctor may

prescribe pain relievers to help relieve muscle aches.
Eventually, the larvae cysts in your muscles tend to calcify,
resulting in destruction of the larvae and the end of muscle
aches and fatigue.
●
● Corticosteroids. Some cases of trichinosis cause allergic
reactions when the parasite enters muscle tissue or when
dead or dying larvae release chemicals in your muscle
tissue. Your doctor might prescribe a corticosteroid to
control inflammation.

Prevention and
Control - The best way to prevent trichinosis is to cook meat to safe
temperatures. A food thermometer should be used to measure the
internal temperature of cooked meat. Do not sample meat until it
is cooked.
- Wash your hands with warm water and soap after handling raw
meat.
- Curing (salting), drying, smoking, or microwaving meat alone
does not consistently kill infective worms; homemade jerky and
sausage were the cause of many cases of trichinellosis reported
to CDC in recent years.
- Freeze pork less than 6 inches thick for 20 days at 5°F (-15°C) to
kill any worms.
- Freezing wild game meats, unlike freezing pork products, may
not effectively kill all worms because some worm species that
infect wild game animals are freeze-resistant.
 - Clean meat grinders thoroughly after each use.

Life Cycle
 8. Taenia solium
Identify their: Description

“Pork Tapeworm”
Common name

Geographical The Philippines is considered an endemic area for cysticercosis because

Distribution in cases in both humans and pigs have been reported; however,
the Phil.
epidemiologic information stays limited. We conducted a pilot survey of
the seroprevalence of human cysticercosis in a village in Leyte, the
Philippines, by measuring antibody specific for Taenia solium cyst-fluid
antigen. The overall cysticercosis seroprevalence in this population was
24.6% (95% CI: 20.82% ~ 28.58%) with no significant difference based
on age, sex, or other helminth coinfection status.

Adult worm:
● Adult Taenia solium is a flattened ribbon like tapeworm
that is white in color.
Morphological
Features ● The adult worm measures about 2-3 meters in length.
● The body of parasite can be divided into 3 parts:- Head
(Scolex), neck and body (strobila)

i. Scolex (Head):

● It measures 1 mm in diameter, about the size of a pinhead.

● It is globular in shape and has 4 circular suckers.
● The head is provided with a rostellum armed with a double
row of alternating large and small hooklets (130-180mm
long).
● The presence of hooklets gave its name to the armed
tapeworm.

ii. Neck:
 ● The neck is short, measuring 5-10 mm in length.

iii. Body (Strobila):

● The body or Strobila consists of segments or proglottids.

● The total number of proglottids are about 800-900.
● The proglottids may be immature, mature or gravid.
● The gravid segment measures 12 X 6 mm in diameter and
looks grayish-black and transparent when fully developed.
● The worm is hermaphrodite and each segment contains
both male and female reproductive organs.
● The common genital pore is marginal, thick-lipped and is
situated near the middle of each segment alternating
between the right and left side.
● Testes consists of 150-200 follicles.
● An ovary is two in number which has a third (accessory
lobe).
● The ovary is situated in the posterior side of the segment.
● The gravid consists of a median longitudinal stem of the
uterus having 7-13 branches on each side of the segment.
● Uterus is completely filled with eggs and each gravid
consists of nearly 30,000-50,000 eggs.
● The vaginal opening is not guarded by a muscular
sphincter.
● The gravid segments are expelled passively, in chains of 5
to 6 at a time and not singly.

-
● Ingestion of uncooked pork infected with Tapeworm
Mode of ● Ingestion of food and water contaminated by the eggs present in
Transmission the infective faeces of a Taenia carrier.
● Endogenous auto infection: Anus-hand-mouth transfer of eggs
by contaminated hands of persons with poor personal hygiene.
● Autoinfection: Reverse peristalsis in which eggs produced by T.
solium are thrown back to the duodenum, where they hatch and
 cause tissue infection

Laboratory
Diagnosis ● Macroscopic examination: A naked examination of the
specimen can be made for segment or proglottids. The whitish
segment can easily be recognized against the dark yellow mass
of the feces.

● Stool Microscopy: Demonstration of eggs and less

frequently proglottids and scolex in faeces is used as a tool
for diagnosis.
● Eggs: can be seen in perianal area and can be detected by
cellophane swab
● Proglottids: Demonstration can be facilitated by staining
them with india ink, injected through the genital pores.
● Antigen detection: Captures ELISA polyclonal antisera
raised against Taenia is employed to detect antigen in
faeces.
● Serodiagnosis: Serological tests are employed to detect
anti-cysticercus antibodies in serum or CSF.
● Histopathological diagnosis: Skeletal cysticercosis can
be diagnosed by histological examination of biopsy
● Imaging method: X-ray of the soft tissue in arm and
thigh, chest and neck may show dead, calcified or
elongated cysts.

Treatment

Praziquantel - Dose- oral, 50 mg/kg body weight, 3 divided doses for

15 days.

ii. Niclosamide:

iii. Albendazole: A dose of 400 mg twice daily for 30 days.

iv. Surgery: For cysticercosis of ocular, ventricular and spinal cord.

Prevention and
Control
- Avoidance of eating raw or insufficiently cooked pork
- Inspection of pork for cysticerci.
- Proper sanitation facilities.
- Treatment of infected persons.
- Avoidance of food contaminated with eggs of T. solium
- Access to preventive chemotherapy;
- Health education;
- Improved pig husbandry
- Anthelmintic treatment of pigs
- Vaccination of pigs
- Improved meat inspection and processing of meat products

Life Cycle
 9. Schistosoma japonica
Identify their: Description

Common name “Blood Fluke”

Geographical
Distribution in Schistosomiasis remains a public health problem in endemic areas in the
the Phil. Philippines with approximately 12 million people residing in 28 endemic
provinces located across 12 different geographical zones at risk of S.
japonicum infection. A total of 190 municipalities and 1212 barangays
(villages) are currently endemic, based on surveys conducted over the past
decade. Two new endemic foci reported in the northern (Gonzaga, Cagayan)
and central (Calatrava, Negros Occidental) parts of the country were
confirmed in 2004 and 2006, respectively. Just like in China, bovines, water
buffaloes (carabaos) in particular, play a major role in the transmission of
schistosomiasis in the Philippines with infection prevalence close to 90% in
some endemic barangays. A 2011 study carried out in the municipality of
Palapag, Northern Samar showed the S. japonicum prevalence in cattle to be
87.5% and 77.1% via real-time PCR (qPCR) and the formalin-ethyl acetate
sedimentation (FEA-SD), respectively. In carabao, the S. japonicum
prevalence was 79.1% and 55.2% by CPR and FEA-SD, respectively. The
same study computed the Bovine Contamination Index (BCI) using the
FEA-SD technique and gave an average of 195,000 eggs per bovine per day.
 A recent study in Leyte Province showed a 97% prevalence via perfusion,
67.7% via qPCR and 34.3% by FEA-SD.

Morphological
Features Eggs: The ova of S.japonicum are 55-85µm by 40-60 µm. They are large,
round and non operculate and have a transparent shell with a minute lateral
spine or knob that may be inconspicuous and difficult to see. The eggs of S.
japonicum frequently have faecal debris adhering to the shell that can
obscure them.

Miracidium: The miracidium is an ovoid, ciliated, free swimming organism

with a functionless digestive tract.

Adult Worms: The worms are yellow or yellow brown in colour. The male
measures 12mm by 0.5mm and female measures 20mm by 0.4mm. Both
sexes have a strong sucker around the mouth and the tegument of the worms
is coated with tiny spines, ridges and sensory organs.

Mode of
Transmission - Occurs when you come in contact with water that contains the free
swimming larvae called cercariae (infective stage of schistosoma
japonicum) which then penetrate the skin to cause infection when
they shed their tails and are then taken via the blood to other parts of
the body
- Animals also contribute as host in the schistosoma life cycle.

Laboratory
Diagnosis - Laboratory confirmation of S. japonicum is by demonstrating the
characteristic eggs in faeces. Their detection is enhanced by a
concentration technique such as formalin/ethyl acetate method since
their eggs are passed in small numbers. The egg output can be
quantified by using the Kato-Katz technique.

Treatment
- Praziquantel: dosage of 40mg/Kg of single dose.

Prevention and
Control 1. Regular drug therapy of affected group of population
2. Elimination of snails populations in freshwater bodies
3. Provision of safe and adequate water supply
4. Practice good environmental hygiene such as avoidance of
improper disposal of human feces
5. Avoid coming in contact with natural or artificial bodies of water
(freshwater) either through fishing or swimming

Life Cycle
 10. Pediculus humanus capitis

Identify their: Description

Common name body louse; head louse

Geographical
Distribution in In the Philippines, the burden of pediculosis capitis among
the Phil. schoolchildren was considered high at 54.7% during 1986 [12]. The
disease burden increased significantly to 84% in the year 2000, and in
2012, it was named as the second highest medical problem among
schoolchildren after tooth decay. At the present time, the growing
problem of pediculosis capitis still persists.

Morphological
Features - The head louse is the most common of the 3 species. The
average length of the head louse is 1-2 mm. Female head lice are
generally larger than males. The louse is wingless and white to
gray and has a long, dorsoventrally flattened, segmented
abdomen. It has 3 pairs of clawed legs. Its average life span is 30
days.

- Head lice form three developmental stages: eggs, nymphs and

adults. Eggs (commonly called nits) appear as white ellipsoidal
 operculate bodies (0.8 x 0.3mm) which are glued to hair shafts.
Nymphs are similar in appearance to adults, but are smaller
measuring 1-2mm in length. Adult lice have elongate
dorsoventrally flattened bodies (2-4mm long) which appear
opaque although darker internal organs can be seen mainly in the
abdomen. Head lice are known colloquially as cooties,
greybacks, or mechanized dandruff.

Mode of
Transmission - Once hatched, head lice undergo gradual metamorphosis
whereby nymphs moult several times before forming adults. No
free-living stages are formed and lice do not survive long off
their hosts. Infestations are therefore transmitted between hosts
by direct physical contact, although some transmission via
contaminated clothing or bedding cannot be entirely dismissed.
The complete life-cycle takes 2-3 weeks, and louse populations
often exhibit pronounced seasonal fluctuations, apparently linked
to crowding during winter housing, particularly in temperate
regions. Female head lice lay around 90 eggs which are
cemented singly onto hair shafts

Laboratory
Diagnosis - The diagnosis of pediculosis is best made by finding a live
nymph or adult louse on the scalp or in the hair of a person.
Finding numerous nits within 6 mm of the scalp is highly
suggestive of active infestation. Finding nits only more than 6
mm from the scalp is only indicative of previous infestation
.

Treatment
● Permethrin should be applied to damp hair, should be washed
with non-conditioner shampoo.
● Pyrethrins plus piperonyl butoxide, spinosad, and malathion
should be applied to dry hair

Prevention and
Control ● Many insecticides (e.g. malathion, carbamyl and pyrethrins) can
be used to control lice and they are available in many hair care
products (shampoos or lotions).
● Repeat washing is required within 10 days as most insecticides
have limited activity against eggs.
● Avoid direct head-to-head contact with ayoe known to have live,
 crawling lice.
● During infestations, daily grooming with nit combs is
recommended to remove eggs and lice. Some countries still
enforce home quarantine of infested school-children to curtail
outbreaks.
● Inter-personnel hygiene must be improved and clothing and
bedding should be well laundered.

Life Cycle
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diseases, diagnosis and treatment

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20to%20other,containing%20encysted%20larvae%20from%20infected%20animals%
2C%20usually%20pigs.
-
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http://www.ukneqasmicro.org.uk/parasitology/images/pdf/FaecalParasitology/Helmint
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ent%20The%20drug%20of%20choice%20for,using%20a%20dosage%20of%2040mg
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-

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Pediculus (parasite.org.au)

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