Introduction to Medical Parasitology Part 2

Parasitology Lecture

Introduction to medical Parasitology • Explain the difference between the Cestodes,

As part of the introduction, we have to relate also the Nematodes, Trematodes and protozoa
things surrounding us. Man and other living things on
Earth live in entangling relationship. There is symbiosis to Parasites – living organisms which take its nourishment
understand the relationship and the interaction. They and other needs from the host
don’t exist in an isolated fashion. They are in their
interdependent and each forms a strand in the web of life. Host – organism which unwarily supporting the parasite

Medical parasitology – a science that deals with the Parasite including in Medical Parasitology are:
organisms (parasite) living inside the human body (host) • Protozoa
and the medical significant of this host-parasite • Helminthes
relationship. • Some arthropods
Parasitology is defined medically, clinically and in general
aspect. Philippine setting – it focuses more on the parasite that
are found in the Philippines.
Parasitism
• relationship of organisms where the one The host vary depending on weather, they harbor the
organism is having benefit at the expense of the various stages in parasitic development.
other.
• Major public health problem due to conducive Different Kinds of Parasites
setting high population density, hot and humid • Ectoparasites – parasitic organism that lives on the
climate, and the environmental factor and poverty outer surface of its host such as the lye, ticks and
factor along with socioeconomic conditions and
mites.
lack of education and sanitation.
• It is important to provide description for • Endoparasites – parasite that live inside the body
environmental factors because in identifying of their host. Ex. Entamoeba hystolica
symptoms and diseases, it is somewhat the last • Obligate parasites – parasite that is completely
sort to identify if this disease is not cause by other dependent on the host during a segment or all of its
bacteria, microorganisms or viruses why he/she life cycle. Ex. Plasmodium sp.
has this kind of symptoms. Most of the
• Facultative parasites – organisms that both exhibit
parasitological diseases and infection have the
similar manifestations and symptoms with other parasitic and non-parasitic mode of living. They do
diseases caused by different pathogens or not absolutely depend on the parasitic way of life but
microorganisms. capable of adapting to it if place on a host. Ex. Brain
eating amoeba (Naegleria fowleri)
Example: Tropical vs Temperate • Accidental parasites (Incidental parasite) – a
• If you’re going to compare the moisture, it parasite attacks an natural host then survive. Found
contributes to the larval development and
in a location which is not expected. Ex. Hymenolepis
propagation of intermediate host.
• In tropical countries (Philippines, India, Central diminuta (rat tapeworm)
and South America) are known to have a hot and • Erratic parasites – kind of parasite that wanders in
humid moist which is a fertile ground an organ that is not actually found. Ex. Entamoeba
development for larvae in intermediate host. hystolica in the liver or human lungs.
• In temperate countries (US, most countries in
Europe) they have typically four seasons in a year Parasites can be found anywhere not only in their
that gives them the advantage not to have high expected habitat or organ to invade.
incidence of parasitic infection.
Different Kinds of Hosts
Learning objectives • Definitive host – a host that harbors a parasite in
• Discuss the various types of parasites and hosts the adult stage or where the parasite undergoes a
• Explain the relationship between a parasite and
sexual method of reproduction.
the host and their effects
• Discuss in detail the classification of medically • Intermediate host - harbors the larval stages of the
important parasites parasite or an asexual cycle of development takes
place. In some cases, larval development is

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 Introduction to Medical Parasitology Part 2
Parasitology Lecture

completed in two different intermediate hosts, helps to identify the different stages of development
referred to as first and second intermediate hosts. and differentiate between pathogenic and
• Paratenic host - a host that serves as a temporary commensal organisms. For example, Entamoeba
refuge and vehicle for reaching an obligatory host, histolytica and Entamoeba coli.
usually the definitive host, i.e. it is not necessary for  Geographical distribution – Particular region or
the completion of the parasites life cycle. country that these parasites are really existing.
• Reservoir host - a host that makes the parasite Found in abundance in the tropics.
available for the transmission to another host and is • Distribution of parasites depends upon:
usually not affected by the infection. a. the presence of food habits of suitable host:
• Natural host - a host that is naturally infected with o Host specificity - Ex. Ancylostoma duodenale
certain species of parasite. requires man as a host where Ancylostoma
• Accidental host – a host that is under normal caninum requires a dog
circumstances not infected with the parasite. o Food habits ex. Consumption of raw or
undercooked meat or vegetables
Symbiosis predisposes to Teniasis, but also to Fasciola
• Mutualism - an association in which both partners (found in kangkong)
are metabolically dependent upon each other, and b. easy escape of the parasites from the host
one cannot live without the help of the other; - the different developmental stages of a parasite
however, none of the partners suffers any harm which are released from the body along with
from the association. One classic example is the faeces and urine are widely distributed in many
relationship between certain species of flagellated parts of the world as compared to those parasites
protozoa living in the gut of termites. The protozoa, which require a vector or direct body fluid contact
which depend entirely on a carbohydrate diet, for transmission.
acquire their nutrients from termites. In return they c. environmental conditions favoring survival
are capable of synthesizing and secreting outside the body of the host - i.e. temperature, the
cellulases; the cellulose digesting enzymes, which presence of water, humidity etc.
are utilized by termites in their digestion. d. The presence of an appropriate vector or
• Commensalism - an association in which the intermediate host - parasites that do not require
commensal takes the benefit without causing injury an intermediate host (vector) for transmission are
to the host. E.g. Most of the normal floras of the more widely distributed than those that do require
humans’ body can be considered as commensals.
vectors.
• Parasitism - an association where one of the
partners is harmed and the other lives at the
expense of the other. E.g. Worms like Ascaris Once we learned about the geographical distribution and
lumbricoides reside in the gastrointestinal tract of conditions favoring the survival in relation to different
man, and feed on important items of intestinal food parasites, effective prevention and contra measures can
causing various illnesses. more easily be devised and implemented. That is why it is
important to understand for us the nature of the problem,
Basic Concepts in Medical Parasitology
disease, source, pathogenic agent that is to come up with
- morphology, geographical distribution, means of
the efficient tool of treatment and prevention
infection, life cycle, host/parasite relationship, pathology
and clinical manifestations of infection, laboratory
 Life cycle of Parasites
diagnosis, treatment and preventive/control measures of - the route followed by a parasite from the time of
parasites. In the subsequent section some of these entry to the host to exit, including the
criteria are briefly presented. extracorporeal life (outside host)
 Morphology - includes size, shape, color and o Extracorporeal – simple (only one host is
position of different organelles in different parasites involved) or complex (involving one or more
at various stages of their development (general and intermediate host)
unique characteristics of different parasites) This is
especially important in laboratory diagnosis which
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 Introduction to Medical Parasitology Part 2
Parasitology Lecture

• Two common phases: o Vaginalis (ping-pong parasite) – causes

o The route a parasite follows inside the body - strawberry cervix
knowledge provides the understanding of the
symptoms and even pathology of the parasite Indirect evidences (cytological and serological)
(symptomatology). That is in addition to the - changes indicative of intestinal parasitic infection
method of diagnosis and selection of • Cytological changes in the blood – that is in
appropriate medication that can be also eosinophilia that often gives an indication of tissue
identified invasion by helminths that also cause the
o The route a parasite follows outside of the reduction in white blood cell count (Kala-Azar –
body - which provide crucial information parasitic infection), anemia and malaria
about epidemiology, prevention, and control (hookworm infestation)
• Anemia – problem in the number of RBC or lack
Signs and Symptoms are different of hemoglobin iron in the blood but anemia can be
also cause by hookworm infestation
Pathology – is the mechanism to which the infection or
disease taken place on how it is possible, what stage of • To understand the cause of the disease first you
the parasite is really causing infection or disease. Also the need to conduct an interview or history taking
reaction of the host to the parasite from the present stage (lifestyle, work, sources of stress, exercise, diet,
of parasite and even to the chemicals that produce from and family history)
these parasites.
 Laboratory Diagnosis - depending on the nature of Serological test – only carried out in laboratory where in
the parasitic infections, understand the nature of special antigens are available
infection to conduct and advise proper laboratory
diagnosis. The following specimens are selected for Effects of parasite on the host
laboratory diagnosis: • Direct effects
a) Blood – in those parasitic infections where the o mechanical injury (hydatid cyst and ball of
parasite itself in any stage of its development Ascaris – blockage of ducts ex. Blood vessel
circulates in the blood stream, examination of producing infraction),
blood film forms one of the main procedures for o deleterious effects of toxic substance
specific diagnosis. (Plasmodium falciparum product – may
cause rigours and other symptoms)
b) Stool – examination of the stool forms an
o depravation of nutrients, fluids, and
important part in the diagnosis of intestinal
parasitic infections and also for those helminthic metabolites
parasites that localize in the biliary tract and • Indirect effects – focus more on immunological
discharge their eggs into the intestine. reaction
o Immunological reaction - nephritic syndrome
c) Urine – when the parasite localizes in the (nephron) following plasmodium infection,
urinary tract, examination of the urine will be of fibrosis of liver after deposition of the ova
help in establishing the parasitological diagnosis.
(Schistosoma)
d) Sputum – examination of the sputum is useful
in the following: Host parasite relationship
• In cases where the habitat of the parasite a. carrier state – perfect host and parasite
is in the respiratory tract relationship where tissue destruction by a parasite
• In amoebic abscess of lung or in the case is balance with the host tissue repair (regeneration
of amoebic liver abscess bursting into the process)
lungs b. disease state – due to imperfect host and parasite
relationship where the parasite dominate the upper
e) Biopsy material - varies with different
parasitic infections. hand (already cause a problem or illness)
immunoresponse is weak
f) Urethral or vaginal discharge

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 Introduction to Medical Parasitology Part 2
Parasitology Lecture

c. parasite destruction – occurs when the host takes • Taxonomic key

the upper hand (other damages – ex. Large o Phylum
intestine there is a tendency that the parasite infest o Subphylum
the brain) ex. amoeba present in GI tract but can o Class
also reach the brain. o Order
o Family
Prevention and control o Genus
• Prevention measures – design to break the o Species
transmission cycle which are crucial to successful
parasitic eradication and such measures include
the following:
o Reduction of the source of infection –
when the parasite is attacked within the host
thereby preventing dissemination of the
infecting agent (anthelmintic drugs) not
completely eradicated
o Sanitary control of drinking water and food
o Proper waste disposal
o Use of insecticides and other chemicals (to
control the vector population not the parasite)
o Protective clothing – prevents vectors
resting in the surface of the body and
inoculate passages during their blood meal
(lab gown – less exposure of the skin)
o Good personal hygiene
o Avoidance of unprotected sex

Classification of medical parasitology

 Medical Protozoology – Deals with the study of the
medically important protozoa
 Medical Helminthology – deals with the study of
Helminthes (worms) that affect man.
 Medical Entomology – deals with the study of
arthropods which cause or transmit disease to man
• Entomology mistaken as invertebrate zoo

Describing Animal Parasites

• Superclass
• Superfamily

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