02 July 2016

Lecture #1: INTRODUCTION TO PARASITOLOGY


Parasitology is the area of science which deals with the study of organisms that lives within the body of another organism for survival.

Types of relationship:

1. Symbiosis – type of relationship between two organisms that cannot exist independently, life apart is impossible.

2. Mutualism – type of relationship beneficial to both the parasite and the host.

3. Commensalism – type of relationship wherein one is benefited, the other is neither benefited nor harmed.

4. Parasitism – refers to harmful or harmonious relationship between two organisms:

Classification of parasite

a. Based on habitat

(1)Endoparasite – those found within the body of the host.
e.g. worms, amoeba

Infection – invasion made by endoparasite

Types of infection:

(a) Superinfection – when an individual harboring a parasite is reinfected with the same species of parasite.

(b)Autoinfection – when the infected person in his own direct source of re–exposure; it may be external (perianal or anus to mouth via finger or soiled linen) or internal in the mode of transmission.

(2) Ectoparasite – those that lives on the surface of the body of the host
      e.g. lies, fleas, ticks

                        Infestation – invasion made by ectoparasite

b. Based on the effect of parasite to host

(1)  Pathogen – disease–producing
(2)  Non–pathogen / Commensals

c. Based on the mode of living

(a) Facultative – those that can survive even without a host

(b) Obligatory – those that cannot live without a host.

(c) Permanent – those found within the host from early life to maturity

(d) Erratic – parasite that becomes fixed in an unusual organ different from that which it ordinary parasitized

(e) Intermittent – those that simply visit the host during feeding time.

(f) Periodic – type of parasite wherein the larval stage develops in a host different from that of adult.

(g) Transitory or temporary – type of parasite wherein the larval stage develops in a host while the adult is free living

(h) Incidental – one that establishes itself in the host in which it does not ordinary live.

(i) Coprozoic or spurious – species that are passed thru the alimentary tract without infecting the host at times recovered in a living or dead stage from human excreta

(j) Saprophytes – that which lives in organic substances in state of decomposition.

Specificity of parasites:

1. Zooparasites

a. Absolute – highly specific for animals, man is completely insusceptible.
b. Relative – specific for animals but man may become susceptible

2. Anthroparasites

a. Absolute – highly specific for men and animals are not susceptible
b. Relative – specific for man but animals may become susceptible

3. Anthrozooparasite – equal specificity of parasite for both man and animals

Related parasitology term

1. Exposure – the act or process of inoculation.

2. Carrier – usually an individual harboring the parasite but do not show any signs and symptoms; a state wherein the parasite live in or on the tissues of its host without causing evident harm.

3. Biological incubation – development of parasite in the particular host; it is usually terminated as soon as the parasite or their products can be demonstrated in the feces or other excreta or in the circulating blood (parasetemia), by aspiration, biopsy or other diagnostic procedure.

4. Clinical incubation – interval between exposure and the earliest evidence of symptoms produced as a result of infection or infestation.

5. Zoonosis – literally, disease of animals but today employed for those diseases of animals which are transmissible to man.

a. Euzoonosis – a type of zoonosis common to man and reservoir host
b. Parazoonosis – a type of zoonosis in which man is an infrequent or incidental host.
c. Anthropozoonosis – infection acquired by man from other vertebrates, e.g., directly, in trichinosis or by large number of infections transmitted by anthropods and molluscan intermediate host.

6. Zooanthroponoses – diseases primarily of human origin which may be acquired by other vertebrates.

7. Amphizenoses – disease common to man and other vertebvrates.

8. Anthroponoses – disease presently restricted to man which have presumable evolved from other host sources.

9.  Pseudoparasite – artifacts mistaken as parasite.


Distribution of disease

1. Endemic – there is a steady, moderate level of disease in human population.

2. Hyperendemic – there is a high prevalence of the disease in a human population.

3. Epidemic – there is a sudden rise in the incidence or an outbreak of considerable intensity occurs in a disease in human population.

4. Sporadic – when the disease in human population appears only occasionally in one or at most a few numbers of a community.

5. Pandemic – when communicable disease have been disseminated over an extensive areas of the world.


Sources of exposure:

1. Contaminated soil or water

a.  A. lumbricoides
b.  T. trichiura
c.  Human hookworm
d.  S. stercoralis
e.  Variable cyst of parasitic amoeba
f.   Intestinal flaggelates
g.  T. solium ova
h.  Infective cercareal stage of the human blood fluke


2. Food containing the immature infective stage of the parasite

a. Fresh water fishes: D. latum, liver and intestinal flukes
b. Crabs & crayfishes: Oriental lung fluke
c. Hog flesh: T. spiralis & T. solium
d. Beef: T. saginata
e. Buffalo nuts: Giant intestinal fluke (F.buski)
f.  Water crests: F. hepatica


3. Blood sucking insects transmit

a.  Malarial parasites
b.  Filarial worms
c.  Leishmanias
d.  Trypanosomes
e.  Viruses
f.   Rickettsias
g.  Bacteria
h.  Spirochetes


4. Domestic or wild animals harboring the parasite

a.  Dogs: hydatid cyste of E. granulosus and T. carius
b.  Herbivorous animals: Trichostrongylus spp.


5. Another person, his clothing, bedding or immediate environment which he has contaminated

a. E. histolytica
b. E. vermicularis
c. H. nana


6. One’s self: autoinfection with

a.  S. stercoralis
b.  T. solium
c.  E. vermicularis


Portal of entry

1. By mouth

a.  Intestinal protozoa (encyted stage)
b.  A. lumbricoides
c.  T. trichiuria
d.  E. vermicularis
e.  H. nana
f.   Trichostrongylus spp.
g.  T. spiralis
h.  T. solium
i.   D. latum
j.   P. westermani


2. Skin penetration

a. Hookworms
b. Stronglyloides
c. Blood flukes


3. Inhalation of eggs

a.   E. vermicularis
b.   A. lumbricoides


4. Transplacental infection

a.  T. gondii
b.  Malarial parasite
c.  Blood flukes


5.  Sexual intercourse

a.  Trichomonas vaginalis


Pathogenesis of parasite to host:

1. Traumatic or physical change – when parasite invades the skin.

2. Lytic necrosis – enzymes elaborated by many parasites make it possible for them to digest available food in the immediate environment and to transform this nutrient into their own protoplasm or to store it for the production of energy; also used as a mean of tissue penetration.

3. Stimulation of host–tissue reactions – there is a cellular proliferation and white cells infiltration at the site of the parasite; these reactions are produced by almost all animal parasite.

4. Toxic and allergic phenomena – when proteins or other metabolites of the parasites are introduced into the body, there is sensitization to the foreign substances which may produce hypersensitization to anaphylactic shock.

5. Opening of pathways for entry of other pathogens into the tissue – secondary invasions by bacteria


Diagnosis

1. Clinical – the physician obtain information concerning the effect of parasitic diseases on the basis of the subjective and objective symptoms evoked, the patient’s history and physical examination.

2. Laboratory – it is important for the clinician to known what type of specimen should be obtained from the patient for laboratory analysis, whether stool, blood, urine, sputum, aspirate or biopsy. It is equally important to know how and when the specimen is to be obtained and what precautions are to be taken so that it will be satisfactory for examination.

a. Stool specimens should be free of oil, particulate minerals (magnesia, kaolin, barium or bismuth), without contamination of urine and should be placed in a sterile container. They should be fresh especially if they are diarrheic; if delay in diagnosis is anticipated, they should be satisfactorily preserved.

b. Blood films should be made on microscope slides which are absolutely clean and grease–free and sera for immunologic tests should be obtained aseptically and free of hemolyzed red cells.


Prevention

1. The detection, accurate diagnosis and evaluation of the clinical importance of the disease in the patient.

2.  Adequate treatment of the patient.

3. Search for and treatment of other cases in the patient’s family.

4. Determination, if possible, of the source of the infection, reporting it promptly to health officials.

5. Advice to patients and their families as to how they can avoid further exposure.

6. Support and cooperation in community preventive measures.


7. Education of patients in ways of utilizing and strengthening local health departments. 


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