Parasitology (Dra.
De Castro)
What is a parasite?
• a pathogen that simultaneously injures and
derives sustenance from its host
• some parasites are commensals neither
benefit nor harm their host
• for example: Entamoeba coli
Parasitology – area of biology concerned with the
phenomenon of dependence of one living organism
on another
Medical Parasitology – concerned primarily with
the animal parasites of humans and their medical
significance, as well as their importance in human
communities
Biological Relationships
Symbiosis
- living together of unlike organisms
- also involve protection or other advantages
to one or both partners
- Different form of symbiosis: distinguished on
whether or not the association is detrimental
to one of the 2 partners.
o Commensalism
o Mutualism
o Parasitism
Commensalism
- symbiotic relationship: 2 species live
together and one species benefits from
relationship without harming or benefiting
the other
- e.g. Entamoeba coli in the intestinal lumen is
supplied nourishment and protected from
harm, while it does not cause any damage to
host
Eis*, Mel* and MR
Introduction to Parasitology
January 21. 2008
Mutualism
- a symbiosis in which 2 organisms mutually
benefit from each other
- e.g. termites and flagellates in their
digestive system, which synthesize cellulose
to aid in breakdown of ingested wood
Parasitism
- a symbiotic relationship where one organism
(the parasite), lives in or on another (the
host), depending on the latter for its survival
and usually at the expense of the host
- e.g. Entamoeba histolytica derives nutrition
from the human host and causes amebic
dysentery
Parasites (According tot heir habitat or mode of
- development)
• Endoparasite: a parasite living inside the
body of a host; presence of an endoparasite
in a host is called an infection
• Ectoparasite: a parasite living outside the
body of a host; presence of an ectoprasite
inside the host is called an infestation
A parasite is considered erratic when it is found in
an organ which is not its usual habitat
Parasites
• Obligate parasites need a host at some
stage of their life cycle to complete third
development and to propagate their species
o E.g. tapeworms depend entirely upon
their host for existence
• Facultative parasite: may exist in a free
living state or may become parasitic when
the need arises
1 of 9
 Parasitology – Introduction to Parasitology by Dra de Castro
o e.g. leeches feed on blood on their
hosts but when released in aquatic
environment survive as free living
organisms
• Accidental or Incidental parasite:
establishes itself in a host where it does not
ordinarily live
o e.g. Diplydiasis in humans is
accidental
• Permanent parasite: remains on or in the
body of the host for its entire life cycle
o Most roundworms are permanent
parasites and live their entire adult
lives in their hosts
• Temporary parasite: lives on the host only
for a short period
o e.g. ticks, flea and mites
• Spurious parasite: a free-living organisms
ha passes through the digestive tract
without infecting the host
o e.g. Isosopora
Hosts
Host: classified based on their role in the life cycle
of the parasite
• definitive or final host: one in which the
parasite attains sexual maturity
o humans are the definitive host in
taeniasis
• intermediate host: harbors the asexual or
larval stage of the parasite
o Pigs or cattle as intermediate hosts of
Taenia spp. while snails are hosts of
Schistomsoma spp.
• Paratenic host: one in which the parasite
does not develop further to later stages.
However, the parasite remains alive and is
able to infect another susceptible host
Page 2 of 9
o Paragonimus metacercariae in raw
wild boar meat can pass through the
intestinal wall of humans and
complete its development
• Reservoir hosts: allow parasite’s life cycle
to continue and become additional sources
of human infection
o pigs are reservoirs of Balantidium coli
o field rats of pargonoimus westermani
o cats of Bruigia malayi
• humans are not always the final host
• man may be the most important host in the
spread of the disease or an incidental host of
parasites prevalent in other animals
Vectors
Vectors: responsible for transmitting the parasite
from one host to another
• Biologic Vector: transmits the parasite only
after the latter has completed its
development within the host
: aedes sucks blood form a patient
with fliariasis, the parasite undergoes
evereal stage of development from the fist
stage larvae to 3rd stage larva before it is
transmitted to another susceptible host
• Mechanical or phoretic vector: transports
the parasite
: flies and cockroaches that feed on
fecal material may carry enteric organisms
and transfer these to food.
Exposure and Infection
Carrier: harbors a pathogen without manifesting
any signs and symptoms
Exposure: process of inoculating an infective agent
Infection: connotes the establishment of the
infecting agent in the host
 Parasitology – Introduction to Parasitology by Dra de Castro Page 3 of 9

Incubation period (clinical incubation period): 5. other sources

period between infection and evidence of symptoms
- another person , his beddings and clothing,
Pre-patent period (biologic incubation the immediate environment he has
period): period between acquisition of this parasite contaminated
and evidence or demonstration of infection
- e.g. asymptomatic carriers of Entmoeba
Autoinfection histolytica working as food handlers

- when an infected individual becomes his

won direct source of infection
Modes of Transmission
- e.g. enterobiasis: infective eggs end up in
the hands by scratching the hperianal areas • mouth is the most likely portal of entry
where the gravid females lay their eggs
- most cesotdes, trematodes and protozoans
- where the self is the source of infection as are food born
seen in the life cycles of E. vermicularis,
Hymenolipsis nana and Strongyloides • skin penetration e.g. hookworms and
stercoralis stronglyoides

Superinfection or Hyperinfection • arthropods: as vectors transmit parasites

through bites
- when the already infected individual is
further infected with the same species - agents of malaria, filarial, leishmaniasis and
leading to massive infection trypanosomaiasis

- alteration in the normal life cycle of • congenital transmission: toxoplasma gondii

Strongyloides results in a large increase in trophozoites can cross the placenta
worm burden  severe debilitation/death
- in transmammmary infection with
Ancylostoma and Strongyloides the parasite
maybe e transmitted through the mother’s
Sources of infection milk

1. contaminated soil and water: most common

- lack of sanitary toilets & use of human

excreta as fertilizer  favor infection with
ascaris, hookworm

- water contaminated with cysts of amoebae

or flagellates as well as cercariae of
Schistosoma

2. food: food may contain the infective stage of

the parasite

3. arthropods: e.g. mosquitoes as vectors of

malaria and fliaria parasites

4. other animals (wild or domesticated ) may

harbor the parasite: e.g. cats are direct
sources of Toxoplasma infection
Other ways
Parasitology – Introduction to Parasitology by Dra de Castro
• inhalation of air-borne eggs of Enetorbius
• Sexual intercourse as in the case of
richomonas vaginalis
Nomenclature
• animal parasites are classified according to
the International Code of Zoological
Nomenclature
• each phylum is subdivided into classes which
are further subdivided into orders, families,
genera and species
- further subdivisions of suborder, superfamily
and subspecies are employed at times
• family names are formed by adding – idae to
the stem of the genus type
• names of the genera and species are
italicized or underlined when written
Life Cycle
Life Cycle
• may be simple of complicated
• As the life cycle becomes more complicated,
the lesser the chances are for eh individual
parasite to survive perpetuation of a species
of parasite depends upon its ability to ensure
transmission from one host to the next
Epidemiologic measure
• Cumulative prevalence
- Percentage of individuals in a population
infected with at least one parasite
• Intensity of infection
- Number of worms per infected person
- Also refereed to as worm burden
- Measured directly by counting helminth eggs
excreted in feces expressed as eggs per
gram (epg)
• Morbidity
Page 4 of 9
- clinical consequences of infections that
affect an individual’s ell being
Diagnosis
• demonstration or parasites
- e.g. eggs, adults, larvae, cysts, oocysts and
trophozoites
• detection of host immune response to the
parasites
- e.g. antibodies and antigens
- in light infections when parasites are still
immature, immunoassays may become
useful
• Specimens for parasitic examination: stool,
blood ,urine, sputum, cerebrospinal fluid,
tissue aspirate, tissue biopsies and orifice
swabs
• Microscopy – simple, informative, can
establish rapid diagnosis, dependent on skill
of microscopists
- limited by low density of parasites in
specimens: may be affected by stage of the
disease, biology of the parasite
- Parasite concentration techniques: require
additional equipment, supplies and reagents
- Parasite culture methods; require a clean
bench and special culture media
- Special staining procedures of fluorescent
microscopy available for better visualization
• Molecular diagnosis: molecular or DNA-Based
methods
- address problems associated with
microscopy and immunodiagnosis
- DNA probes, detection of specific nucleic
acid sequences
• Rapid diagnostic tests (RDTs)
- newer and more advance methods of
immunodiagnosis (antigen-capture tests)
Parasitology – Introduction to Parasitology by Dra de Castro
- detects fewer parasites, faster results
- easy to perform and require minimal training
of personnel
Immunodiagnosis
• overcome problems related to microscopy
examination
• detect antigen or antibodies in clinical
specimens
- Immunofluorescent Assay ELISA, indirect
Hemagglutination Assay, RIA, and dot blot
• antibody detection tests
- limited in distinguishing active from prior
infections useful in detecting exposure and
etiology of outbreaks an in mapping foci of
infection
- serve as alternatives when microscopic
exam fails
Treatment
• Deworming: use of antihelminthic drugs
• Cure rate
- no. (expressed as percentage) of previously positive
subjects found to be egg-negative on examination of a
stool or urine sample at a set time after deworming
- Indicator used to measure reduction in intensity of
infection
Eradication versus Elimination
• Egg reduction rate (ERR)
- percentage fall in egg counts after deworming
- Indicator used to measure reduction in intensity of
infection
• Selection treatment
-involves individual-level deworming with selection for
treatment based on a diagnosis of infection
• Targeted treatment
Page 5 of 9
- group-level deworming where the (risk) group to be
treated (without prior diagnosis) may be defined by age,
sex, or social characteristics irrespective of infection
status
• Universal treatment
- population-level deworming in which the community is
treated irrespective of age, sex, infection status, or other
social characteristics
Prevention and Control
• Morbiditty control
- the avoidance of illness caused by infections
• Information-education-communication
- a health education strategy that aims to encourage
people adapt and maintain healthy life practices
• Environmental management
- manipulation of environmental factors or their
interaction with human beings
- aim: prevent or minimize vector or intermediate host
propagation and reduce contact between humans and
infective agent
• Environmental sanitation: interventions to reduce
environmental health risks
- Includes safe disposal and hygienic management of
human and animal excreta, refuse and waste water
- Involves the control of vectors, immediate hosts, and
reservoirs of disease
- provision of safe drinking water and food safety
• Disease eradication
- permanent reduction to zero of the worldwide incidence
of infection caused by specific agent, as a result of
deliberate efforts
- continued measures no longer needed
• Disease elimination
- reduction to zero of the incidence of a specified disease
in a defined geographic area as a result of deliberate
efforts
 Parasitology – Introduction to Parasitology by Dra de Castro Page 6 of 9

- continued intervention/surveillance still required • Chemicalcomponents of body fluid

- Lipase content of breastmilk: toxic to G. lamblia in vitro
Mechanisms by Which Parasites Cause
Injury to Host
Immunology of Parasitic infection

• Most common: interference with the vital processes of
the host through the enzymes systems
- Secretory and excretory products of parasites allow
them to metabolize nutrients from the host
- Ex. E histolytica trophozoites secrete cysteine
proteinases digest cellular materials and degrade
epithelial basement membrane facilitating tissue invasion
• Invasion and destruction of host tissue
- Plasmodium invades rbc, and causes its rupture
• Host’s cellular components on the skin and mucosal
system of the GIT serves as a protective mechanism for
the host
- Langerhan’s cells, dendritic cells, mast cells and re-
circulating T lymphocytes on the skin (SALT)
- Gut associated lymphoid tissues (GALT)
• Mounting of acquired specific responses against parasite
antigen
- Response: recognize self from non self
- Destroys the parasite

Host immune response to parasitic infection

• Deprivation of the host of essential nutrients and • Well defined genetic control
substances • Parasite antigens are processed and presented to T
- Heavily hookworm infestation causes iron deficiency helper lymphocytes (Th1 or Th2)→ produce
anemia lymphokines→ bring about CMI response or antibody
production
• Antibodies involved: IgE, IgG, IgM and IgA
• Most common response:
• Genetic make-up
Effects of the ofHost
the host
on the Parasite - eosinophilia and elevated serum IgE
- influence the interaction with the parasite
- Ex. marked immunologic response in Angiostrongylus
- sickle-cell trait confers some protection from cantonesis and T. canis
Falciparum malaria
• Bound IgE antibodies mediate explusion of adult GI
• Nutritional status of the host helminthes
- high protein diet not suitable for the development of • IgG1 and IgE
intestinal protozoan - act as mast cells and basophils→degranulation and
eventual release pharmacologically active substances
• Immune processes
- Acquired immunity important in modifying severity of →Type 1 hypersensitivity reaction called anaphylaxis
disease in endemic areas
Ex. rupture of larval infection with E. granulosus

• IgG and IgM prevent penetration of rbcs by

Immunology and Parasitic Infection Plasmodia spp and Babesia spp
• Secretory IgA: protect against metacestode and
Host-Parasite Interactions
GI infxns
• Non specific defenses
• IgM and IgA: mediate antibody dependent cell
- intact skin: hookworms synthesize a protein that aids in mediated cytotoxicity in G. lamblia infection
the penetration process
Parasite Evasion mechanism
- acidic pH of vaginal secretions and gastric acid juice: T.
vaginalis trophozoites: unable to survive the acidic
• Immune suppression
environment of the vagina - reduce immune function of macrophages leading
to defective antigen processing in Plasmodium
• Mucus secretion
infection
- envelope parasites (G. lamblia) affecting its motility and
reducing pathology on the host
• Antigenic variation
 Parasitology – Introduction to Parasitology by Dra de Castro Page 7 of 9

- surface protein variation seen in T. gambiense

and G. lamblia infection

• Host mimicry
- tegument of Schistosoma spp adult can acquire
antigenic molecules from the host

• Intracellular sequestration
- Trypanosoma and Leishmanic proliferate in
macrophages and escape the host immune
response Protozoa

All protozoa fall under Kingdom Protista

Adverse effects of Immune Response to the host

• Intense or abnormal immune responses may result in • Nucleus/nuclei

pathological manifestation • Cyroplasm
- T cruzi→ massive damage not only to infected cells but • Outer limiting membrane
also to surrounding nerve cells and myofibers • Cellular elaborations: organelles

- recurrent Plasmodium infection, immune complexes are * Locomotory apparatus

associated with Hyperactive Malarious Splenomegaly
(HMS)→ patient suffer from persistent splenomegaly and
anemia
 In P. malariae infection, these immune
complexes are deposited in glomerular
basement membrane →kidney failure and
nephritic syndrome
☻May require a wet environment for feeding,
locomotion, osmoregulation and reproduction
☻Form infective stages called cysts which are resistant
to environmental changes compared to the vegetative
stages ccalled trophozoite

Groups of Parasites with Medical and

Public Health Importance

Unicellular protozoan

Parasitic infections

Multicellular metazoan

Kingdom
Protista Phylum Organelle of locomotion

Phylum Sarcomastigophora
Sarcomastig Ciliophora Microspora
Apicomplexa
ohora Subphylum Mostigophora Flagella(whip-like
structure)
Subphylum Sarcodina
Pseudophodia (foot-like
Metazoan parasites extrusions)

Phylum Ciliophora Cilia (hair-like projection)

Helminths Arthropods

Annelids Ex. Nematodes Flatworms

Leeches
Trematodes
Cestodes
 Parasitology – Introduction to Parasitology by Dra de Castro Page 8 of 9

Phylum Apicomplexia
Phylum Microspora
Apical complex at the • Provided with separate sexes; some may be
anterior end consisting of parthenogenetic
polar rings, subpellicular • With sensory organs in the anterior (amphids) and
tubules, conoid, rhoptries, posterior ends (phasmids)
and micronemes -those with phasmids are called phasmids nematodes
Extrusion apparatus to
-without phasmids: aphasmids nematodes
insert infective material to
the host cell
• 3 aphadsmids worms of medical importance:
- Trichuris, Trichinella and Capillaria

Classification of Protozoan Parasites

Phylum Subphylum Species

Sarcomastigophora Chilomastix mesnili, Dientamoeba fragilis, Cestodes: Tapeworms

Giardia lamblia, Trichomas hominis, T. tenax, T.
Mastigoph vaginalis, Leishmania brazilensis, L. donovani, L.
ora tropica, Trypanosoma brucei complex, T. cruzi
Acanthamoeba castellani, Endolimax nana,
Entamoeba coli, E. dispar, E. histiolytica
lodamoeba butschlii, Naegleria fowleri
• Belong to Platyhelminthes
• Dorsoventrally flattened with bilateral symmetry
• Segmented, ribbon-like appearance
• Adult tapeworms are hermaphroditic
- provided with scolex (main attachment to the host)→
neck region, from it will start segmentation or
strobilization

2 orders with medical importance: Pseudophyllidea and

Cyclophyllidea

Sarcodina Pseudophyllidean Cyclophylidea tapeworms

Nematoda tapeworms
Ciliophora Balantidium coli
Intestinal
scolex Ascaris, scolex
Spatulate Capillaria, Enterobius,
with Globular with 4 Hookworm,
muscular
Apicomplexa Babesia spp., Cryptosporidium hominis, Isospora Strongyloides,
sucking groves Trichuris
called suckers
belli, Cyclospora cayatenesis, Plasmodium spp., bothria
Toxoplasma Angiostrongylus, Filaria, Trichenella
Extraintestinal
Genital pores Present but has uterine Present but without uterine
gondii pore which allows release pore, instead undergo the
Cestoidea of eggs from gravid uterus process of apolysis
Microspora Enterocytozoon bineusi, Encephalitozoon spp., whereby gravid segments
Cyclophyllide Diphylidium, Echinococcus, Hymenolepis,
Vittaforma cornea, Pleistophora spp., are detached from the main
a Raillientina, Taenia
Trachipleistophora hominis, Microsporidium spp., body and eggs are
Brachiola vesicularum eventually released
Diphyllobothrium, Spirometra
Recovery of Segments are not Both eggs and segments
bothPseudophyllid Artylechinostomum, Clonorchis, Echinostoma,
eggs and generally found are recovered from patients
ea Fascioloa, Fasciolopsis, Heterophyids, Opisthorchis,
Classification of Metazoan Parasites segments
Paragonimus, Schistosoma
Eggs Eggs are operculated and Eggs are nonoperculated
Arthrophods immature and require and are passed out readily
aquatic development of containing the hexacaanth
Arachnida Mites, Scorpion, Spider, Ticks
the embryo called embryo
coracidium
Chilopoda Centipedes

Nematodes Crustacea Copepods, Crabs

Intermediate Require 2 IH; In the 1st IH,
Only 1 IH, but diff species
• Elongated, cylindrical, with bilateral symmetry and a host Diplopodia eggsMillipedes
encyst as procercoid prod. diff types of encysted
complex digestive tract larvae in the IH
Insecta In Flies,
the Flea,
2nd Beetle,
IH: Lice,
as Wasps, Bugs, Mosquitoes
pleocercoid larvae Ex. Taenia produce
Tongue worms

Pentastomida
 Parasitology – Introduction to Parasitology by Dra de Castro Page 9 of 9

This is best represented cysticerus type

by Diphyllobothrium which
causes adult infection and Hymenolepis, Dipylidium
Spirometra which causes and raillietina produce the
larval infection in man cysticercoid type
Echinococcus produce
hydatid

Infection with adult tapeworms is through the consumption of infected

intermediate hosts

*Some are infected with the larval stage of L. solium called cysticercosis
and of Echinococcus spp. Called hydatid cyst

Trematodes or Flukes

• Leaf-like and unsegmented

• Adults have an oral sucker and a ventral sucker called
acetabulum
• Require 2 intermediate hosts
• While the 1st IH is always a snail, the 2nd IH vary from
fish, to crustacean, to another snail, or to fresh water
plants
• Generally grouped based on their habitat
o Adult shistosomes sre found in the
mesenteric veins→ blood flukes
o Adult Paragonimus found in the lung
parenchyma
o Flukes that inhabit the livea and bile
passages: Fasciola, Clonorchis and
Opisthrchis
o Flukes that inhabit the intestines:
Fasciolopsis, Echinostoma and Heterophyids

Arthropods

• Billaterally symmetrical organisms with segmented

and jointed appendages
• Chitinous exoskeleton covers the body
• Includes: insects, mites, ticks, spiders, scorpions,
centipedes, millipiedes and crustaceans