Blood and tissue nematodes

General features:
Long thread -like worms
Adults live in the tissues of human (lymphatic
system, subcutaneous tissues or muscle)
Requires two host to complete their life cycle.
Females are viviparous, larvae hatch in the uterus
The female produce first stage larvae (L 1)

The

immature

L1

stage

larva

is

called

Microfilariae
Small , slender, motile forms
L1 require blood sucking insects (IH) to
develop to infective form (L3)
No reproduction in the vector, rather
development
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Classification:
Tissue nematodes can be classified based on:
Habitat in the body
Clinical manifestation
Morphology

Three families/ groups

1. FAMILY FILARIDAE( Filarial worm)
- Common/pathogenic filaria

Wuchereria bancrofti
Brugia malayi
Brugia timori
Loa loa
Onchocerca ovolvulus
2. FAMILY TRICHINELOIDAE

Trichinella spiralis
3. FAMILY DRACUNCULIDAE( guinea worm)

Dracunculus medinensis
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2.1.3.3.
FAMILY FILARIDAE
( Filarial worm)
General features:
Filariae live as adults in various human tissues
Three of these are responsible for most of the morbidity:
W. bancrofti and B. malayi cause lymphatic filariasis, and
O. volvulus causes onchocerciasis (river blindness).

 Diagnosis is based on finding the microfilaria with specific

morphologic features as
Size, presence or absence of sheath,
periodicity(noturnal,diurnal,subperiodic),source, appearance,
arrangement of nuclei and weather it reaches to tip of the tail

Flarial worm causes 3 main diseases

lymphatic filariasis (Elephantiasis)
Loasis
Onchocerciasis (river blindness)

Lymphatic Filariasis

Disease caused by filarial worms living in the human

lymphatic system
Agents of Lymphatic Filarias reside in lymphatic vessels
and lymph nodes.
Causative agents
Wuchereria bancrofti
Brugia malayi
Burigia timori
These worms lodge in the lymphatic system
They live for four to six years, producing millions of
minute larvae that circulate in the blood
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Lymphatic Filariasis

Large numbers are present in the lymphatics of the:

Lower extremities (inguinal and obturator groups),

Upper extremities (axillary lymph nodes), and,
Male genitalia (epididymis, spermatic cord, testicle)
- particular for W. bancrofti

Social consequences
It is one of the most debilitating and disfiguring
diseases of the world
1. Disfigurement of the limbs and genitals leads
to:

Stigma
Anxiety
Ostracization(exclude from society)
Psychological trauma
Sexual disability

Epidemiology of Lymphatic Filariasis

Endemic in 83 countries
1.2 billion at risk
> 120 million people infected
> 25 million men suffer from genital disease,
> 15 million people suffer from lymphoedema or
elephantiasis of the leg
~ 2/3 of infected people live in India and Africa
Others live in parts of Asia, the Pacific, & in
Central and South America.
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Distribution
Wuchereria bancrofti
affects an estimated 119 million individuals and disfigures 40
million.
Wide distribution (Africa, SE Asia, Indonesia, South Pacific
Islands)
In Ethiopia seen in two communities living adjacent to
Baro river near town of Gambella
Brugia malayi
Limited distribution (China, India, SE Asia, Indonesia,
Philippines)
Brugia timori
Leser sunda, island of Indonesia
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Wuchereria bancrofti
Disease: Bancroftian filariasis, Wuchereriasis, elephantiasis

Transmission and life

cycle
Requires two host
Human-DH
Mosquitoes-IH

Transmission
Bite female mosquitoes (Genera Culex, Aedes,
Anopheles, Mansonia)

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Clinical manifestation.

Depends on:
Site occupied by adult
Number of worms,
Length of infection and
Immune response of the host

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14

Loiasis

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Loiasis
Caused by filarial worms living in subcutaneous tissue

Causative agents
Loa loa (Eye worm)

Distributed in Rain Forest areas of West Africa

and equatorial Sudan.
Horse flies (Tabanidae) in genus
Chrysops

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17

ONCHOCERCIASIS
Is a filarial disease caused by O. Volvulus
Commonly known as river blindness
The worlds second leading infectious cause of blindness
WHO estimates the global prevalence is 17.7 million, of
whom about 270,000 are blind

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Onchocerca volvulus
Habitat:
Adult:
Subcutaneous nodules and in the skin
Adults can live ~ 8 10 years in nodules
Microfilariae:
Skin, eye and other organs of the body
Infective larvae in:
Gut, mouth parts and muscles of black fly
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Onchocerca volvulus
Transmission:
By the bite of infected vector (simulium species)

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Trichinella spiralis
A tissue nematode which Causes Zoonotic disease
Disease in humans: Trichinosis, Trichiniasis, Trichinelliasis,
Trichinellosis
Distribution: Temperate regions where pork is eaten
1.
2.
3.

T. Spiralis spiralis found in temperate regions

T. Spiralis nativa found in the Arctic
T. Spiralis nelsoni found in Africa and S. Europe

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Trichinella spiralis
Habitat:

Adults in the small intestine of man and animals specially pigs and
rats (reservoir hosts)
Larvae : encysted in muscles

Transmission
Eating flesh of infected pork (raw/undercooked)

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Encysted in
pressed muscle
tissue.

Larvae, freed from

their cysts

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2.1.3.8. Dracunculus medinenis

Guinea worm,

24

Dracunculosis
Synonyms: Dracontiasis, Dracunculosis, Dracunculiasis
Causative agent

Scientific name: Dracunculus medinensis

Common name: Medina worm or Guinea worm

Epidemiology
Most common in areas of limited water supply where individuals acquire water by
physically entering water sources.
Walk-in well
Water holes in parts of Africa

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Dracunculosis
Habitat:
Adults in subcutaneous tissues (under skin) of

man/reservoir animals

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Adult worm of D. medinensis

27

Adult worm of D. medinensis

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D. medinensis

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