Introduction of Parasitology

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GENERAL
INTRODUCTION OF
MEDICAL
PARASITOLOGY

Bin Ye
Professor,
Ph. D.
Email:pasobo@sina.com
week
lecture
general introduction
roundworm, whipworm
pinworm, hookworm
filariae,trichinella
trematode, liver fluke
basic tech
3
4
lung & intestine fluke

schistosomes
nematodes
cestode, pork tapeworm
No class
beef & sheep tapeworm
1
1
2
practice
trematodes
week
lecture
practice
cestodes
protozoa, amoebae
giardia, trichomonas
leishmania,toxplasma
protozoa
malaria
arthropodes, mosqiuto, fly

louse, flea, mite,
sumerrize
arthropodes
GENERAL
INTRODUCTION OF
MEDICAL
PARASITOLOGY
Parasite
Parasite:
an organism which obtains food and shelter
from another organism and derives all
benefits from association.
Microparasites & Macroparasites

Traditionally, protozoa,arthropods,helminths are
defined as parasites.
Within broad definition, parasites include
microparasites: viruses, bacteria, fungi, protozoa.
macroparasites: helminths, arthropods.


Protozoa malaria parasite
helminths
arthropods
INTRODUCTION
Medical Parasitology and Parasitic
Disease
Parasitism and Parasite
Interaction of Parasites and Hosts
Epidemiology and Prevention of
Parasitic Disease
Medical
Parasitology
and
Parasitic Disease
Parasitology :
science that deals with the parasites of
human and domestic animals.
interactions between a host and the

population of parasites
interactions between host populations
and the parasites that infect them
Aspects of Parasitology :
parasites---morphology, biochemistry,
physiology, life cycles
host---immunological,
clinical responses
treatment and control
public health
pathological,
Medical parasites and Parasitology:
Protozoasingle-celled parasites
/Protozoology
Helminthsflukes, tapeworms,nematodes
/ Helminthology
Arthropodsinsects,ticks,mites
/Arthropodology
Important Parasitic
Diseases
Malaria
Filariasis
Schistosomaiasis
Leishmaniasis
Trypanosomiasis
Burden of Diseases in Developing

World
Endemic
countries
Deaths/yr
(million)
Disease
Burden
(DALYs
million)
HIV/AIDS
180
2.8
86
Malaria
101
1.2
44.7
TB
211
1.6
35.4
African tryps
36
0.05
1.5
Chagas Disease
21
0.01
0.7
Leishmaniasis
88
0.05
Filariasis
80
5.8
Schistosomiasis
76
0.01
1.7
Onchocerciasis
36
0.5
Disease
Disability Adjusted Life Years (DALYs)
July 2008
Neglected Tropical Diseases
Protozoan Infections
Leishmaniasis (VL, CL and MCL)
Human African trypanosomiasis (sleeping sickness)
Chagas disease
Helminth Infections
Soil-transmitted helminth infections
Ascariasis-Trichuriasis-Hookworm
Lymphatic filariasis (elephantiasis)

Onchocerciasis (river blindness)
Schistosomiasis
Dracunculiasis (guinea-worm disease)
Cysticercosis and other zoonotic helminthiasis
Viral Infections
Dengue & dengue haemorrhagic fever
Bacterial Infections
Leprosy
Trachoma
Buruli ulcer
NTDs in poor populations

Previousl
y
neglected
diseases
TB
Neglected tropical diseases
HIV/AIDS
Soil transmitted helminthiasis

Anthrax
Schistosomiasis
Malaria
Lymphatic filariasis
Bovine tuberculosis
Onchocerciasis Cysticercosis
Leprosy
Brucellosis
Trachoma
Leishmaniasis Echinococcosis
Zoonotic trypanosomiasis
Buruli ulcer
Chagas disease
Rabies
Human African
trypanosomiasis
Dengue & DHF
Neglected zoonoses
or poor populations and (all) their
(undermining) diseases ?
Impact on poverty
making interventions cost-effective
Global distribution of NTDs

.
Approximately 1 billion people are affected by more than one of NTDs
Important Parasitic
Diseases
Malaria
Filariasis
Schistosomaiasis
Leishmaniasis
Trypanosomiasis
Important Parasitic
Diseases
Malaria
Filariasis
Schistosomaiasis
Leishmaniasis
Trypanosomiasis
Elephantiasis of leg due to filariasis.
Elephantiasis of leg due to filariasis
Important Parasitic
Diseases
Malaria
Filariasis
Schistosomaiasis
Leishmaniasis
Trypanosomiasis
Schistosomaiasis
A 13-year-old boy with schistosomiasis.

Hepatosplenomegaly, ascites, muscle atrophy, pyrexia, anaemia and
haemorrhage from the gastrointestinal tract.
victims of schistosomiasis
showing typical distension of the abdomen.
Important Parasitic
Diseases
Malaria
Filariasis
Schistosomaiasis
Leishmaniasis
Trypanosomiasis
Profile view of a teenage

boy suffering from visceral
leishmaniasis.
The boy exhibits
splenomegaly, distended
abdomen and severe
muscle wasting.
Skin ulcer due to leishmaniasis, hand of Central American adult.
Important Parasitic
Diseases
Malaria
Filariasis
Schistosomaiasis
Leishmaniasis
Trypanosomiasis
Vector of African Trypanosomiasis
Trypanosomes
African Trypanosomiasis
African Trypanosomiasis
Trypanosoma cruzi
Trypanosoma cruzi
Vectors of American Trypanosomiasis
American Trypanosomiasis
Other Parasitic Diseases
hookworm
A hookworm on mucosa of stomach

Gastroscopy images
Whipworm adults
Whipworm adults embed in mucosa
pinworms
Trichinella spiralis larvae in muscles
Chinese liver flukes
lung fluke
Pork tapeworm adult
Beef tapeworm adult
Hydatid,
sheep
tapeworm
larva
amoeba
Histopathology of a typical flask-shaped ulcer of

intestinal amebiasis
Gross pathology of liver containing amebic abscess
giardiasis lamblia
Giardia lamblia
Toxoplasma gondii trophozoites
Brain damages caused by T gondii
follicle mite
Scabies, itch mite
lice
flea
tick
INTRODUCTION
Disease
Parasitic Disease
Parasitism
and
Parasite
Parasitism
Symbiosis:
An association in which both
partners are so dependent upon
each other that one cannot live
without the other.
Symbiosis: association between

animals of different species living
together.
Mutualism
Commensalism
Parasitism
symbiosis
advantage
advantage
+
cilliate
+
ox,sheep
commensalism
+
small fish
big fish
parasitism
+
roundworm
human
mutualism
Mutualism:
In symbiosis, a special relationship
that is beneficial to both partners.
Commensalism:
An association in which the
commensal only is deriving benefit
without causing injury to its host. A
commensal is capable of leading an
independent life.
Parasitism:
parasite derives benefit
host always suffers some injury.
A parasite has its power
independent life.
of
hookworms on small intestinal mucosa
Parasitism------important features
involves two species, parasite and host.
parasite receives nourishment and shelter
from host
parasite is always the beneficiary and
host is always the provider.
pathological changes in hosts that may
result in disease.
treatment and control of parasitic diseases
requires information about parasite and its
interactions with their hosts.
1. Types of parasites
Obligatory parasite, Facultative parasite
Endoparasite, Ectoparasite
Permanent parasite ,Temporary parasite
Accidental parasite , Wandering parasite
Opportunistic parasite
on selections of host, parasites are divided into:
Obligatory parasite -- a parasite cannot

exist without a parasitic life, it must live
entirely or at least partially in or on the host
to get food.
Facultative parasite-- a parasite lives a
parasitic life when opportunity arises,it can
live without the host.
Obligatory parasite
Facultative parasite-Acanthamoeba
1.Types of parasites
on living sites, parasites are divided into:
Endoparasite-- a parasite lives inside

the body of the host; in the blood, tissues,
body cavities, digestive tract and other
organs.
Ectoparasite-- a parasite lives outside
on the surface of the body of the host.
Endoparasite, hookworms on small intestinal mucosa
Ectoparasite
on living time, parasites are divided into:
Permanent parasite --must live in or on

the host during the entire life time of the
parasite.
Temporary parasite-- may live on the
host for a short period during its feeding,
then leaves.
Permanent parasite
Temporary parasites
Nomenclature of Parasites:
Phylum---Subphylum
---(Superclass)-Class-(Subclass)
---Order-(Suborder)
---(Superfamily)-Family-(Subfamily)
---Genus---Species
On if host or site is normal or abnormal, some
parasites are divided into:
Accidental or Occasional parasite a parasite

enters or attaches to the body of an unusual
host by a chance.
Wandering or Aberrant parasite a parasite
happens to reach a place where it cannot live.
Accidental parasite
myiasis caused
by a fly larva.
Accidental parasite
myiasis caused
by fly larvae.
Aberrant parasite
ascarid larva in
brain
on possibility of damage to host, some parasites
are
Opportunistic parasites can cause

damage to the host when the host is under
a susceptible condition,such as
Toxoplasma gondii in AIDS patients .
Opportunistic parasites
Toxoplasma gondii from an HIV infected patient.
2. Life cycle of parasites

------ the whole process of parasite
growing, developing and reproduction.
Some parasites have complex life cycles, others have
simple life cycles.
Direct type: no intermediate host

Indirect type: need intermediate host
Life cycle of ascarid
Life cycle of Chinese liver fluke
Types of Life cycle

Multicellular Parasite:
adults---- eggs----- larvae----- adults
Unicellular Parasite (protozoa):
sexual reproduction phase ------ asexual
reproductive phase.
Arthropods:
adults--- eggs--- larvae--- pupa--- adult
3. Types of host
Definitive host / Final host
Intermediate host
Reservoir host
Paratenic host / Transport host
Definitive /Final host

harbors the adult stage of the parasite
or where the parasite utilizes the sexual
method of reproduction.
In majority of human parasitic infection,
man is definitive host.
Intermediate host
harbors the larval stages of the parasite
or where the parasite utilizes the asexual
method of reproduction.
Certain parasites have 2 intermediate
host, known as the 1st and 2nd
intermediate host respectively .
Definitive /Final host

harbors the adult stage of the parasite or where
the parasite utilizes the sexual method of
reproduction.
Intermediate host
harbors the larval stages of the parasite or
where the parasite utilizes the asexual method
of reproduction.
Human ??? host
larvae
In Suitable host
adult
vertebrate Animal ??? host
In UnSuitable host
larve
vertebrate Animal-- ??? host
Reservoir host
a normal vertebrate animal host that
harbors the parasites of human.
ensure continuity of the parasite's life
cycle and act as additional sources of
human infection.
Domestic animals are chief reservoir
hosts.
Paratenic / Transport host

an abnormal vertebrate host which
harbors the larvae of helminths, the
larvae remains viable without further
development, but is infective to their
normal hosts.
Usually,an insect transmitting the
parasitic infection known as the
vector, not as a transport host.
Reservoir host
a normal vertebrate animal host that harbors the
parasites of human, act as additional sources of
human infection.
Paratenic / Transport host

an abnormal vertebrate host which harbors the
larvae of helminths, the larvae remains viable
without further development, but is infective to
their normal hosts.
life cycle of Spirometra mansoni
Human definitive host
larvae
In Suitable host
adult
vertebrate Animal reservoir host
In UnSuitable host
larve
vertebrate Animal-- Transport host
INTRODUCTION
Disease
Parasitic Disease
Interaction
between
Parasites & Hosts
1.Effects of Parasites on Hosts

Depend upon parasite species, strain,
amount of parasites, parasitic sites,
secretion and excretion of parasites.
Proliferation, multiplication and
metastasis in protozoal infection are
important.
Pathogenic Factors of a parasite

migratory pathway in host
anatomical site where parasite develops
feeding habits
suitable living site
stimulate hyperactive immunological responses
in host that may lead to immunopathological
changes (fibrosis, granulomas, autoimmuine
reactions, allergic reactions and splenomegaly.)
transmit other infectious agents. ( relevant to
arthropods. )

Competition for hosts nutrients
Physical Damages to Tissues or Organs
Toxic and Allergic Effect on Host

roundworm,tapeworm gets nutrition from
intestine of man.

roundworms can block intestine, invade
appendix or bile duct.

toxin of arthropods; proteolytic enzyme secreted
by amoeba; metabolite, secretions, excretions
from parasites or dead parasites act as antigen,
induce hypersensitive immune response or allergy,
damage tissues.

roundworm,tapeworm gets nutrition from
intestine of man.

roundworms can block intestine, invade
appendix or bile duct.

toxin of arthropods; proteolytic enzyme secreted
by amoeba; metabolite, secretions, excretions
from parasites or dead parasites act as antigen,
induce hypersensitive immune response or allergy,
damage tissues.
2.Effects of Hosts on Parasites

host offers some resistance to
injury done by the parasite,
there may be some adaptation
(tolerance) between parasite and host

Every species of animals is naturally
resistant to infection of many different
parasites.

Every species of animals is naturally
resistant to infection of many different
parasites.
Diet or nutritional status of host is
major important in outcome of parasitic
infection. High protein diet is unfavorable
for many intestinal protozoa.
Carbohydrate-rich diet favors some
tapeworms.
Resistance to parasites----
Innate Immunity
Acquired Immunity
(1) Innate Immunity/Innate Barrier

Skin, mucous membrane, placenta.
Phagocytosis of phagocytes.
innate immunity features:
natural heritage,
non-specific,
not very strong.
(2) Acquired Immunity

established by previous infection.
Sterilizing Immunity
Non-Sterilizing Immunity
Sterilizing Immunity
can wipe out the parasite radically,the
clinical symptoms disappear completely,
can acquire long-time specific resistance
to the reinfection of this parasite. E.g.
Leishimania tropical.
absolute sterilizing immunity to

reinfection is rare in protozoa,
probably never in helminths.
Non-Sterilizing Immunity
can wipe out most of the parasite,
but not completely, host can acquire
certain degrees of resistance to the
reinfection. If all of the parasites cleared
radically, the resistance would
disappear completely.
It is a common immunity caused by
many protozoa and helminths.
Non-Sterilizing Immunity includes
premunition
concomitant immunity
Premonition --specific immunity to some

protozoa infection,which can
wipe out most of the parasites,
results in clinical recovery and
resistance to the challenge from
same parasites.
concomitant immunity --specific immunity to some

helminths infection, which can resist
the subsequent challenge infection
of the larvae of same parasites,
whereas the adults that induce the
response can survive.
Premunition--a specific immunity to

some protozoa infection,which can wipe out
most of the parasites,results in clinical
recovery and resistance to the challenge
from same parasites.
Concomitant immunity-- a specific

immunity to some helminths infection, which
can resist the subsequent challenge
infection of the larvae of same
parasites,whereas the adults that induce the
response can survive.
3. Interaction of Parasites and Hosts

harm (A)
HOST
resist (B)
A<B, parasites are cleared.
A=B, cleared partially,carrier
A>B, parasitic disease.
INTRODUCTION
Disease
Parasitic Disease
Epidemiology &
Prevention
of Parasitic Disease
1. Basic Factors of Transmission

Infective source: patients, carriers, reservoir
hosts(dog, pig, cat, cattle, rat, etc.).

Susceptible hosts: common people without

specific immunity.

Susceptible hosts: common people without

specific immunity.
Pathways of transmission: path from

infective source to susceptible hosts.It includes
contaminated food and water, polluted soil,
direct contact, biting of arthropods, congenital
infection from pregnant mother to fetus in the
uterus.
2. Infection of Parasites
Stage of infection: a stage of a parasite, which
can invade the human body and establish infection.
Method of infection: methods by which a

parasite invades the human body.Such as by
ingesting of contaminated food and drink water,
flesh, aquatic plants; by invading of the skin or
mucous membrane; by the biting of insects vectors.
Method of infection: methods by which a

parasite invades the human body.Such as by
ingesting of contaminated food and drink water,
flesh, aquatic plants; by invading of the skin or
mucous membrane; by the biting of insects vectors.
Entry of infection: the avenue through which a

parasite enters human body. E.g., mouth, skin,
placenta, respiration duct, genital canal, blood
vessel, etc.
3. Epidemiological features
Endemic
Climate factors (temperature, humidity ),
Biologic factors (vectors and intermediate hosts),
Living habits and modes or conditions of working.
Distribution of West African or Gambian Sleeping Sickness

and East African or Rhodesian Sleeping Sickness
The distribution of tsetse fly and cattle raising areas
helminth
Endemic
Seasonal
Distribution and population of vectors and of
intermediate hosts vary with different seasons.
Different modes of working at different seasons.
Endemic
Seasonal
Distribution and population of vectors and of
intermediate hosts vary with different seasons.
Different modes of working at different seasons.
Zoonosis
A parasite can live in animal and human body.
Reservoir hosts is the source of infection to man.
4. Prophylaxis Principles
(1) Eradicate infective sources
therapy patients and carriers,
therapy or kill reservoir hosts
(2) Block transmission routes
proper dispose of feces,
mange water resource.
control vectors and intermediate hosts.
(2) Block transmission routes
proper dispose of feces,
mange water resource.
control vectors and intermediate hosts.
(3) Protect susceptible individuals
improve personal hygiene
change bad eating and working habits,
improve working modes and conditions,
drug prophylaxis.
Scheme Followed in Parasitological Studies

1.Habitat inside the human host.
2.Morphology and life cycle(staining methods
and cultivation).
3.Modes of infection: Reservoir host, sources of
infection,
portal
of
entry, vehicle
of
transmission.
4.Effects of the parasite; Pathogenic lesions,
Clinical manifestations.
5.Immunological responses.
6.Methods for specific diagnosis.
7.Approved therapy for eradication of the
parasitic infection.
8. Geographical distribution. Prophylactic
measures for the prevention of parasitic
infection of the individual as well as of the
community.

Introduction of Parasitology

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Teaching handouts

trematode, liver fluke

lung & intestine fluke

cestode, pork tapeworm

beef & sheep tapeworm

arthropodes, mosqiuto, fly

Microparasites & Macroparasites

Microparasites & Macroparasites

Microparasites & Macroparasites

Protozoa malaria parasite

interactions between a host and the

Medical parasites and Parasitology:

Burden of Diseases in Developing

Disability Adjusted Life Years (DALYs)

Neglected Tropical Diseases

Lymphatic filariasis (elephantiasis)

NTDs in poor populations

Neglected tropical diseases

Soil transmitted helminthiasis

Global distribution of NTDs

Approximately 1 billion people are affected by more than one of NTDs

Elephantiasis of leg due to filariasis.

Elephantiasis of leg due to filariasis

A 13-year-old boy with schistosomiasis.

Profile view of a teenage

Skin ulcer due to leishmaniasis, hand of Central American adult.

Vector of African Trypanosomiasis

Vectors of American Trypanosomiasis

Other Parasitic Diseases

A hookworm on mucosa of stomach

Whipworm adults embed in mucosa

Trichinella spiralis larvae in muscles

Chinese liver flukes

Pork tapeworm adult

Beef tapeworm adult

Histopathology of a typical flask-shaped ulcer of

Gross pathology of liver containing amebic abscess

Toxoplasma gondii trophozoites

Brain damages caused by T gondii

Scabies, itch mite

Symbiosis: association between

hookworms on small intestinal mucosa

Obligatory parasite -- a parasite cannot

on living sites, parasites are divided into:

Endoparasite-- a parasite lives inside

Endoparasite, hookworms on small intestinal mucosa

on living time, parasites are divided into:

Permanent parasite --must live in or on

Accidental or Occasional parasite a parasite

Opportunistic parasites can cause

2. Life cycle of parasites

Direct type: no intermediate host

Life cycle of ascarid

Life cycle of Chinese liver fluke

Types of Life cycle

Definitive /Final host

Definitive /Final host

Life cycle of Chinese liver fluke

Human ??? host

vertebrate Animal-- ??? host

Life cycle of Chinese liver fluke

Paratenic / Transport host

Paratenic / Transport host

life cycle of Spirometra mansoni