Parasitic

Protozoa,
Helminths, and
Arthropod
Vectors
Parisitology
• Protozoan and helminthic parasites exist worldwide
• Occur among people in rural, undeveloped, or overcrowded places
• Emerging as serious threats in developed nations
• Parasitic infections often involve several hosts
• Definitive host
• Intermediate host
• Parasites can infect humans in one of three ways:
• Ingestion
• Vectorborne transmission
• Direct contact
Figure 23.1 The major routes by which humans acquire parasitic infections.
Arthropod Vectors
• Vectors are animals that carry microbial pathogens
• Arthropods are common vectors
• Some arthropods are biological vectors
• Serve as hosts for the pathogens they transmit
• Disease vectors belong to two classes of arthropods:
• Arachnida
• Insecta
Protozoan Parasites of Humans
• Protozoa are unicellular eukaryotes
• Protozoa that enter the body via ingestion have two morphological forms:
• Trophozoite
• Feeding and reproducing stage that lives within the host
• Cyst
• Infective form that survives in the environment
• Undergoes excystment when ingested, developing into trophozoites
• Trophozoites undergo encystment before leaving the host in feces
• Parasites classically grouped by their mode of locomotion
• Ciliates, amoebae, flagellates, and apicomplexans
Protozoan Parasites of Humans
• Ciliates
• Protozoa that use cilia in their trophozoite stage
• Balantidium coli
• Trophozoites attach to mucosal epithelium lining the intestine
• Balantidiasis occurs in those with poor health
• Persistent diarrhea, abdominal pain, and weight loss
• Severe infections may produce dysentery and ulceration
 • Infections treated with the antibacterial tetracycline
• Makes small intestine unsuitable
• Prevention relies on good personal hygiene and proper water sanitation
Protozoan Parasites of Humans
• Amoebae (Pseudopodia for locomotion)
• Entamoeba
• Entamoeba histolytica carried asymptomatically in the digestive tracts of
humans
• Infection most commonly occurs by drinking contaminated water
• Trophozoites migrate to the large intestine
Protozoan Parasites of Humans
• Amoebae
• Entamoeba histolytica
• Invasive amebic dysentery
• Severe diarrhea, colitis, appendicitis, and ulceration of
the intestinal mucosa
• Invasive extraintestinal amebiasis
• Trophozoites in the blood are carried through the body
Prevention/Treatment:
• Symptomatic amebiasis treated with idoquinol
• Oral rehydration therapy often coupled with drug treatment
• Maintaining clean water is important in prevention
Figure 23.2 Cyst of Entamoeba histolytica in fecal smear.
Protozoan Parasites of Humans
• Amoebae
• Acanthamoeba and Naegleria (Careful around water!)
• Acanthamoeba
• Enters through cuts, scrapes, the conjunctiva, or inhalation
• Keratitis occurs when trophozoites invade the eye
• Amebic encephalitis is the more common disease
• Causes headache, altered mental state, neurological
defects, and eventually death
• Naegleria
• Infection occurs when swimmers inhale contaminated water
• Amebic meningoencephalitis may result
• Causes hemorrhage, coma, and usually death
Protozoan Parasites of Humans
• Flagellates (Flagella for locomotion)
• Trypanosoma cruzi
• Causes Chagas' disease
• "Kissing bugs" feed preferentially from blood vessels in the lips
(Feces in eye)
• Acute stage characterized by chagomas
• Symptomatic stage characterized by congestive heart failure
 • limiting contact with kissing bugs
Figure 23.4 Mature, flagellated trypanosomes of T. cruzi among erythrocytes.
Protozoan Parasites of Humans
• Flagellates
• Trypanosoma brucei
• Causes African sleeping sickness
• The insect vector is the tsetse fly
• African sleeping sickness is 100% fatal if untreated
• Fly bite becomes a lesion, Fever, Meningoencephalitis
• Personal insecticides, netting, and long clothing help reduce insect
feeding
Protozoan Parasites of Humans
• Flagellates
• Leishmania
• Causes leishmaniasis
• Dogs and rodents are common reservoirs
• Transmitted by sandfly bites
• Prevention limited to reducing exposure to reservoir and vector
Protozoan Parasites of Humans
• Flagellates
• Leishmania
• Three clinical forms of leishmaniasis often observed:
• Cutaneous leishmaniasis
• Large painless skin ulcers form at the bite wounds
• Mucocutaneous leishmaniasis
• Skin lesions enlarge to encompass mucous membranes of
the mouth, nose, or soft palate
• Visceral leishmaniasis
• Macrophages carry the parasite to the liver, spleen, bone
marrow, and lymph nodes
• Fatal in 95% of untreated cases
Figure 23.7 Mucocutaneous leishmaniasis.
Protozoan Parasites of Humans
• Flagellates
• Giardia
• Giardia intestinalis
• Causative agent of giardiasis
• Common gastrointestinal disease in the US
• Ingest cysts in contaminated food, water, or hands
• Diarrhea, pain, bloating, nausea, vomiting, and fever
• Prevent infections in endemic areas by use of filtered water
Protozoan Parasites of Humans
• Flagellates
• Trichomonas vaginalis
 • Most common protozoan causing human disease in
industrialized nations
• Lives in the genitourinary system of men and women
• Transmitted almost exclusively via sex
• Occurs in people with preexisting STD or multiple sex partners
• Infection of women results in vaginosis (Men asymptomatic)
• Vaginal discharge, vaginal and cervical lesions, abdominal pain, and painful
urination and intercourse
• Prevention involves abstinence and safe sex
Protozoan Parasites of Humans
• Flagellates
• Trichomonas
• Trichomonas vaginalis
• Infection of women results in vaginosis
• Causes odorous discharge, vaginal and cervical lesions,
abdominal pain, and painful urination
• Infection of men is typically asymptomatic
• Presence of trophozoites in vaginal or urethral secretions is
diagnostic
• Infections treated with nitroimidazole drugs
• Prevention involves abstinence and safe sex