Trichuris trichiura

diseases
• Trichuriasis,whipworm infection
 Life cycle
• People are the principal hosts
 Morphologic characteristics
• 1.attenuated whiplike anterior,3/5th traversed by
a narrow esophagus resembling a string of beads,
• 2.a more robust posterior,2/5th containing the
intestine and a single set of reproductive organs
• 3.similarity in length of male(30 to 45mm) and
female(35 to 50mm),and
• 4.the bluntly rounded posterior end of the female
and the coiled posterior extremity of the male
with its single spicule and retractile sheath
• The number of eggs produced per day by a
female estimated at 3000 to 10000
• Eggs are lemon-shaped with pluglike
translucent polar prominences.They have a
yellowish outer and a transparent inner shell
• Fertilized eggs are unsegmented at oviposition
• Embryonic development takes place outside
the host
• An unhatched,infective,first-stage larvae is
produced in 3 weeks in a favorable
warm,moist ,shaded soil
• When embryonated egg is ingested by
humans,the activated larva escapes from the
weakened egg shell in the upper small
intestine and penetrates the villus,3 to 10days
near the crypts of Lieberkuhn.Upon reaching
adolescence-down to cecum-a spearlike
projection at its anterior enables worm to
embed in intestine
• The development period from ingested egg to
ovipositing adult covers 30-90 days.lifespan 4-
6 years usually
 epidemiology
• Prevalence is high but intensity is usually light
• 80% in tropical countries
• Coextensive with that of A. lumbricoides
• Highest incidence in heavy rainfall,subtropical
climate,highly polluted soil
• Children more frequently infected than adults
• Young children who lives largely at ground
level,
• Infection results from the ingestion of
embryonated eggs via hands,food, or drink
that have been contaminated directly by
infested soil or playthings
 Pathology and symptomatology
• Trichuris primarily lives in the human
cecum,but also found in the appendix and
lower ileum
• Prolapsed rectum due to straining at frequent
stools
• 30,000 eggs per gram of feces were likely to
have evidence of disease attributable to
trichuriasis
 Chronic Trichuris infections
• 1.frequent,small,blood-streaked diarrheal
stools
• 2.Abdominal pain and tenderness
• 3.nausea and vomiting
• 4.anemia
• 5.weight loss
• 6.occasional rectal prolapse with worms
embedded in the mucosa
• 0.005 ml of blood is lost per day per each
Trichuris
• eosinophilia
 diagnosis
• Lemon-shaped eggs in stool
 treatment
• Mebendazole 100mg bid x 3 days
 prevention
• 1.treatment of infected individuals
• 2.sanitary disposal of human feces
• 3.washing of hands before meals
• 4.instruction of children in sanitation and
personal hygiene
• 5.thorough washing and scalding of uncooked
vegetables(esp impt in countries using night
soil for fertilizer)