Bio 51 Parasitology

Dave P. Buenavista, Ph.D. and Eric Claire Selpa, M.Sc.

Department of Biology, Central Mindanao University
Parasitolog
•yParasites-hosts
• Linnaeus is credited with the description of the
sheep liver fluke, Fasciola hepatica, and over
the next 100 years many common parasites, as
well as their developmental stages, were
described.
• Epidemiologist may need to understand
sociological and political factors, climate, local
traditions, and global economics, as well as
pharmacology, pathology, biochemistry, and
clinical medicine, to devise a scheme for
controlling parasitic infections.
Adult flukes Fasciola hepatica in bile
ducts (liver of goat)
• South Cotabato reports 33
cases from two barangays
in 2021
Symbiosi
s
 Symbiosis
• Parasitology is largely a study of symbiosis, or,
literally, “living together.”
• Some authors restrict the term symbiosis to
relationships wherein both partners benefit,
• As originally proposed by the German
scholar
A. de Bary in 1879: Any two organisms living in
close association, commonly one living in or on
the body of the other, are symbiotic, as
contrasted with free living
• Usually the symbionts are of different species
but not necessarily.
 Interactions of
Phoresis Symbionts
• Phoresis exists when two symbionts
are merely “traveling together,” and
there is no physiological or
biochemical dependence on the part
of either participant.
• Usually one phoront is smaller than
the other and is mechanically carried
about by its larger companion

Examples: bacteria on the legs of a fly or fungal spores on the feet of a beetle
Mutualism
• Relationship in which both partners benefit from the association.
• Usually obligatory, since in most cases physiological dependence has
evolved to such a degree that one mutual cannot survive without the
other.
• Example: Termites and their intestinal protozoan

Termites cannot digest cellulose because they cannot synthesize and

secrete the enzyme cellulase. The myriad flagellates in a termite’s
intestine, however, synthesize cellulase and consequently digest wood
eaten by their host. The termite uses molecules excreted as a by-
product of the flagellates’ metabolism. If we kill the flagellates by
exposing termites to high temperature or high oxygen concentration,
then the termites starve to death, even though they continue to
eat wood.
 Other examples
• Blood-sucking leeches cannot digest blood,
for example, but their intestinal bacteria,
species that are restricted to leech guts, do
the digestion for their hosts.
• Many many mites, spiders, crustaceans, and
nematodes, are infected with bacteria of
genus Wolbachia.
• Filarial nematodes such as Wuchereria
bancrofti and Onchocerca volvulus, which
cause serious human diseases, are infected
with Wolbachia, and they can be “cured” of
their bacterial infections by treating patients Section of female B. malayi worm (≈ 200×)
showing many bacteria (red) concentrated in
with antibiotics. But then the worms die the hypodermal lateral cords and around the
too! uterus (ut) (arrows) as well as within
microfilaria (mf)
 Cleaning symbiosis
• Behavioural phenomenon that occurs between certain crustaceans and small fish
—the cleaners—and larger marine fish on coral reefs. Cleaners often establish
stations, which the large fish visit periodically, and the cleaners remove
ectoparasites, injured tissues, fungi, and other organisms.
• Some evidence exists that such associations may be in fact obligatory; when all
cleaners are carefully removed from a particular area of reef, for example, all the
other fish leave too.

Two adult bluestreak cleaner wrasse Labroides dimidiatus (represented by the white arrows) inspect and clean the mouth and
the gills of the parrotfish Scarus frenatus
 Commensalism
• One partner benefits from the association, but the host is neither
helped nor harmed. The term means “eating at the same table,” and
many commensal relationships involve feeding on food “wasted” or
otherwise not consumed by the host.

• A remora is a slender fish

whose dorsal fin is modified
into an adhesive organ,
which it attaches to large
fish, turtles, and even
submarines!
• The remora gets free rides
and scraps, but it does not
harm the host or rob it of
food.

Pilot fish (Naucrates spp.) and remoras (Echeneidae) and sharks

 facultative or obligate
• Commensalism may be facultative, in the sense
that commensal may not be required to
participate in an association to survive. Stalked
ciliates of the genus Vorticella are frequently
found on small crustaceans, but they survive
equally well on sticks in the same pond.
• Related forms, however, such as Epistylis spp., are
evidently obligate commensals, because they are
not found except on other organisms, especially
crustaceans
• Humans harbor several species of
commensal protozoans, such as Entamoeba
gingivalis. This ameba lives in the mouth,
where it feeds on bacteria, food particles,
and dead epithelial cells but never harms
healthy tissues. It has no cyst or other
resistant stage in its life cycle.
• Adult tapeworms are universally regarded
as parasites, yet some have no known ill
effects on their host.
Parasitism
• Parasitism is a relationship in which one of the
participants, the parasite, either harms its host
or in some sense lives at the expense of the
host.
• Parasites may cause mechanical injury, such as
boring a hole into the host or digging into its
skin or other tissues, stimulate a damaging
inflammatory or immune response, or simply
rob the host of nutrition. Most parasites inflict
a combination of these conditions on their
hosts.
 Types of Parasites
• Ectoparasite (infestation) vs Endoparasite (infection)
• Obligate vs Facultative parasites
• Most parasites are obligate parasites;
that is, they cannot complete their life
cycle without spending at least part of
the time in a parasitic relationship.

• However, many obligate parasites have

free-living stages outside any host,
including some periods of time in the
external environment within a protective
eggshell or cyst.

Facultative parasites are not normally parasitic but can become so when they are accidentally eaten or
enter a wound or other body orifice. Two examples are certain free-living amebas, such as Naegleria
fowleri (“brain-eating amoeba”), and free-living nematodes belonging to genus Halicephalobus . Infection
of humans with either of these is extremely serious and usually fatal.
• When a parasite enters or attaches to the body
of a species of host different from its normal one,
it is called an accidental, or incidental, parasite.

For instance, it is common for nematodes, normally parasitic in

insects, to live for a short time in the intestines of birds or for a
rodent flea to bite a dog or human. Accidental parasites usually do
not survive in the wrong host, but in some cases they can be
extremely pathogenic.

Rat tapeworms (Hymenolepis diminuta) are good examples of

accidental parasites. Although they must affect rats, these
parasites have been shown to affect human beings.
• Erratic parasite - is one that wanders in to an organ in which it is not
usually found. E.g. Entamoeba histolytica in the liver or lung of
humans.

Life cycle of Entamoeba histolytica

• Some parasites live their entire adult lives within or on their hosts and
may be called permanent parasites, whereas a temporary, or
intermittent, parasite, such as a mosquito or bed bug, only feeds on
the host and then leaves.
• Temporary parasites are often referred to as micropredators, in
recognition of the fact that they usually “prey” on several different
hosts (or the same host at several discrete times).
• Predation and parasitism are conceptually similar in that both the
parasite and the predator live at the expense of the host or prey.
What is the difference?
Parasitoids
• are insects, typically wasps or flies (orders Hymenoptera and Diptera,
respectively), whose immature stages feed on their host’s body,
usually another insect, but finally kill the host.
• Parasitoids resemble predators in this regard, but they only require a
single host individual.

A tobacco hornworm that has been killed by Cotesia larvae

which have pupated outside the host.
 Protelean parasites
• Are insects in which only the immature stages are parasitic.
Mermithid nematodes and hairworms (Phylum Nematomorpha) may
also be considered protelean parasit

Mature juvenile grasshopper nematodes, Mermis nigrescens Dujardin, that have left the body of a grasshopper.
Photograph by John Capinera, University of Florida.
 Host
s
• A definitive host is one in which the parasite
reaches sexual maturity. Sexual reproduction has
not been clearly shown in some parasites—such as
amebas and most trypanosomes—and in these
cases we arbitrarily consider the definitive host the
one most important to humans.
• Definitive hosts are often but
not necessarily vertebrates;
malarial parasites,
Plasmodium spp., reach
sexual maturity and undergo
fertilization in mosquitoes,
which are therefore by
definition their definitive
hosts, whereas vertebrates
are the intermediate hosts
• An intermediate host is one that is required for parasite development but
one in which the parasite does not reach sexual maturity.
• harbors the larval stages of the parasite or an asexual cycle of development
takes place. In some cases, larval development is completed in two different
intermediate hosts, referred to as first and second intermediate hosts.
• A paratenic or transport host is one in
which the parasite does not undergo any
development but in which it remains alive
and infective to another host.
• Paratenic hosts may bridge an ecological gap
between the intermediate and definitive
hosts.
• The host that serves as a temporary refuge
and vehicle for reaching an obligatory host,
usually the definitive host, i.e. it is not
necessary for the completion of the
parasites life cycle. In the example of
phoresis, the mosquito would be a paratenic
host of Dermatobia hominis.
• Reservoir host – a host that makes the parasite
available for the transmission to another host
and is usually not affected by the infection

• Natural host – a host that is naturally infected

with certain species of parasite.
• Accidental host – a host that is under normal
circumstances not infected with the parasite
 Vectors
• Responsible for transmitting parasite from one host to
another.
• Biologic vector – transmits the parasite only after the latter
has completed its development within the host.
• Essential part of parasite’s life cycle
• Ex. When an Aedes mosquito sucks blood from a patient with filariasis,
the parasite undergoes several stages of development from 1st stage
larva to 3rd stage larva before the latter (infection stage) is transmitted
to another susceptible host.
• Mechanical or phoretic vector – they only transport the
parasite.
• Example, flies and cockroaches that feed on fecal material may carry
enteric organisms and transfer theses to food, which could be ingested
by humans
 Host specificity
• Most parasites develop only in a restricted
range of host species. That is, parasites exhibit
varying degrees of host specificity, some
infecting only a single host species, others
infecting a number of related species, and a
few being capable of infecting many host
species.
• The pork tapeworm, Taenia solium, apparently
can mature only in humans, so adult T. solium
have absolute host specificity. The nematodes
Trichinella spp. seem to be able to mature in
almost any mammal.
Trichinellosis, also called trichinosis, is a disease that people can get by eating raw or undercooked meat from animals
infected with the microscopic parasite Trichinella.
• Any animal that harbors an infection that can be transmitted to
humans is called a reservoir host, even if the animal is a normal host
of the parasite.
• Examples are rats and wild carnivores with Trichinella spiralis, dogs
with Leishmania spp., and armadillos with Trypanosoma cruzi, the
causative agent of Chagas’ disease.
• Finally, many parasites host other parasites, a condition known as
hyperparasitism. Examples are Plasmodium spp. in mosquitoes, a
tapeworm juvenile in a flea, a monogene (Udonella caligorum) on a
copepod parasite of fish, and the many insects whose larvae
parasitize other parasitic insect larvae.
Host parasite relationship
Host parasite relationship
• Infection is the result of entry and development within the body of any
injurious organism regardless of its size. Once the infecting organism is
introduced into the body of the host, it reacts in different ways and this
could result in:
• a. Carrier state - a perfect host parasite relationship where tissue
destruction by a parasite is balanced with the host’s tissue repair. At
this point the parasite and the host live harmoniously, i.e. they are at
equilibrium.
• b. Disease state - this is due to an imperfect host parasite relationship
where the parasite dominates the upper hand. It can result either from
lower resistance of the host or a higher pathogenecity of the parasite.
• c. Parasite destruction – occurs when the host takes the upper hand.
 Parasitology and Human welfare
• Humans have suffered greatly through the
centuries because of parasites.
• Fleas and their obligate symbiont bacteria
together destroyed a third of the European
population in the 17th century, and malaria,
schistosomiasis, and African sleeping sickness
have sent untold millions to their graves.
• Even today, after successful campaigns against
yellow fever, malaria, and hookworm
infections in many parts of the world, parasitic
diseases in association with nutritional People who died of bubonic plague in a mass
deficiencies are the primary killers of humans. grave from 1720 to 1721 in Martigues, France
Recent summaries of worldwide prevalence
of selected parasitic diseases
 2015 Nobel Prize in Physiology or Medicine
jointly with William C. Campbell and Satoshi Ōmura

For her breakthrough in twentieth-century tropical medicine, saving millions of lives in South China,
Southeast Asia, Africa, and South America.
• The majority of the more serious infections occur in tropical regions,
particularly in less-developed countries, so most dwellers within
temperate, industrialized regions are unaware of the magnitude of
the problem.
• The global prevalence (proportion of a population infected) of Ascaris
lumbricoides was estimated in 2003 at 26%, that of Trichuris trichiura
at 17%, and of hookworm at 15%.
• These figures remained virtually unchanged for 50 years, despite the
fact that the earth’s population had more than doubled in that
period!
• The notion held by the average person that
humans in the United States are free of worms
is largely an illusion!
• Some estimates place the number of children in
the United States infected with worms at about
55 million. This is a gross underestimate if one
includes pinworms (Enterobius vermicularis) ,
which infect people of all socioeconomic
groups.
• Some authorities believe that infection with
juveniles of dog roundworm (Toxocara canis)
may be more common than pinworm infection
in the United States and Canada
• Some one-celled parasites, such as
Pneumocystis, Toxoplasma, and
Cryptosporidium, are among the most
common opportunistic infections in patients
with acquired immunodeficiency syndrome
(AIDS).
• The first infection of Cyclospora cayetanensis
in humans was diagnosed in 1977, and it was
reported only sporadically between 1977 and
1996. In 1996 and 1997 there were many
Cyclosporiasis is an intestinal illness
outbreaks involving hundreds of people in the caused by the microscopic parasite
United States. Cyclospora cayetanensis. People can
become infected with Cyclospora by
consuming food or water contaminated
with the parasite.
https://www.rappler.com/environment/how-bukidnon-
quinine-helped-world-war-2-allies-pacific/
 Parasites of domestic and wild animals
• Both domestic and wild animals are subject to a
wide variety of parasites.
• Although wild animals are usually infected with
several species of parasites, they seldom suffer
massive deaths, or epizootics, because of the
normal dispersal and territorialism of most
species.
• For example, the protozoa known as coccidia
thrive under crowded conditions; they may
cause up to 100% mortality in poultry flocks,
28% reduction in wool in sheep, and 15%
reduction in weight of lambs.
• Infections in poultry are controlled by the costly
method of prophylactic drug administration in
feed. Unfortunately, coccidia have become Coccidiosis is the clinical illness caused by infection with
resistant to one drug after another the protozoan parasite genus Eimeria (coccidia)
• Another important aspect of animal
parasitology is transmission to humans of
parasites normally found in wild and
domestic animals. The resultant disease
is called a zoonosis.

• Zoonoses are diseases naturally transmitted from animals to humans.

• They can pass from animals to humans in several important ways.
• Many zoonoses are rare and cause
little harm, but some are more
common and important to public
health. An example is trichinosis, a
serious disease caused by a minute
nematode, Trichinella spp. These
worms exist in several sylvatic cycles
that involve wild animals and in an
urban or domestic cycle chiefly
among rats and swine.
• People become infected when they
enter the cycles, such as by eating
undercooked bear or pork.
• Another zoonosis is
echinococcosis, or hydatid disease,
in which humans accidentally
become infected with juvenile
tapeworms when they ingest eggs
from dog feces.
• Toxoplasma gondii, which is
normally a parasite of felines and
rodents, is now known to cause
many human birth defects.
Exposure and
Infection
• Majority of the parasites are pathogens – harmful and can cause
mechanical injury to their hosts.
• Carrier – harbors a particular pathogen without manifesting any sign
and symptoms.
• What’s the difference between exposure and infection?
• Exposure is the process of inoculating an infective agent, while infection
connotes the establishment of the infective agent in the host.
• Incubation period is the period between infection
and evidence of symptoms. It is sometimes referred
to as clinical incubation period.
• The pre-patent period, also known as the biologic
incubation period, is the period between infection or
acquisition of the parasite and evidence or
demonstration of infection.
• Autoinfection – results when an infected
individuation becomes his own source of infection. In
enterobiasis, infection may occur through hand-to-
mouth transmission. Infective eggs may end up in the
hands by scratching the perianal areas where the
gravid females lay their eggs.
 Sources of
infection
• Contaminated soil
• Lack of sanitary toilets
• Use of night soil or human excrete as fertilizer allows
eggs to come in contact with the soil and favor the
development of Ascaris lumbricoides, Trichuris night soil collectors
trichiura, Strongyloides stercoralis, and hookworm.
• Contaminated water
• Contaminated with cysts of ameba or flagellates, as
well as cercariae of Schistosoma.

Patients with severe schistosomiasis

 Sources of
infectionFood
• Contaminated
• Consumption of undercooked or raw freshwater fish can result
in several intestinal and liver fluke infections.
• Raw crabs are considered a delicacy in areas where
paragoniamiasis is endemic.
• Bullastra snails are associated with Artyfechinostomum
malayanun infection.

An adult (A), egg (B), snail host, Pila

sp. (C), and metacercaria (D) of
Artyfechinostomum malayanum
obtained in Cambodia. The snail
host was purchased in a local
market of Phnom Penh.
Paragoniamiasis caused by lung fluke
• Arthropods can also transmit
infection
• Mosquitoes are vectors for
malaria and
filarial parasites.
• Triatoma bugs are carriers of
Trypanosoma cruzi causing Chagas
disease.
• Sand flies (ex., Phlebotomus spp.) are
the natural vectors of all types of
Leishmania.
• Animals, both wild and
domesticated
• Cats are direct sources of Toxoplasma Leishmaniasis
infection.
• Rats may be infected with Hymenolepis
nana. Phlebotomine sand flies
 Other sources of infection
• Another person, his/her beddings and
clothing, as well as the immediate
environment, or even one’s self.
• Asymptomatic carriers of Entamoeba
histolytica working as food handlers in food
establishments may be important sources of
infection.
• Autoinfection, where the infected person
himself is the source of infection, is seen in the
life cycles of Capillaria philippinensis, Enterobius The definitive host of Capillaria philippinensis are fish
eating birds. Fish, the intermediate hosts, ingest eggs in
vermicularis, Hymenolepis nana, and fresh water, and larvae migrate to muscle tissues. Most
human infection are seen in South East Asia where
Strongyloides stercoralis outbreaks may occur following ingestion of raw or
undercooked fish, such as in this dish koi pla.
 Modes (route) of transmission
• Food borne – eating food harboring the infective larval
stage; includes intestinal protozoans, cestodes, and
trematodes. Ex., Taenia solium, Taenia saginata, and Cysticercosis in pork.
Diphyllobothium latum. The larval cysticercoid stage occurs in the
pig, giving rise to ‘measly pork’. Humans
• Ingesting raw or improperly cooked freshwater fish acquire the tapeworm by ingesting
inadequately cooked meat.
containing infective larvae. Ex., Clonorchis, Opistorchis,
and Haplorchis
• Drinking contaminated water with cysts.
• Skin penetration. Ex., Hookworms and Strongyloides –
enter via exposure of skin to soil, while Schistosoma
species enter skin via water.
 Modes (route) of transmission
• Arthropods serve as vectors and transmit parasites
through their bites. Examples are agents of malaria,
filariasis, leishmaniasis, trypanosomiasis, and babesiosis.
• Congenital transmission – Toxoplasma gondii
trophozoites can cross the placental barrier during
pregnancy.
• In transmammary infection with Ancylostoma and
Strongyloides, the parasites may be transmitted through
mother’s milk.
• Inhalation of airborne eggs. Ex., Enterobius
• Sexual intercourse – Trichomonas vaginalis
Hydrocephalus in congenital toxoplasmosis. Vertical transmission may
occcur and acquisition of infection during early pregnancy is associated
with the congenital toxoplasmosis syndrome which can result in major
neurological impairment in survivors. (Courtesy, Dr M. Dynski-Klein.)
Nomenclature
• Animal parasites are classified according to the International Code of
Zoological Nomenclature.
• Each phylum is divided into classes, which are further subdivided into
orders, families, genera, and species. At times, it is further subdivided
into suborder, superfamily, and subspecies.
• Scientific names are latinized
• Family names are formed by adding -idea to the stem of the genus.
• Recall the proper way of writing scientific names!
Epidemiologic measures
• Epidemiology – the study of patterns, distribution, and occurrence of
disease
• Incidence – the number new cases of infection appearing in a
population in a given period of time.
• Prevalence – the number of individuals (usually expressed as
percentage) in a population estimated to be infected with a parasite
at a given time.
• Cumulative prevalence – the percentage of individuals in a population
infected with at least one parasite.
• Intensity of infection – refers to burden of
infection that is related to the number of worms
per infected person.
• Measured directly or indirectly, ex., counting the
expelled worms during treatment, or indirectly by
counting helminth eggs excreted in feces.
• The latter is expressed as the number of eggs per
gram (epg).
• Clinical consequences of infections or diseases
that affect an individual’s well-being refer to
morbidity.
Treatment
• Deworming – the use of antihelminthic drugs in an individual or
public health program.
• Cure rates – refers to the number of previously positive subjects found to be
egg negative on examination of a stool or urine sample after deworming.
• Egg reduction rate (ERR) – the percentage fall in egg counts after deworming
based on examination of a stool or urine samples.
• Parasitic worm infection may be treated by administering deworming
drugs, Albendazole, or Menbendazole.
• Selective deworming – involves individual-level deworming with
selection for treatment based on diagnosis of infection or an
assessment of the intensity of infection, or based on presumptive
grounds.
Treatment
• Targeted treatment – is group level deworming
where the (risk) group to be treated (without
prior diagnosis) may be defined by age, sex, or
other 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.
• National School Based
Deworming month (NSDM)
aims to deworm 17,813,379
children in public schools
ages 5-18 years old.
• Community Based
Deworming month (CBDM)
targets 10,572,404 preschool
children ages 1-4 years old
and 15,471,889 children not
enrolled in public schools
through various health
centers and rural health units
under the LGUs.
Treatment
• Preventive chemotherapy – is the regular, systematic, large-scale
intervention involving the administration of one or more drugs to
selected population groups with the aim of reducing morbidity and
transmission of selected helminth infections
• Coverage – the proportion of the target population reached by an
intervention. It could be the percentage of school-age children during
a treatment day.
• Efficacy – is the effect of a drug against an infective agent in an ideal
experimental conditions and isolated from any context.
Treatment
• Effectiveness – is the measure of the effect of a drug against an
infective agent in a particular host, living in a particular environment
with specific ecological, immunological, and epidemiological
determinants.
• Usually measured by means of qualitative and quantitative diagnostic tests
that detect eggs or larvae in feces or urine after an optimal time interval,
which is variable for each parasite.
• Cure rate and egg reduction rate are indicators that are commonly used to
measure the reduction in prevalence and reduction of intensity of infection,
respectively.
• Drug resistance – is genetically transmitted loss of susceptibility to a
drug in a parasite population that was previously sensitive to the
appropriate therapeutic dose.
Prevention and
Control
• Morbidity control – is the avoidance of illness caused by infections. It may
be achieved by periodically deworming individuals or groups, known to be
at risk of morbidity
• Information-education-communication (IEC) – is a health education
strategy that aims to encourage people to adapt and maintain healthy life
practices.
• Environmental management – is the planning, organization, performance,
and monitoring of activities for the modification and/or manipulation of
environmental factors or their interaction with human beings with a view
to preventing or minimizing vector or intermediate host propagation and
reducing contact between humans and the infective agent.
 Prevention and
Controlsanitation – involves interventions to
• Environmental
reduce environmental health risks including the safe
disposal and hygienic management of human and
animal excreta, refuse, waste water.
• Involves the control of vectors, intermediate hosts, and
reservoirs of disease.
• It covers the provision of safe drinking water and
food safety
• Housing that is adequate in terms of location,
quality of
shelter, and indoor living conditions.
• Facilities for personal and domestic hygiene
• Safe and healthy working conditions
• Sanitation – is the process of access to adequate
facilities for the safe disposal of human excreta, usually
Eradication versus elimination
• Disease eradication – is defined as a permanent reduction to zero of
the worldwide incidence of infection caused by a specific agent, as a
result of deliberate efforts. Once this is achieved, continued measures
are no longer needed.
• Disease elimination – is a reduction to zero of the incidence of a
specified disease in a defined geographic area as a result of deliberate
efforts. Continued intervention or surveillance measures are still
required.
Let’s not forget what we went through
Full paper is available at: https://www.nature.com/articles/s41598-021-91470-2
According to DOH
“Eat, drink, and be merry, for tomorrow
we
”