MEDICAL

HELMINTOLOGY
 Phylum
Platyhelminthes.
Class Trematoda
 GENERAL CHARACTERISTICS OF
HELMINTHS
• Most helminthic worms are macroscopic in
size and often visible to naked eye.
• All helminths with a few exceptions produce
eggs.
• Life cycle of helminths may be completed in
one or more than one hosts.
• According to the way of development
parasites are classificated into
biohelminthes and geohelminthes.

• Geohelminthes develop without

intermediate hosts.

• Biohelminthes complete their life cycle

with intermediate hosts.
• Helminths or parasitic worms are
multicellular, bilaterally symmetrical,
elongated, flat or round helminth
animals.
Helminths which occur as parasites in
humans belong to two phyla:
• • Phylum Platyhelminthes
• • Phylum Nemathelminthes
 PHYLUM PLATYHELMINTHES
The platyhelminthes or flatworms are
dorsoventrally flattened, leaf-like or tape-
like. Their alimentary canal is incomplete
or entirely lacking and body cavity is
absent. They are mostly hermaphrodites
(monoecious). Human pathogenic
helminths of this phylum belong to two
classes - the Cestoidea and the
Trematoda.
 General characteristic of Class Trematoda
- Flattened dorsoventrally (leaf-
like). Size from 1 mm to several
centimeters in length.
- Unsegmented.
- Body is covered by cuticle.
- Organs of fixation: oral sucker
through which the digestive tract
opens, ventral
sucker(acetabulum) for
attachment
-Trematodes are hermaphrodites
except genus Schistosoma.
• Life cycle
• Trematodes pass their life cycle in two
different hosts. Man, who harbours the
adult worm, is the definitive host and a
freshwater snail or mollusc is the
intermediate host. A second
intermediate host (fish or crab) is
required for encystment in some
trematodes.
Life Cycle Overview
• Eggs(1) leave the host and are
either eaten by a snail in which they
hatch, or they hatch in the water
and become a ciliated free-
swimming larva called the
miracidium (2); if it is a free-
swimming miracidium it must
penetrate the snail host
•Soon after penetration, the larva discards
its ciliated epithelium and
metamorphoses into a simple sac-like
sporocyst (3)
• Germinal cells within the sporocyst
develop into rediae (4), these mature and
emerge from a birth pore or are liberated
by rupture of the sporocyst
• Each germ cell in the rediae develops
into a cercaria (5), which mature and
emerge from a birth pore or are liberated
by rupture of the rediae
Life Cycle Overview cont.

•Cercaria leave the snail host and are

propelled through the environment by a
tail-like structure
• Cercaria usually develop into encysted
metacercariae (6) in a second
intermediate host
• The fully developed, encysted
metacercaria is infective to the definitive
host and develops there into the adult
trematode (7)
 BLOOD FLUKES
• Transmission: infection
through skin of larvae
from snail hosts.

• Infective stage: cercaria.

• Intermediate host: snail.

• Definitive host: man.

• Mode of transmission:
penetration of skin by
cercaria.
 Schistosomiasis
• Schistosomiasis is an infection with blood
flukes and is a major infectious diseases.

• More then 200 million people are infected

worldwide with these flukes, which they
acquire swimming or walking in water in
which the intermediate snail host lives
 Schistosomiasis
• Schistosome eggs enter the water when
infected people defecate in or near water.

• Eggs hatch and the miracidium seeks out a

snail. Inside the snail the parasite develops
into a sporocyst and asexual reproduction
takes place. Cercaria eventually is released
into the water.
 Schistosomiasis
• When a schistosome cercaria swims it takes
care to avoid UV light which can damage it,
but it is very sensitive to the scent of humans.

• When it senses molecules from human skin it

swims rapidly and jerks around looking for the
person. When it makes contact it releases
chemicals that soften the skin and it burrows
in shedding its tail at the same time.
Prophylaxis
Preventive measures include the following:
• Prevention of pollution of water with human
excreta.
• Avoidance of swimming, bathing, or washing in
infected water.
• Effective treatment of infected persons to lessen
the likelihood of water pollution.
 LUNG FLUKE: PARAGONIMUS WESTERMANI –

( paragonimiasis )
• Distribution: Far East,
Central America, Africa,
and India.
• Morphology: an egg-
like form of the body,
from 7,5 to 16 mm.

• Life span of adult worm

is about 6-7 years
 LUNG FLUKE
• Mode of transmission:
ingestion of metacercarial
cysts in crabs or crayfish.
• Final hosts: carnivorous
mammals, pigs, humans.
• Intermediate hosts:
• 1) snail (sporocyst, redia,
cercaria);
• 2) crabs or crayfish
(metacercaria).
• Infective stage: metacercariae
 LUNG FLUKE
• Clinical disease: a chronic cough with bloody
sputum, dyspnea, chest pain, and pneumonia.
• Laboratory diagnosis: eggs in sputum or
faeces.
• Prevention: cooking crabs and crayfish
properly.
 LIVER FLUKES
FASCIOLA HEPATICA ( fascioliasis.)

• Fascioliasis occurs worldwide. Human

infections with F. hepatica are found
in areas where sheep and cattle
are raised.
Localization: bile ducts, gallbladder,
and pancreas.
• Morphology: large size (3-5 cm) and
conical form of the body
• sucking disks (oral and ventral)
• Multibranched uterus is situated
under the ventral sucking disk.
• Testis are branched too and located
in the middle part of the body.
 FASCIOLA HEPATICA
• Life-cycle:
• Final host -
herbivorous mammals
(horses) and human.
• Intermediate host —
the snail
• Transmission: fecal-
oral
• Invasive stage:
adolescariae.
 FASCIOLA HEPATICA
• Diagnosis: detection
of eggs in stool.

• Prophylaxis:
avoidance of eating
raw or undercooked
aquatic vegetation.
 OPISTHORCHIS FELINEUS
• Opisthorchiasis.
• Common name: The cat liver
fluke
• Morphology:
• They are thin, lancet-shaped
and measure 7-12 mm in
length by 2-3 mm in breadth.
• In the middle part of the body
there is a branched uterus.
• Behind it there is a round
ovary.
•
OPISTHORCHIS
Life-cycle:
FELINEUS
• Final host - carnivorous
mammals and human.
• Intermediate host
• 1) - snail
• 2) - fish.
• Transmission: ingestion of fish,
which contains metacercariae.

• Invasive stage: metacercariae

cysts in fish muscles.

• Localization: bile ducts,

gallbladder, liver.
 OPISTHORCHIS FELINEUS

• Diagnosis: eggs in stool.

• Prophylaxis avoidance of eating
undercooked or contaminated raw,
frozen fish