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ZOONOTIC helminthiasis Prof Pratiwi TS Semester V 1NEMATODA -ZOONOSIS-1 pts They are like monsters!!!!

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Presentation on theme: "ZOONOTIC helminthiasis Prof Pratiwi TS Semester V 1NEMATODA -ZOONOSIS-1 pts They are like monsters!!!!"— Presentation transcript:

1 ZOONOTIC helminthiasis Prof Pratiwi TS Semester V 1NEMATODA -ZOONOSIS-1 pts They are like monsters!!!!

2 Parasitic zoonoses n Fleas n Mites n Ticks n Hydatids n Visceral larva migrans (Toxocara canis, T cati, Toxascaris leonina?) n Cutaneous larva migrans (Ancylostoma caninum, Uncinaria stenocephala) n Trichinellosis n Fascioliasis n Swimmers itch (Cercaria longicauda) 2NEMATODA -ZOONOSIS-1 pts

3 n Helminth: parasitic worm (Greek) –Platyhelminthes (flukes, tapeworms) –Nematodes- (roundworms) literally means thread-like n Pathogenic helminths are some of most common parasites n Worlwide distribution 3NEMATODA -ZOONOSIS-1 pts

4 ZOONOTIC HELMINTHIASIS n Toxocariasis (visceral/ocular larval migrans) –Toxocara canis, T. cati n Meningoencephalitis –Balysascaris procyonis n Trichinosis –Trichinella spiralis n Taeniasis –Taenia soleum, T. saginata n Hydatid disease –Echinococcus granulosus, E. multilocularis 4NEMATODA -ZOONOSIS-1 pts

5 NEMATODES n Life cycle –Reproduction Amphimictic (sexual) Parthenogenetic (from eggs without fertilization) Hermaphroditic (possess both male and female organs or reproduction) Oviparous – eggs hatch after laid Ovoviviparous – eggs hatch within uterus, live young expelled –Types of life cycle Direct- intermediate host not required Indirect – intermediate host required 5NEMATODA -ZOONOSIS-1 pts

6 TRICHINOSIS (1) n Agent: –Trichinella spiralis - intestinal nematode of many wild and domestic carnivores and omnivores –T. nativa - Arctic bears –T. pseudospiralis - mammals and birds –T. nelsoni - African predators and scavengers –T. britovi - carnivores in Europe, Western Asia n Other names for disease: –trichinellosis –trichiniasis 6NEMATODA -ZOONOSIS-1 pts

7 Larva in cyst from muscleLarva from Alaskan bear 7NEMATODA -ZOONOSIS-1 pts

8 n Agent: Larva in cyst from muscleLarva from Alaskan bear 8NEMATODA -ZOONOSIS-1 pts

9 n Life cycle: –larva released from ingested cyst –invade mucosa of small intestine where they develop into adults –after 4 weeks (life span in intestine), females release larva that migrate to striated muscle –encystment complete in 4-5 weeks note: T. pseudospiralis does not encyst –may remain viable for several years 9NEMATODA -ZOONOSIS-1 pts


11 n Reservoir: –swine, dogs, cats, rodents, many wild animals, especially bears, boars, marine mammals, and large felids n Occurrence: –worldwide, most common in Europe and US –age adjusted incidence rate: 2% Epidemiology 11NEMATODA -ZOONOSIS-1 pts

12 Epidemiology n Transmission: –ingestion of raw or undercooked meat pork and pork products bear meat marine mammal meat hamburger adulterated with pork 12NEMATODA -ZOONOSIS-1 pts

13 Clinical features n Incubation period: –generally 8-14 days; up to 45 days n Symptoms: –from inapparent to highly fatal –myalgia –edema - periorbital and facial edema –conjunctivitis –fever –eosinophilia –gastrointestinal - diarrhea, pain, vomiting 13NEMATODA -ZOONOSIS-1 pts

14 Clinical features n Life threatening symptoms: –myocarditis –CNS involvement –pneumonitis 14NEMATODA -ZOONOSIS-1 pts

15 Diagnosis n Serology –EIA ES (excretory-secretory) products - TLS-1 surface antigens conserved in all species, can be used for detection in animals or humans Ab levels not present until 3-5 weeks post infection - IgM, IgG, IgE; peak in 2-3 months IgG most sensitive used for routine screening –Bentonite flocculation n Muscle biopsy n Microscopic examination 15NEMATODA -ZOONOSIS-1 pts

16 TRICHINOSIS n Diagnosis: detection of larvae in muscle 16NEMATODA -ZOONOSIS-1 pts

17 TRICHINOSIS Treatment n Anthelmintics –mebendazole (Vermox®) –only effective against intestinal stages, not encysted stage n Corticosteriods –decrease severity of symptoms during muscle invasion phase 17NEMATODA -ZOONOSIS-1 pts

18 TRICHINOSIS Prevention n Proper cooking of pork and pork products and meat from wild animals –internal temperature should reach 160ºF (71ºC) n Irradiation of food effective –low level gamma - sterilization –higher levels - effectively kills trichinae n Freezing will inactivate larvae of T. spiralis but not of T. nativa (arctic strains) 18NEMATODA -ZOONOSIS-1 pts

19 Trichinella spiralis – trichinellosis Rodent > pig cycle Human infection from eating undercooked pork 19NEMATODA -ZOONOSIS-1 pts

20 Dogs, cats Toxocara sp., Toxascaris Horses Parascaris equorum Swine Ascaris suum Cattle Neoascaris (Toxocara) vitulorum Roundworms NEMATODA -ZOONOSIS-1 pts20

21 Toxocariasis (2) n Toxocara canis n Toxocara catti n Toxocara vitulorum 21NEMATODA -ZOONOSIS-1 pts

22 TOXOCARA VITULORUM NEMATODA -ZOONOSIS-1 pts22 Studi epidemiology 54,24%-76% Garut (Simon dan Syahrial, 1992) % Srilanka (Robert, 1992) 89 % Myanmar (Lorh et al, 1986) 75 % Bali (Gunawan dan Putra, 1982) Hasil Pengamatan UB 76 % Malang Selatan (Ifar dan Pratiwi, 1991 – INRES) 89 % Nganjuk (Pratiwi, dkk STD3 )



25 Visceral larva migrans 25NEMATODA -ZOONOSIS-1 pts

26 Cutaneous larva migrans Uncinaria stenocephala Ancylostoma caninum Direct penetration of the skin by hookworm 3rd stage larvae, which develop in the environment from eggs shed in dog or cat faeces. 26NEMATODA -ZOONOSIS-1 pts

27 Ascarids of dogs and cats n Toxocara canis, T. Cati n Toxascaris leonina n Very common & important roundworms n virtually all puppies & kittens are infected early in life n zoonotic: cause visceral & ocular larval migrans in humans NEMATODA -ZOONOSIS-1 pts27

28 Cutaneous Larval Migrans n Hookworms (Ancylostoma and Uncinaria) can produce cutaneous larval migrans n Eggs are passed n Larva develop and penetrate human skin- cases of walking barefoot in yard- Australia n Ingestion of worms leads to intestinal problems NEMATODA -ZOONOSIS-1 pts28


30 Toxocara cati n Common roundworm of wild and domestic felids n Very common in kittens, Rare in dogs n Common in feral cats, wild felids as result of ingesting paratenic hosts n rodents, chickens, birds, earthworms, cockroaches, ruminants etc n Milk based transmission only n NO transplacental transmission NEMATODA -ZOONOSIS-1 pts30

31 Adults in small intestine eggs (lots!) in feces Infective larva develops within egg in ~2-4 weeks Egg with larva ingested Larva hatches in duodenum Life cycle of T. canis NEMATODA -ZOONOSIS-1 pts31

32 Larval migration: pathway & fate of larvae varies with host age and susceptibility young hosts<12 weeks: liver- lungtracheal migration older hosts > 12 weeks: liver- lungsomatic migration Life cycle of T. canis NEMATODA -ZOONOSIS-1 pts32

33 Summary: T. canis transmission n Transplacental transmission to fetal liver via activated hypobiotic larvae in bitch n Ingestion of: * Egg in environment with infective larva NEMATODA -ZOONOSIS-1 pts33

34 NEMATODA -ZOONOSIS-1 pts34 Larvae from colostrum or milk of dam Hypobiotic larvae in paratenic host tissues Eggs, larvae or immature worms in puppy vomit or feces

35 Hookworms of dogs and cats NEMATODA -ZOONOSIS-1 pts35

36 Hookworms & Roundworms 36NEMATODA -ZOONOSIS-1 pts

37 Hookworms & Roundworms NEMATODA -ZOONOSIS-1 pts37 n Carried by dogs and cats n Kids often get infected from playing in sand boxes which animals have defecated n Or by putting toys in their mouth which have been on the ground

38 NEMATODA -ZOONOSIS-1 pts38 n Can penetrate the skin and gain entry into the human body n Bare feet are a common route of entry Hookworms (3)

39 Wearing shoes is one of the best ways to prevent parasites from entering your feet!!! 39NEMATODA -ZOONOSIS-1 pts

40 Hookworm transmission L3 (infective larvae) can be acquired by: 1. Skin penetration 2. Ingestion * In food or water * Lactogenic transmission: major source of infection of puppies * Ingestion of arrested larvae in paratenic hosts 3. Transplacental route ~unimportant 40NEMATODA -ZOONOSIS-1 pts

41 Ancylostoma caninum(4) Very common in dogs of all ages in midwest More significant problem in south & central US Infectious larval stage (L3) survive best in moist,sandy-loam soils at moderate temperatures do not survive freezing do not survive at temps >37 ºC Clinical cases more common during warm weather 41NEMATODA -ZOONOSIS-1 pts

42 Hookworms of dogs and cats Ancylostoma caninum common hookworm of dogs very rare in cats most pathogenic hookworm in dogs/cats A. tubaeforme common hookworm of felids rare in dogs 42NEMATODA -ZOONOSIS-1 pts

43 Uncinaria stenocephala (5) More prevalent in northern US less common & less pathogenic than A.caninum because it sucks less blood Structure eggs slightly larger than A. caninum Lactogenic transmission important No prenatal transmission 43NEMATODA -ZOONOSIS-1 pts

44 Persistent hookworm infection Source of infection: hypobiotic larvae in SI mucosa or muscles 1. Larvae leak out of these sites ~continuously and reach the SI lumen if animal already has adults in SI: probably shed into lumen and expelled if no hookworms present: develop to adults 2. If adult hookworms killed by an anthelmintic, arrested larvae can be activated and quickly repopulate the SI 44NEMATODA -ZOONOSIS-1 pts

45 Persistent hookworm infection Source of infection: hypobiotic larvae in SI mucosa or muscles 1. Larvae leak out of these sites ~continuously and reach the SI lumen if animal already has adults in SI: probably shed into lumen and expelled if no hookworms present: develop to adults 45NEMATODA -ZOONOSIS-1 pts

46 Hookworms: Public health importance Cause cutaneous larval migrans (CLM) linear, tortuous, erythematous and intensely pruritic eruptions caused by migration of nematode larvae in humans Most commonly caused by A. braziliense A. caninum, U. stenocephala, Bunostomum spp & Strongyloides spp. can also cause CLM Known as barnyard itch, creeping eruptionor ground itch 46NEMATODA -ZOONOSIS-1 pts

47 Typical clinical signs in pups Pot-belly Ill thrift Dull dry hair coat Abdominal discomfort Vomiting Mucoid diarrhea may alternate with constipation Toxocara in vomit/feces 47NEMATODA -ZOONOSIS-1 pts

48 Trichinella in muscle 48NEMATODA -ZOONOSIS-1 pts

49 49 Pinworm (Enterobius (4)) Extremely common, most notable in young children 400,000,000 worldwide Direct life cycle Female 8-13 mm Male 2-5 mm Image from OSU NEMATODA -ZOONOSIS-1 pts

50 50 Pinworm (Enterobius) Eggs ingested Larvae hatch in small intestine (2 molts) and migrate to colon Mature and mate Females (containing ~10,000 eggs) migrate out of anus and lay eggs on anal skin after explosive evagination of uterus Eggs become infective (embryonate) after 6 h NEMATODA -ZOONOSIS-1 pts

51 51 Pinworm (Enterobius) INTENSE ANAL ITCHING – main symptom! but many persons with low level carriage are asymptomatic Diagnosis: characteristic eggs on anal skin - detected using clear sticky tape (Scotch tape test). Sometimes worms seen in feces NEMATODA -ZOONOSIS-1 pts

52 52 Whipworm – Trichuris (5) n Similar life cycle to pinworm except adults live in colon and females release ~5000 eggs/day directly into feces. n Eggs take ~3-4 weeks to become infectious (embryonate) in soil n Infection by ingesting embryonated eggs NEMATODA -ZOONOSIS-1 pts

53 53 Whipworm - Trichuris n Often coinfecting with hookworm and Ascaris 1 billion persons Extremely heavy infections can cause rect al prolapse NEMATODA -ZOONOSIS-1 pts

54 54 Egg shape and size allows you to identify a helminth. Fecal preps Fluke eggs Often have a cap operculum Roundworms Tapeworms Flukes Urine and feces Sputum and feces NEMATODA -ZOONOSIS-1 pts

55 Tugas presentasi 55NEMATODA -ZOONOSIS-1 pts

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