Parasitology (Trematodes & Cestodes) Study Objectives From the selected trematode and cestode parasites that follow, recall the basic physiology and morphology, pathogenesis, life cycle and transmission and subsequent host response (if given). Trematodes: −Fasciola hepatica −Opisthorchis sinensis −Paragonimus westermania −Schistosoma mansoni, S. haematobium, S. japonicum Cestodes: −Taenia solium, T. saginata −Echinococcus granulosus −Diphyllobothrium latum Randal K. Gregg, PhD READING: Medical Microbiology chapters 84-85
Life Cycle FascioliasisFascioliasis TransmissionTransmission −Foodborne/Waterborne −Ingestion of metacercariae in contaminated unwashed watercress (also water itself) Reservoirs = sheep, cattle also can complete life cycle Eggs passed in feces (mature 9-15 d in environment)…require light to hatch Fasciola hepatica 1 fluke = ~20,000 eggs/d 24 h SEXUAL ASEXUAL ~12 mo 5-10 yrs
Life Cycle OpisthorchiasisOpisthorchiasis −Also caused by O. felineus and O. viverrini TransmissionTransmission −Foodborne −Ingestion of metacercariae in contaminated raw fish (12 spp.) −Also contaminated frozen, dried, salted, smoked, pickled fish Reservoirs = dogs, cats Eggs do not hatch in water…require snail ingestion 50 yrs 1 fluke = ~4,000 eggs/d SEXUAL ASEXUAL Opisthorchis sinensis
Life Cycle ParagonimiasisParagonimiasis TransmissionTransmission −Foodborne / Fecal-oral −Ingestion of metacercariae in contaminated raw crustaceans (crabs, crayfish) Reservoirs = bird, pigs, dogs, cats (also can serve as definitive hosts) Eggs coughed out in sputum or swallowed and passed in feces Eggs have prolonged maturation in water Paragonimus westermani 5-20 yrs SEXUAL ASEXUAL ~3-4 mo ~ wks ~6-8 wks Survive only hrs Survive 1-4 d
Life Cycle TaeniasisTaeniasis −T. saginata (beef tapeworm) −T. solium (pork tapeworm) TransmissionTransmission −Foodborne / Fecal-oral −Ingestion of contaminated undercooked beef or pork containing cysticercus −Also ingestion of egg- contaminated food (T. solium) Attach in the jejunum Eggs of T. solium are infective for humans (intermediate host) Taenia spp yrs Can survive 5 mo Muscle of tongue, diaphragm, hindqtrs ~3-4 mo Survive 5 yrs Any tissue (brain, skin, muscle) Mature ~2-3 mo SEXUAL ASEXUAL 1 proglottid = 100,000 eggs (T. saginata); 50,000 eggs (T. solium)
Pathogenesis Cysticercosis Humans as intermediate host Cysticerci dispersed by circulation: Subcutaneous Muscles Heart Lungs Liver Brain Eyes Asymptomatic if: Number of cysticerci is small Cysticerci remain viable Symptoms (death of cysticerci): Inflammation in infested tissue Fever Arthralgia Eosinophilia Neurological sequelae (epilepsy, seizures,…) Death (encephalitis, stroke, intracranial pressure) 50,000 deaths (1,000 cases in US annually) Taenia spp.
Life Cycle Agent of Human Echinococcosis (Hydatidosis, Hydatid Disease)Agent of Human Echinococcosis (Hydatidosis, Hydatid Disease) TransmissionTransmission −Fecal-oral −Ingestion of eggs (from soil, water, food) Definitive hosts = dogs, wolves, other canines Intermediate hosts = sheep, goats, camels, deer, caribou, moose, humans (or dead-end) Echinococcus granulosus 5 mo 1-3 mo 12 mo SEXUAL ASEXUAL Grow over 5-20 yrs Viable 1 yr
Life Cycle Agent of Diphyllobothriasis (Fish Tapeworm Disease)Agent of Diphyllobothriasis (Fish Tapeworm Disease) TransmissionTransmission −Foodborne / Fecal-oral −Ingestion of undercooked contaminated freshwater fish containing plerocercoid larvae Reservoirs = dogs, pigs, bears, cats, birds Attach to the ileum Eggs mature & hatch upon contact with water ZOONOTIC Diphyllobothrium latum 1 worm = >1,000,000 eggs/d Viable 3 yrs SEXUAL 5-20 yrs