1. Department of Parasitology
Human Parasitology
Shandong University
Department of Parasitology
He Shenyi （何深一 ）
MD, Ph.D. Professor

3. Introduction to Human Parasitology
Concept of Human Parasitology
The Scope of Human Parasitology
Terms of Parasitology
Parasites’ Harms to Man
Human Immunity against Parasites
Characteristics of parasitic diseases

4. Human parasitology
Human parasitology is the study of those organisms which parasitise humans.  According to the very broad definition of parasitology, parasites should include the viruses, bacteria, fungi, protozoa and metazoa (multi-celled organisms) which infect their host species.  However, for historical reasons the first three have been incorporated into the discipline of Microbiology. 

5. 2. The Scope of Human Parasitology
Parasitology claims those protozoa (single celled animals), helminths (worms) and arthropods whose existence depends on the availability of host animals It is also possible to argue about whether certain insects and mites are "temporary parasites" or "micro-predators", insects as a group belong to the discipline of Entomology, while ticks and mites are the concern of Acarology.  The insects that are of most interest in human parasitology are those that are vectors of several parasitic infections.

6. Human Parasitology Class Lobosea Class Zoomastigophorea Medical
Class Sporozoa
Class Ciliophora
Medical
Protozoology
Human Parasitology
Class Nematoda
Class Trematoda
Class Cestoda
Class Metacanthocephala
Medical
Helminthology
Class Insecta
Class Arachnida
Class Crustacea
Class Chilopoda
Medical
Arthropodology

7. Class Lobosea
Entamoeba histolytica
Non-pathogenic amoeba

8. Class Zoomastigophorea
Leishmania sp
Giardia
Trichomonas vaginalis

9. Class Sporozoa Plasmodium spp Toxopasma gondii Cryptosporidium
Pneumocycstis carinii

10. Class Ciliophora
Balantidium coli

12. Class Nematoda Trichuris trichiura Hookworm Enterobius vermicularis
Ascaris lumbricoides
Trichuris trichiura
Hookworm
Enterobius vermicularis
Filaria
Trichinella spiralis

13. Nematoda

14. Class Trematoda Fasciolopsis buski Paragonimus westermani
Clonorchis sinensis
Fasciolopsis buski
Paragonimus westermani
Schistosoma japonicum

15. Trematoda

16. Class Cestoda
Taenia solium
Taenia saginata Echinococcus granulosus

17. Cestoda

18. Class Metacanthocephala
Macracanthorhynchus
hirudinaceus

19. Lice Sandflies , Fleas Class Insecta Anopheles sinensis
Lucilia sericata
Lice
Sandflies , Fleas

21. Class Arachnida
Ticks; Mites
Sarcopes scabiei
follicle mite

22. Class Crustacea
Cambaroides
Potamon  

23. Class Chilopoda
centipede

24. 4. Terms of Parasitology

25. Symbiosis
(1)Symbiosis（共同生活）Two different organisms live together and interact, in this association one partner lives in or on another one’s body. including 3 types:Mutualism, Commensalism, Parasitism.

26. Symbiosis
*(2)Mutualism(互利共生）is a permanent association between two different organisms that life apart is impossible, two partners benefit each other, such as termites and flagellates.
The mutuals are metabolically dependent on one another; one cannot survive in the absence of the other.

28. Symbiosis
(3) Commensalism（片利共生或共栖）is the association of two different organisms, in which one partner is benefited while the other neither benefited nor injured, such as E. coli and man.
(4) Parasitism（寄生关系）is the association of two different organisms, in which one partner is benefited while the other is injured, such as Ascaris lumbricoides and man.

29. Parasite
(5) Parasite（寄生虫） In parasitism, it is the benefited partner. It is an animal organism which lives in or on the host in order to obtain nourishment and shelter from the host as well as does harms to the host.

30. Parasite
endoparasite ectoparasite temporary parasite permanent parasite obligatory parasite facultative parasite accidental parasite opportunistic parasite

31. Endoparasite

32. Ectoparasite

33. Host
(6) Host（宿主） In parasitism, it supplies the parasite with nourishment and shelter, it is the injured partner.
(7) Carrier（带虫者） A person who harbours parasite has no clinical symptoms, is an important source of infection in epidemiology.

34. (8) Definitive (final) host（终宿主）harbours adult or sexually reproductive stage of a parasite. (9) Intermediate host（中间宿主）harbours larval or asexually reprodctive stage of a parasite, according to priority they are classified into first intermediate host, second intermediate host, third intermediate host.

35. (10) Reservoir hosts（保虫宿主）are the vertebrate hosts which harbour the same species of parasite at same stage as a human host. They are an important source of infection in epidemiology.

36. Zoonosis
(11) Zoonosis（人兽共患病）refers to animal’s diseases which can be transmitted to man. (These animals infected with parasites are called reservoir hosts.)

37. (12) Paratenic host or transport host（转续宿主）is an abnormal host in which some parasitic larvae can survive but can’t develop into adults. If the larvae have a chance to enter their appropriate hosts, they can continue to develop into adults there.

38. (13)  Larva migrans（幼虫移行症）means that the larvae living in their abnormal hosts in which they can not grow into adults but can wander everywhere and cause the local and systemic pathological lesions of the hosts.

39. Life cycle
(14) Life cycle（生活史） is the process of a parasite’s growth, development and reproduction, which proceeds in one or more different hosts depending on the species of parasites. (15)Infective Stage（感染期）is a stage when a parasite can invade human body and live in it .

40. Life cycle
(16) Infective Route（感染途径）is the specific entrance through which the parasite invades the human body.
(17) Infective Mode（感染方式） means how the parasite invades human body, such as the cercariae of the blood fluke actively penetrate the skin of a swimming man and the infective ascaris eggs are swallowed by man.

41. Life cycle
(18) Alternation of Generation:
In life cycles of some parasites, there are the regular alternations of sexual and asexual reproductions , this phenomenon is called alternation of generation, such as the life cycle of Plasmodium vivax.

42. (19) Mechanical Transmission: Arthropods play a role of the transportation of pathogens, which is not indispensable for the disease transmission, such as flies carry typhoid bacilli, ascarid eggs and amoebic cysts.

43. (20) Biological Transmission: Pathogens have to spend a part of their life cycle in the vector arthropods in which they multiply or develop into the infective stage and then invade the human body under the help of the arthropod, such as Anopheles mosquitoes transmit malaria.

44. Evolution of Parasitism
endoparasite Free living
ectoparasite Commensalism（片利共生）
temporary parasite Symbiosis Mutualism（互利共生）
permanent parasite Parasitism
obligatory parasite carrier
facultative parasite parasite Host
accidental parasite Patient
opportunistic parasite
Final host Intermediate host Reservoir host Paratenic host
Zoonosis Larva migrans

45. 4. Parasites’ Harms to Man
Mechanical effects of parasites on host tissues and organs: e. g. , biliary ascariasis and larva migrans.
Depriving nourishment from hosts: e.g. hookworms suck blood.
Toxic effect: e. g., mosquitoes, spiders and ticks introduce venom when they insert their mouth parts into the skin.
Immuno-pathological lesion e.g. schistosoma liver cirrhosis; when hydatid fluid is released from the rupture of a hydatid cyst anaphylaxis often results.

46. 5. Human Immunity against Parasites
Its intensity and specificity are usually at a lower level than those produced by bacteria and viruses. It refers to Non-sterilizing immunity (Premunition带虫免疫；Concomitant immunity伴随免疫). The host may be protected from superinfection重复感染as long as the parasites remain in the body. This situation is known as premunition(带虫免疫). This may be of great importance in endemic areas in limiting the severity of infection with Plasmodium, Schistosome , hookworms and other parasites.

47. (WHO) - Priority Diseases
1. Schistosomiasis
2. Malaria
3. Filariasis
4. Trypanosomiasis
5. Leishmaniasis
6. Leprosy (replaced by HIV/AIDS)

48. Why were they selected? Schistosomiasis - 200,000,000 infected
500,000-1,000,000 deaths/year
Malaria - 500,000,000 infected
2,500,000 deaths/year
Filariasis - 250,000,000 infected
Trypanosomiasis - 25,000,000 infected
65,000 deaths/year
Leishmaniasis - 1,200,000 infected
Leprosy - 1,300,000 infected
Approximately 25% of world's population infected by one of these.

49. General Characteristics:
1. Chronic diseases
2. No effective vaccine
3. No practical chemotherapy
4. Affect young
5. Affect underprivileged
6. Vector-borne

50. Geographic Distribution Factors (Endemicity):
1. Presence of a suitable host
2. Habits of the host
3. Escape from the host
4. Favorable conditions outside of host
5. Economic and social conditions

51. Presence of Diseases in a Population (Prevalence):
Factors required:
1. Source
infected persons
carriers
animals

52. Presence of Diseases in a Population (Prevalence):
2. Mode of transmission
direct
indirect
vectors
3. Susceptible host
immunity

53. Three key links of disease transmission 1. Source of infection 2
Three key links of disease transmission 1.Source of infection 2. Route of transmission 3. Susceptible people excrement mouth secretion food, water, finger skin or wound blood direct or indirect contact mucosa focus of placenta infection blood transfusion, injection, intermediate host, insects sucking blood, congenital , touch soil, water, grass

54. Diagnosis of Parasitic Infections:
1. Clinical diagnosis
2. Laboratory diagnosis

55. Treatment of Parasitic Infections:
1. Medical and surgical
2. Chemotherapy
3. Adequate nutrition

56. Prevention and Control:
1. Reduction in sources
2. Education
3. Destruction and/or control of reservoir hosts and vector