Microbiology & Helminths

Parasitology

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 Learning Objectives
At the end of this lecture, the students
should be able to:

• Define helminths.
• List the classification of helminths.
• Explain each classification of helminths in
• Morphology.
• Life cycle.
• Modes of infection.
• Measures to prevent infection
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 Classification of Parasites
Parasites

Unicellular Multicellular

Protozoa Helminths Arthropods

(endoparasites) (endoparasites) (ectoparasites)

- Amoebae - Lice
- Trematodes
- Flagellates - Mites
- Nematodes
- Apicomplexans - Ticks
- Cestodes
- Ciliates - Fleas 3
Helminths - Definition
• Derived from Greek meaning worm.

• Helminths are higher, multicellular forms of parasite with specialized

organs.
(Baumann, 2007)

• Can be found throughout natural world.

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Helminths - classification

Helminths

Phylum Phylum
Platyhelminthes Nemathelminthes
(Flat worms) (Round worms)

Cestodes Trematodes
Nematodes
(Tapeworm) (flukes)
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Helminths – classification (cont.)

Cestodes (tape
worm)

Trematodes (flukes) Nematodes (round worm) 6

Cestodes – Tapeworms

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Cestodes – Tapeworms (cont.)
• Cestodes are members of Phylum Platyhelminthes.

• Commonly called tape worms.

• Cestodes are flat, segmented, intestinal parasites that

completely lack digestive systems.

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Cestodes – Tapeworms (cont.)

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Cestodes – Tapeworms (cont.)
• Always reside in the gut of definitive host (human).

• Human infected with adult or larva forms of

tapeworms.

• Adult worms obtain nourishment from semi digested

food of the host.

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Cestodes – Tapeworms (cont.)
• Adult tapeworm:
• Long, flattened, whitish, ribbon like-body.
• Consist of a scolex, an organ of attachment.
• Scolex act as a hook or sucker.
• Scolex attached to intestinal mucosa, usual stay in ileum,
may be present in jejunum & colon.

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Cestodes – Tapeworms (cont.)

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Cestodes – Tapeworms (cont.)

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Cestodes – Tapeworms (cont.)

• A neck for growing

purposes.

• Body segment is known

as proglottids.
• Grow from neck
continuously.

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Cestodes – Tapeworms (cont.)

Proglottids / Strobila
segments

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Cestodes – Tapeworms (cont.)
• New proglottids displace older ones moving them
farther from the neck.
• Proglottids near the neck are immature.
• Proglottids in the middle are mature.
• Proglottids mature, producing both male and female
reproductive organs.
• Proglottids that near the end are full of fertilized eggs.

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Cestodes – Tapeworms (cont.)

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Cestodes – Tapeworms (cont.)
• After fertilization occurs and proglottids fill with eggs,
gravid proglottids break off the strobila and pass out of
the intestine along with feces.

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Cestodes – Tapeworms (cont.)

• Some tapeworms produce

proglottids large enough to
be obviously visible in stools.

• Length of tapeworms = 3 to
10 meter.

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Cestodes – Tapeworms (cont.)

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Generalize Tapeworm life cycle

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Generalize Tapeworm life cycle (cont.)
Gravid proglottids and/or 20 hosts become infected by
eggs enter the ingesting vegetation
environment in feces from contaminated with gravid
infested humans (10 host). proglottids or eggs.

Larvae develop into

Once the eggs reach the 20 host’s
tapeworm in human
intestines, they hatch into larvae
intestine.
that penetrate through the
intestinal wall and migrate to
Humans become other tissues, often muscle.
infected by consuming
meat containing larvae.
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Types of cestodes (tapeworms)
Cestodes

Intestinal Tissue
cestodes cestodes

• Diphyllobothrium Latum
• Taenia saginata/
Taenia solium • Echinococcus
• Hymenolepis nana granulosus
• Hymenolepis diminuta • Multiceps species
• Dipylidium caninum 24
Diphyllobothrium latum - morphology

• The broad fish

tapeworm.

• Is the largest
tapeworm found in
human.

• Strobila measuring
more than 10 meter.

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Diphyllobothrium latum – morphology
(cont.)
• Has 2 shallow sucking grooves, called bothria.

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Diphyllobothrium latum – morphology
(cont.)

• D. latum is the only

tapeworm that can lay
eggs.
• The only tapeworm that
produces operculated eggs.

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D. Latum –
Transmission & pathogenesis
• Acquired by ingestion of tapeworm larvae in raw or
undercooked freshwater fish.

• Most individual with tapeworm infection are

asymptomatic.

• Digestive disturbances, such as abdominal pain &

weight loss may occur.

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D. Latum –
Laboratory diagnosis

• Diagnosis is made by the recovery of characteristic

eggs in human feces.

• Proglottids and, rarely, the scolex may be found.

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D. Latum –
Treatment & prevention
• Praziquantel & niclosamide are recommended for
the treatment.

Praziquantel Niclosamide 30
D. Latum –
Treatment & prevention (cont.)

• Prevention:
• Avoid from ingesting raw / undercooked fish.
• Proper disposal of human waste.

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Taenia saginata / Taenia solium - Morphology
• T. saginata refers to beef tapeworm.

• T. solium refers to pork tapeworm.

• These parasites measure 5cm and 3cm.

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Taenia saginata / Taenia solium –
Morphology (cont.)

T. saginata T. solium 33
Taenia saginata – Morphology

• Scolex – 4 suckers but no

hooks.

• > 1000 proglottids.

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Taenia solium – Morphology

• Has a rostellum with 2

rows of hooks and 4
suckers.

• < 1000 proglottids.

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Taenia solium –
Transmission & pathogenesis
• Worldwide infection, especially with poor sanitary
conditions.

• Ingestion of raw / undercooked meat contaminated

with tapeworm larvae leads to infection.

• Most cases are asymptomatic.

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Taenia solium –
Transmission & pathogenesis (cont.)

• Mild symptoms – diarrhea and abdominal pain.

• Slight eosinophilia may be present.

• Contaminated food or water with feces containing

tapeworm eggs.

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Taenia solium –
Transmission & pathogenesis (cont.)
• Symptoms depend on the location of the cysticercus
(larva form of Taenia tapeworm).

• Cystecercus larva migrates to the brain causing a

condition called neurocysticercosis (parasite infection
of the CNS).
• Symptoms – headache & seizures.

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Neurocysticercosis

Normal 39
 Taenia solium –
Laboratory diagnosis
• Taenia infection is made by recovery of gravid proglottids or eggs, in
human feces.

• Cysticercosis is diagnosed by CT scan, magnetic resonance imaging

(MRI).

• Serologic studies may be need to confirm the diagnosis of T. solium

antigen.

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Taenia solium –
Treatment & prevention

• Praquantel & niclosamide are effective treatments for

taeniasis.

• Preventions:
• Thorough cooking of beef and pork.
• Good sanitary practices.
• Vaccination.

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Hymenolepis nana - Morphology

• Is the smallest tapeworm that infects humans –

hymenolepiasis.

• Adult worm measuring 25 – 40 mm in length.

• Common found in mice.

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Hymenolepis nana – Morphology (cont.)

• Has a short rostellum with

one row of hooks & 4
suckers.

• H. nana proglottids are 2

mm wide & 1 mm long.

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 Hymenolepis nana –
Treatment & prevention
• Paraziquantel is the treatment of choice.

• Niclosamide.

• Good sanitary practices.

• Elimination of rats.

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Hymenolepis diminuta
• H. diminuta resembles H. nana.

• Common in rats and also infests human.

• Small rostellum, but lacking the hooks found in H.

nana.

• Eggs of H. diminuta are resembles those of H. nana

but size are bigger.

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Hymenolepis diminuta –
transmission & pathogenesis
• Ingestion of infected beetles or other arthropods,
usually in grain or cereals.

• Symptoms are mild and usually include:

• Diarrhea.
• Nausea.
• Slight abdominal pain.

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Hymenolepis diminuta –
Laboratory diagnosis

• Recovery of characteristic
eggs in feces.

• Scolex found in stool

specimen.

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Hymenolepis diminuta –
Treatment & prevention

• Niclosamide is recommended treatment.

• Paraziquantel.

• Prevention of infection:
• Sanitary practice.

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Echinococcus granulosus
• Is the causative agent of Hydatid cyst disease.
• Greek hydatis = a drop of water.

• Is the smallest of all tapeworms.

• 3 – 9 mm long.
• Only 3 proglottids.

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Echinococcus granulosus –
Transmission & pathogenesis
• Definitive host is a carnivorous predator that preys on
the intermediate host which is usually a herbivorous
mammal.
• Definitive host – dog.
• Intermediate host – sheep, cattle, pig, human.

• Humans become infected by consuming food or

water contaminated with Echinococcus eggs shed in
dogs’ feces.

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Echinococcus granulosus –
Transmission & pathogenesis (cont.)
• Symptoms are depending on the location of cyst in
tissue.

• Lung and liver is the most common area affected.

• Pulmonary symptoms such as cough & chest pain may

develop with lung infection.

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 Echinococcus granulosus –
Transmission & pathogenesis (cont.)
• Serious complication of hydatid disease is the risk of anaphylatic
shock, following rupture of the cyst.

Cyst in the liver

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Echinococcus granulosus –
Laboratory diagnosis

• The eggs of E. granulosus are not found in human

feces.

• The diagnosis of hydatid cyst disease may be made

by radiographic and serologic studies.

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Hydatid cyst in the lung

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Echinococcus granulosus –
Treatment & prevention
• Surgical removal of cyst.

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Echinococcus granulosus –
Treatment & prevention (cont.)

• Anti-helminthic agents, Paraquantel & mebendazole.

• Prevention:
• Avoiding contact with infected dogs and cats and
elimination of their infection.

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