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Microbiology

5.2 Parasitic Helminths

Microbiology 5.2 Parasitic Helminths
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  1. Preface
  2. 1 An Invisible World
    1. Introduction
    2. 1.1 What Our Ancestors Knew
    3. 1.2 A Systematic Approach
    4. 1.3 Types of Microorganisms
    5. Summary
    6. Review Questions
      1. Multiple Choice
      2. Fill in the Blank
      3. Short Answer
      4. Critical Thinking
  3. 2 How We See the Invisible World
    1. Introduction
    2. 2.1 The Properties of Light
    3. 2.2 Peering Into the Invisible World
    4. 2.3 Instruments of Microscopy
    5. 2.4 Staining Microscopic Specimens
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. Fill in the Blank
      3. Short Answer
      4. Critical Thinking
  4. 3 The Cell
    1. Introduction
    2. 3.1 Spontaneous Generation
    3. 3.2 Foundations of Modern Cell Theory
    4. 3.3 Unique Characteristics of Prokaryotic Cells
    5. 3.4 Unique Characteristics of Eukaryotic Cells
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. True/False
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  5. 4 Prokaryotic Diversity
    1. Introduction
    2. 4.1 Prokaryote Habitats, Relationships, and Microbiomes
    3. 4.2 Proteobacteria
    4. 4.3 Nonproteobacteria Gram-Negative Bacteria and Phototrophic Bacteria
    5. 4.4 Gram-Positive Bacteria
    6. 4.5 Deeply Branching Bacteria
    7. 4.6 Archaea
    8. Summary
    9. Review Questions
      1. Multiple Choice
      2. True/False
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  6. 5 The Eukaryotes of Microbiology
    1. Introduction
    2. 5.1 Unicellular Eukaryotic Parasites
    3. 5.2 Parasitic Helminths
    4. 5.3 Fungi
    5. 5.4 Algae
    6. 5.5 Lichens
    7. Summary
    8. Review Questions
      1. Multiple Choice
      2. Fill in the Blank
      3. Short Answer
      4. Critical Thinking
  7. 6 Acellular Pathogens
    1. Introduction
    2. 6.1 Viruses
    3. 6.2 The Viral Life Cycle
    4. 6.3 Isolation, Culture, and Identification of Viruses
    5. 6.4 Viroids, Virusoids, and Prions
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. True/False
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  8. 7 Microbial Biochemistry
    1. Introduction
    2. 7.1 Organic Molecules
    3. 7.2 Carbohydrates
    4. 7.3 Lipids
    5. 7.4 Proteins
    6. 7.5 Using Biochemistry to Identify Microorganisms
    7. Summary
    8. Review Questions
      1. Multiple Choice
      2. True/False
      3. Matching
      4. Fill in the Blank
      5. Short Answer
      6. Critical Thinking
  9. 8 Microbial Metabolism
    1. Introduction
    2. 8.1 Energy, Matter, and Enzymes
    3. 8.2 Catabolism of Carbohydrates
    4. 8.3 Cellular Respiration
    5. 8.4 Fermentation
    6. 8.5 Catabolism of Lipids and Proteins
    7. 8.6 Photosynthesis
    8. 8.7 Biogeochemical Cycles
    9. Summary
    10. Review Questions
      1. Multiple Choice
      2. True/False
      3. Matching
      4. Fill in the Blank
      5. Short Answer
      6. Critical Thinking
  10. 9 Microbial Growth
    1. Introduction
    2. 9.1 How Microbes Grow
    3. 9.2 Oxygen Requirements for Microbial Growth
    4. 9.3 The Effects of pH on Microbial Growth
    5. 9.4 Temperature and Microbial Growth
    6. 9.5 Other Environmental Conditions that Affect Growth
    7. 9.6 Media Used for Bacterial Growth
    8. Summary
    9. Review Questions
      1. Multiple Choice
      2. Matching
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  11. 10 Biochemistry of the Genome
    1. Introduction
    2. 10.1 Using Microbiology to Discover the Secrets of Life
    3. 10.2 Structure and Function of DNA
    4. 10.3 Structure and Function of RNA
    5. 10.4 Structure and Function of Cellular Genomes
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. True/False
      3. Matching
      4. Fill in the Blank
      5. Short Answer
      6. Critical Thinking
  12. 11 Mechanisms of Microbial Genetics
    1. Introduction
    2. 11.1 The Functions of Genetic Material
    3. 11.2 DNA Replication
    4. 11.3 RNA Transcription
    5. 11.4 Protein Synthesis (Translation)
    6. 11.5 Mutations
    7. 11.6 How Asexual Prokaryotes Achieve Genetic Diversity
    8. 11.7 Gene Regulation: Operon Theory
    9. Summary
    10. Review Questions
      1. Multiple Choice
      2. True/False
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  13. 12 Modern Applications of Microbial Genetics
    1. Introduction
    2. 12.1 Microbes and the Tools of Genetic Engineering
    3. 12.2 Visualizing and Characterizing DNA, RNA, and Protein
    4. 12.3 Whole Genome Methods and Pharmaceutical Applications of Genetic Engineering
    5. 12.4 Gene Therapy
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. True/False
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  14. 13 Control of Microbial Growth
    1. Introduction
    2. 13.1 Controlling Microbial Growth
    3. 13.2 Using Physical Methods to Control Microorganisms
    4. 13.3 Using Chemicals to Control Microorganisms
    5. 13.4 Testing the Effectiveness of Antiseptics and Disinfectants
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. True/False
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  15. 14 Antimicrobial Drugs
    1. Introduction
    2. 14.1 History of Chemotherapy and Antimicrobial Discovery
    3. 14.2 Fundamentals of Antimicrobial Chemotherapy
    4. 14.3 Mechanisms of Antibacterial Drugs
    5. 14.4 Mechanisms of Other Antimicrobial Drugs
    6. 14.5 Drug Resistance
    7. 14.6 Testing the Effectiveness of Antimicrobials
    8. 14.7 Current Strategies for Antimicrobial Discovery
    9. Summary
    10. Review Questions
      1. Multiple Choice
      2. True/False
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  16. 15 Microbial Mechanisms of Pathogenicity
    1. Introduction
    2. 15.1 Characteristics of Infectious Disease
    3. 15.2 How Pathogens Cause Disease
    4. 15.3 Virulence Factors of Bacterial and Viral Pathogens
    5. 15.4 Virulence Factors of Eukaryotic Pathogens
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. Fill in the Blank
      3. Short Answer
      4. Critical Thinking
  17. 16 Disease and Epidemiology
    1. Introduction
    2. 16.1 The Language of Epidemiologists
    3. 16.2 Tracking Infectious Diseases
    4. 16.3 Modes of Disease Transmission
    5. 16.4 Global Public Health
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. Matching
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  18. 17 Innate Nonspecific Host Defenses
    1. Introduction
    2. 17.1 Physical Defenses
    3. 17.2 Chemical Defenses
    4. 17.3 Cellular Defenses
    5. 17.4 Pathogen Recognition and Phagocytosis
    6. 17.5 Inflammation and Fever
    7. Summary
    8. Review Questions
      1. Multiple Choice
      2. Matching
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  19. 18 Adaptive Specific Host Defenses
    1. Introduction
    2. 18.1 Overview of Specific Adaptive Immunity
    3. 18.2 Major Histocompatibility Complexes and Antigen-Presenting Cells
    4. 18.3 T Lymphocytes and Cellular Immunity
    5. 18.4 B Lymphocytes and Humoral Immunity
    6. 18.5 Vaccines
    7. Summary
    8. Review Questions
      1. Multiple Choice
      2. Matching
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  20. 19 Diseases of the Immune System
    1. Introduction
    2. 19.1 Hypersensitivities
    3. 19.2 Autoimmune Disorders
    4. 19.3 Organ Transplantation and Rejection
    5. 19.4 Immunodeficiency
    6. 19.5 Cancer Immunobiology and Immunotherapy
    7. Summary
    8. Review Questions
      1. Multiple Choice
      2. Matching
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  21. 20 Laboratory Analysis of the Immune Response
    1. Introduction
    2. 20.1 Polyclonal and Monoclonal Antibody Production
    3. 20.2 Detecting Antigen-Antibody Complexes
    4. 20.3 Agglutination Assays
    5. 20.4 EIAs and ELISAs
    6. 20.5 Fluorescent Antibody Techniques
    7. Summary
    8. Review Questions
      1. Multiple Choice
      2. Fill in the Blank
      3. Short Answer
      4. Critical Thinking
  22. 21 Skin and Eye Infections
    1. Introduction
    2. 21.1 Anatomy and Normal Microbiota of the Skin and Eyes
    3. 21.2 Bacterial Infections of the Skin and Eyes
    4. 21.3 Viral Infections of the Skin and Eyes
    5. 21.4 Mycoses of the Skin
    6. 21.5 Protozoan and Helminthic Infections of the Skin and Eyes
    7. Summary
    8. Review Questions
      1. Multiple Choice
      2. Fill in the Blank
      3. Short Answer
      4. Critical Thinking
  23. 22 Respiratory System Infections
    1. Introduction
    2. 22.1 Anatomy and Normal Microbiota of the Respiratory Tract
    3. 22.2 Bacterial Infections of the Respiratory Tract
    4. 22.3 Viral Infections of the Respiratory Tract
    5. 22.4 Respiratory Mycoses
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. Fill in the Blank
      3. Short Answer
      4. Critical Thinking
  24. 23 Urogenital System Infections
    1. Introduction
    2. 23.1 Anatomy and Normal Microbiota of the Urogenital Tract
    3. 23.2 Bacterial Infections of the Urinary System
    4. 23.3 Bacterial Infections of the Reproductive System
    5. 23.4 Viral Infections of the Reproductive System
    6. 23.5 Fungal Infections of the Reproductive System
    7. 23.6 Protozoan Infections of the Urogenital System
    8. Summary
    9. Review Questions
      1. Multiple Choice
      2. Fill in the Blank
      3. Short Answer
      4. Critical Thinking
  25. 24 Digestive System Infections
    1. Introduction
    2. 24.1 Anatomy and Normal Microbiota of the Digestive System
    3. 24.2 Microbial Diseases of the Mouth and Oral Cavity
    4. 24.3 Bacterial Infections of the Gastrointestinal Tract
    5. 24.4 Viral Infections of the Gastrointestinal Tract
    6. 24.5 Protozoan Infections of the Gastrointestinal Tract
    7. 24.6 Helminthic Infections of the Gastrointestinal Tract
    8. Summary
    9. Review Questions
      1. Multiple Choice
      2. Fill in the Blank
      3. Short Answer
      4. Critical Thinking
  26. 25 Circulatory and Lymphatic System Infections
    1. Introduction
    2. 25.1 Anatomy of the Circulatory and Lymphatic Systems
    3. 25.2 Bacterial Infections of the Circulatory and Lymphatic Systems
    4. 25.3 Viral Infections of the Circulatory and Lymphatic Systems
    5. 25.4 Parasitic Infections of the Circulatory and Lymphatic Systems
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. Fill in the Blank
      3. Short Answer
      4. Critical Thinking
  27. 26 Nervous System Infections
    1. Introduction
    2. 26.1 Anatomy of the Nervous System
    3. 26.2 Bacterial Diseases of the Nervous System
    4. 26.3 Acellular Diseases of the Nervous System
    5. 26.4 Fungal and Parasitic Diseases of the Nervous System
    6. Summary
    7. Review Questions
      1. Multiple Choice
      2. Matching
      3. Fill in the Blank
      4. Short Answer
      5. Critical Thinking
  28. A | Fundamentals of Physics and Chemistry Important to Microbiology
  29. B | Mathematical Basics
  30. C | Metabolic Pathways
  31. D | Taxonomy of Clinically Relevant Microorganisms
  32. E | Glossary
  33. Answer Key
    1. Chapter 1
    2. Chapter 2
    3. Chapter 3
    4. Chapter 4
    5. Chapter 5
    6. Chapter 6
    7. Chapter 7
    8. Chapter 8
    9. Chapter 9
    10. Chapter 10
    11. Chapter 11
    12. Chapter 12
    13. Chapter 13
    14. Chapter 14
    15. Chapter 15
    16. Chapter 16
    17. Chapter 17
    18. Chapter 18
    19. Chapter 19
    20. Chapter 20
    21. Chapter 21
    22. Chapter 22
    23. Chapter 23
    24. Chapter 24
    25. Chapter 25
    26. Chapter 26
  34. Index

Learning Objectives

  • Explain why we include the study of parasitic worms within the discipline of microbiology
  • Compare the basic morphology of the major groups of parasitic helminthes
  • Describe the characteristics of parasitic nematodes, and give an example of infective eggs and infective larvae
  • Describe the characteristics of parasitic trematodes and cestodes, and give examples of each
  • Identify examples of the primary causes of infections due to nematodes, trematodes, and cestodes
  • Classify parasitic worms according to major groups

Parasitic helminths are animals that are often included within the study of microbiology because many species of these worms are identified by their microscopic eggs and larvae. There are two major groups of parasitic helminths: the roundworms (Nematoda) and flatworms (Platyhelminthes). Of the many species that exist in these groups, about half are parasitic and some are important human pathogens. As animals, they are multicellular and have organ systems. However, the parasitic species often have limited digestive tracts, nervous systems, and locomotor abilities. Parasitic forms may have complex reproductive cycles with several different life stages and more than one type of host. Some are monoecious, having both male and female reproductive organs in a single individual, while others are dioecious, each having either male or female reproductive organs.

Nematoda (Roundworms)

Phylum Nematoda (the roundworms) is a diverse group containing more than 15,000 species, of which several are important human parasites (Figure 5.19). These unsegmented worms have a full digestive system even when parasitic. Some are common intestinal parasites, and their eggs can sometimes be identified in feces or around the anus of infected individuals. Ascaris lumbricoides is the largest nematode intestinal parasite found in humans; females may reach lengths greater than 1 meter. A. lumbricoides is also very widespread, even in developed nations, although it is now a relatively uncommon problem in the United States. It may cause symptoms ranging from relatively mild (such as a cough and mild abdominal pain) to severe (such as intestinal blockage and impaired growth).

A micrograph of a tapered oval cell of approximately 30 mm in length.
Figure 5.19 A micrograph of the nematode Enterobius vermicularis, also known as the pinworm. (credit: modification of work by Centers for Disease Control and Prevention)

Of all nematode infections in the United States, pinworm (caused by Enterobius vermicularis) is the most common. Pinworm causes sleeplessness and itching around the anus, where the female worms lay their eggs during the night. Toxocara canis and T. cati are nematodes found in dogs and cats, respectively, that can be transmitted to humans, causing toxocariasis. Antibodies to these parasites have been found in approximately 13.9% of the U.S. population, suggesting that exposure is common.7 Infection can cause larval migrans, which can result in vision loss and eye inflammation, or fever, fatigue, coughing, and abdominal pain, depending on whether the organism infects the eye or the viscera. Another common nematode infection is hookworm, which is caused by Necator americanus (the New World or North American hookworm) and Ancylostoma duodenale (the Old World hookworm). Symptoms of hookworm infection can include abdominal pain, diarrhea, loss of appetite, weight loss, fatigue, and anemia.

Trichinellosis, also called trichinosis, caused by Trichinella spiralis, is contracted by consuming undercooked meat, which releases the larvae and allows them to encyst in muscles. Infection can cause fever, muscle pains, and digestive system problems; severe infections can lead to lack of coordination, breathing and heart problems, and even death. Finally, heartworm in dogs and other animals is caused by the nematode Dirofilaria immitis, which is transmitted by mosquitoes. Symptoms include fatigue and cough; when left untreated, death may result.

Clinical Focus

Part 2

The physician explains to Sarah’s mother that ringworm can be transferred between people through touch. “It’s common in school children, because they often come in close contact with each other, but anyone can become infected,” he adds. “Because you can transfer it through objects, locker rooms and public pools are also a potential source of infection. It’s very common among wrestlers and athletes in other contact sports.”

Looking very uncomfortable, Sarah says to her mother “I want this worm out of me.”

The doctor laughs and says, “Sarah, you’re in luck because ringworm is just a name; it is not an actual worm. You have nothing wriggling around under your skin.”

“Then what is it?” asks Sarah.

  • What type of pathogen causes ringworm?

Jump to the next Clinical Focus box. Go back to the previous Clinical Focus box.

Check Your Understanding

  • What is the most common nematode infection in the United States?

Platyhelminths (Flatworms)

Phylum Platyhelminthes (the platyhelminths) are flatworms. This group includes the flukes, tapeworms, and the turbellarians, which include planarians. The flukes and tapeworms are medically important parasites (Figure 5.20).

The flukes (trematodes) are nonsegmented flatworms that have an oral sucker (Figure 5.21) (and sometimes a second ventral sucker) and attach to the inner walls of intestines, lungs, large blood vessels, or the liver. Trematodes have complex life cycles, often with multiple hosts. Several important examples are the liver flukes (Clonorchis and Opisthorchis), the intestinal fluke (Fasciolopsis buski), and the oriental lung fluke (Paragonimus westermani). Schistosomiasis is a serious parasitic disease, considered second in the scale of its impact on human populations only to malaria. The parasites Schistosoma mansoni, S. haematobium, and S. japonicum, which are found in freshwater snails, are responsible for schistosomiasis (Figure 5.22). Immature forms burrow through the skin into the blood. They migrate to the lungs, then to the liver and, later, other organs. Symptoms include anemia, malnutrition, fever, abdominal pain, fluid buildup, and sometimes death.

a) Class Turbellaria – a photograph of a flat oval-shaped worm labeled Pseudobiceros bedfordi. B) Class Monegena – a micrograph of a rectangular cell with a bulb at one end. Labeled Dactylogyrus sp. C) Class Trematoda – A photograph of a long oval organism labeled Fascioloides magna and two smaller oval organisms labeled Fasciola hepatica. D) Class Cestoda – A photograph of a very long tapeworm labeled Taenia saginata.
Figure 5.20 Phylum Platyhelminthes is divided into four classes. (a) Class Turbellaria includes the Bedford’s flatworm (Pseudobiceros bedfordi), which is about 8–10 cm long. (b) The parasitic class Monogenea includes Dactylogyrus spp. Worms in this genus are commonly called gill flukes. The specimen pictured here is about 0.2 mm long and has two anchors, indicated by arrows, that it uses to latch onto the gills of host fish. (c) The Trematoda class includes the common liver fluke Fasciola hepatica and the giant liver fluke Fascioloides magna (right). The F. magna specimen shown here is about 7 cm long. (d) Class Cestoda includes tapeworms such as Taenia saginata, which infects both cattle and humans and can reach lengths of 4–10 meters; the specimen shown here is about 4 meters long. (credit c: modification of work by “Flukeman”/Wikimedia Commons)
a) A micrograph of Opisthorchis viverini; an oval cell with a projection at one end. B) A micrograph of one end of Taenia solium showing a whorl of small projections above an area labeled scolex.
Figure 5.21 (a) The oral sucker is visible on the anterior end of this liver fluke, Opisthorchis viverrini. (b) This micrograph shows the scolex of the cestode Taenia solium, also known as the pork tapeworm. The visible suckers and hooks allow the worm to attach itself to the inner wall of the intestine. (credit a: modification of work by Sripa B, Kaewkes S, Sithithaworn P, Mairiang E, Laha T, and Smout M; credit b: modification of work by Centers for Disease Control and Prevention)

The other medically important group of platyhelminths are commonly known as tapeworms (cestodes) and are segmented flatworms that may have suckers or hooks at the scolex (head region) (Figure 5.21). Tapeworms use these suckers or hooks to attach to the wall of the small intestine. The body of the worm is made up of segments called proglottids that contain reproductive structures; these detach when the gametes are fertilized, releasing gravid proglottids with eggs. Tapeworms often have an intermediate host that consumes the eggs, which then hatch into a larval form called an oncosphere. The oncosphere migrates to a particular tissue or organ in the intermediate host, where it forms cysticerci. After being eaten by the definitive host, the cysticerci develop into adult tapeworms in the host's digestive system (Figure 5.23). Taenia saginata (the beef tapeworm) and T. solium (the pork tapeworm) enter humans through ingestion of undercooked, contaminated meat. The adult worms develop and reside in the intestine, but the larval stage may migrate and be found in other body locations such as skeletal and smooth muscle. The beef tapeworm is relatively benign, although it can cause digestive problems and, occasionally, allergic reactions. The pork tapeworm can cause more serious problems when the larvae leave the intestine and colonize other tissues, including those of the central nervous system. Diphylobothrium latum is the largest human tapeworm and can be ingested in undercooked fish. It can grow to a length of 15 meters. Echinococcus granulosus, the dog tapeworm, can parasitize humans and uses dogs as an important host.

Schistoma mansoni, japonicum, and haematobium are found in feces; S. japonicum and S. haematobium are also found in urine. These can be diagnosed in the water and produce eggs which hatch releasing miracidia. The miracidia penetrate snail tissues and produce sporocysts in the snail (successive generations). The Cercariae released by snail into the water are free flowing and are the infective stage which can penetrate skin. S. mansoni travels to the large intestines, S. japonicum travels to the small intestines, and S. haemotobium travels to the rectum. The cercariae lose their tails during penetration and become schistosomalae. Theese enter circulation and migrate to portal blood in liver and mature into adults. The paired adulted worms migrate to the mesenteric venules of the bowels/rectum (laying egs that circulate to the liver and are shed in stools) – for S. mansoni and S. Japonicum. S. haematobium migrates to the venous plexus of the bladder.
Figure 5.22 The life cycle of Schistosoma spp. includes several species of water snails, which serve as secondary hosts. The parasite is transmitted to humans through contact with contaminated water and takes up residence in the veins of the digestive system. Eggs escape the host in the urine or feces and infect a snail to complete the life cycle. (credit “illustration”: modification of work by Centers for Disease Control and Prevention; credit “step 3 photo”: modification of work by Fred A. Lewis, Yung-san Liang, Nithya Raghavan & Matty Knight)
Eggs or gravid proplottidis from an infected individual are passed into the environment; this is the diagnostic stage. Cattle (T. saginata) and pigs (T. solium) become infected by ingesting vegetation contaminated by eggs or gravid proglottids. Oncospheres hatch, penetrating intestinal wall and circulate to musculature. The oncospheres develop into cysticerci in muscles and become infective. Humans are infected by ingesting raw or undercooked infected meat. The scolex attaches to intestine and adults are found in the small intestine.
Figure 5.23 Life cycle of a tapeworm. (credit “illustration”: modification of work by Centers for Disease Control and Prevention; credit “step 3 micrographs”: modification of work by American Society for Microbiology)

Check Your Understanding

  • What group of medically important flatworms is segmented and what group is unsegmented?

Micro Connections

Food for Worms?

For residents of temperate, developed countries, it may be difficult to imagine just how common helminth infections are in the human population. In fact, they are quite common and even occur frequently in the United States. Worldwide, approximately 807–1,221 million people are infected with Ascaris lumbricoides (perhaps one-sixth of the human population) and far more are infected if all nematode species are considered.8 Rates of infection are relatively high even in industrialized nations. Approximately 604–795 million people are infected with whipworm (Trichuris) worldwide (Trichuris can also infect dogs), and 576–740 million people are infected with hookworm (Necator americanus and Ancylostoma duodenale).9 Toxocara, a nematode parasite of dogs and cats, is also able to infect humans. It is widespread in the United States, with about 10,000 symptomatic cases annually. However, one study found 14% of the population (more than 40 million Americans) was seropositive, meaning they had been exposed to the parasite at one time. More than 200 million people have schistosomiasis worldwide. Most of the World Health Organization (WHO) neglected tropical diseases are helminths. In some cases, helminths may cause subclinical illnesses, meaning the symptoms are so mild that that they go unnoticed. In other cases, the effects may be more severe or chronic, leading to fluid accumulation and organ damage. With so many people affected, these parasites constitute a major global public health concern.

Micro Connections

Eradicating the Guinea Worm

Dracunculiasis, or Guinea worm disease, is caused by a nematode called Dracunculus medinensis. When people consume contaminated water, water fleas (small crustaceans) containing the nematode larvae may be ingested. These larvae migrate out of the intestine, mate, and move through the body until females eventually emerge (generally through the feet). While Guinea worm disease is rarely fatal, it is extremely painful and can be accompanied by secondary infections and edema (Figure 5.24).

A worm is being pulled out of  a wound in the leg of an infected individual.
Figure 5.24 The Guinea worm can be removed from a leg vein of an infected person by gradually winding it around a stick, like this matchstick. (credit: Centers for Disease Control and Prevention)

An eradication campaign led by WHO, the CDC, the United Nations Children’s Fund (UNICEF), and the Carter Center (founded by former U.S. president Jimmy Carter) has been extremely successful in reducing cases of dracunculiasis. This has been possible because diagnosis is straightforward, there is an inexpensive method of control, there is no animal reservoir, the water fleas are not airborne (they are restricted to still water), the disease is geographically limited, and there has been a commitment from the governments involved. Additionally, no vaccines or medication are required for treatment and prevention. In 1986, 3.5 million people were estimated to be affected. After the eradication campaign, which included helping people in affected areas learn to filter water with cloth, only four countries continue to report the disease (Chad, Mali, South Sudan, and Ethiopia) with a total of 126 cases reported to WHO in 2014.10

Footnotes

  • 7 Won K, Kruszon-Moran D, Schantz P, Jones J. “National seroprevalence and risk factors for zoonotic Toxocara spp. infection.” In: Abstracts of the 56th American Society of Tropical Medicine and Hygiene; Philadelphia, Pennsylvania; 2007 Nov 4-8.
  • 8 Fenwick, A. “The global burden of neglected tropical diseases.” Public health 126 no.3 (Mar 2012): 233–6.
  • 9 de Silva, N., et. al. (2003). “Soil-transmitted helminth infections: updating the global picture”. Trends in Parasitology 19 (December 2003): 547–51.
  • 10 World Health Organization. “South Sudan Reports Zero Cases of Guinea-Worm Disease for Seventh Consecutive Month.” 2016. http://www.who.int/dracunculiasis/no_new_case_for_seventh_consecutive_months/en/. Accessed May 2, 2016.
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