NEMATODES

Species of Interest
Trichinella spiralis
Ascaris lumbricoides
Strongyloides stercoralis
Enterobius vermiculari
Trichuris trichiura
Necator americanus
Ancylostoma duodenale
Dracunculus medinensis
Brugia malayi
Onchocerca volvulus

General Characteristics
Introduction
If you have ever owned a dog, chances are pretty good that you have
had a personal contact with the phylum Nematoda. Nematodes, or
roundworms, are incredible creatures that escape the average eye because
of their buried existence beneath the sheltering cloak of mother earth. They
make themselves recognized by us in the uncontrollable itches we scratch,
on the plant that withers and dies. The damage inflicted upon man, animals
and plants by nematodes is measured in hunger, disease and untold billions
of dollars over the years and for this reason, knowledge of their existence is
important.
Nematodes are long, thin, and cylindrical or round worms with
transparent bodies that may or may not be broken by annulations. Most
nematodes are small, averagely ranging in size from 100 micrometers in
length to the female giant nematodes which may extend to a length of 1
meter. The smallest nematodes measure 80 micrometers in length while the
largest nematode, Placentonema gigantissima, has a length of about 8.4
meters.
Scientific Classification
Kingdom:
Animalia
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Phylum:

Nematoda

Etymology
Nematos-
-eides

Thread
species

Ecology
Nematodes have successfully adapted to nearly every ecosystem they
get carried into. From the saltiest water-bodies to fresh water, to soils, and
from the polar regions to the tropically-regulated countries, as well as the
highest and lowest elevation in earth, they ubiquitously inhabit every
environment imaginable. (This just proves that the nematodes are one of the
fewest successful organisms, as they could adapt to every ecosystem.)

Anatomy
Roundworms are considered as pseudocoelomates organisms which
possess a defined pseudocoelom. A pseudocoelom is a fluid-filled body cavity
that is not completely lined with mesodermal tissue which separates the
digestive tract of an organism from its outer body wall. In advanced, nonnematode species, the body cavities are lined with mesoderm, however, in
pseudocoelomates, the body cavity is lined with mesodermal tissue
externally but endodermal tissue on the inside. Endodermal tissue
progressively develops into the digestive tract, while mesodermal tissue
differentiates into a number of different body tissues, such as bones, skin,
and liver.
Roundworms are frequently confused with flatworms as both species
possess similarities in terms of physical features. However, nematodes have
thread-like, round or cylindrical bodies. Furthermore, their bodies are nonsegmented. Generally, nematodes are bilaterally symmetrical, meaning both
halves of their bodies are equally identical.
Nervous System
Nematodes have a reasonably well developed nervous system. It is
characterized by a rear nerve ring surrounding the area of the pharynx and
two pairs of lengthwise nerve cords which run along the body. Moreover,
there are also dorsal (back) and ventral (belly) nerve cords as well as a set of
lateral nerve cords across the body. These nerve cords are responsible for
the transmission of sensory information and coordination of movement.
Nematodes have also a variety of sensory receptors, such as tactile
receptors (touch) at the front and back ends of the body, and chemosensory
(chemical-sensitive) cells at the front end.

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Circulatory System
Roundworms have no circulatory system like most organisms do.
Instead, their way of circulation is achieved by diffusion (movement of
material from areas of high concentration to areas of low concentration).
They highly rely to the fluid in their body cavities for the transport of
nutrients.
Respiratory System
Roundworms do not respire in the sense that vertebrates, such as
humans and other animals, do. Instead, roundworms obtain the oxygen
essential for their metabolic activity also through diffusion. Diffusion allows
roundworms to provide oxygens to their cells without the aid of complex
organs, such as the lungs. Diffusion takes place through the worms skin. The
oxygen is taken through their skin, then the oxygen molecules are diffused
through their bodies and into their cells essentially the oxygen goes to
parts of the body where less oxygen is present. When the cells use the
oxygen, they produce carbon dioxide, which builds up in a high concentration
that is diffused back through the skin into the environment where it can be
less concentrated.

Musculo-Skeletal System
Roundworms have no skeleton to serve as a framework of its body.
Instead, it has a layer of skin the epidermis which is highly unusual.
Unlike human skin, it is not composed of cells, but instead is a mass of
undifferentiated cellular material. This epidermis secrets a thick, tough and
flexible layer of cuticle which forms an additional coating over the skin,
supplementing another protection for its body. This layer of cuticle is utilized
by the roundworms as a support and a leverage point for movement.
However, the movement of the roundworms are influenced by its muscles.
These muscles, which are beneath the epidermis, are all aligned
longitudinally along the inside of the body, so the nematode can only bend
its body from side to side, not crawl or lift itself.
Digestive System
The digestive system of general roundworms is very distinct and runs
along the length of their bodies. It has an oral cavity lined with cuticle. (The
cuticle is often underwired with ridges, and in some carnivorous species, may
bear a number of teeth.) The mouth often includes a stylet (probe), which
the roundworm uses to thrust into its prey, and sometimes, to suck liquids.
The oral cavity opens into a muscular pharynx, also lined with cuticle.
The digestive glands in this region produce enzymes which start to break
down the food. (In stylet-bearing organisms, it maybe even injected into the
prey.)

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The pharynx is then connected directly to the intestine which forms the
main length of the gut. This further bathes the food with enzymes, and also
absorbs nutrients through its single cell-layered lining. The intestine then
opens to a rectum, which expels waste through the anus in the other end of
the body. The bodily locomotion of the worm as well as the intestinal
sphincters of the worm influences the movement of the food through the
body.
Reproductive System
The reproductive system of male nematodes include: one testis, a
seminal vesicle and a vas deferens opening into a cloaca. Most of the male
nematodes only has one testis but some have two. The spermatogonia of
nematodes are produced in the testis and is stored in the seminal vesicle
until the nematode mates. The reproductive system of male nematodes also
contains spicules which help dilate the vulva and can also serve as a canal
for the spermatozoa.
The reproductive system of female nematodes include: one or two
ovaries, seminal receptacles, uteri, ovijector and a vulva. The ovary produces
oogonia, which later develop into oocytes. The seminal receptacles, stores
the spermatozoa until they are needed to fertilize an oocyte. The fertilized
oocyte then develops into an egg in the uterus. The ovijector is very
muscular and uses body movement combined with the high internal body
pressure of the nematode to expel the egg through the vagina.
Reproduction
The nematode phylum exhibits all modes of sexual reproduction known
in the animal kingdom. These are gonochoristic, hermaphroditic and
parthenogenetic. A few species exhibits a mixture of these in parallel, such
as Rhabditis sp. However, the majority of nematodes species appears to
follow a gonochoristic mode of reproduction, usually with equal number of
males and females. In contrast, asexual reproduction from somatic cells has
not been described in nematodes.
Gonochorism, also known as amphimixis, is seen in species living in
diverse free-living ecosystems, whereas it is underrepresented in some
parasitic groups. It is considered the ancestral mode of reproduction in
nematodes with multiple, independent evolutionary transitions toward
hermaphroditism and parthenogenesis.
Hermaphroditism in nematodes is exclusively of the self-fertilizing type,
in contrast to cross-fertilizing hermaphroditism as found in annelids, mollusk
and other phyla. As an example the Caernorhabditis elegans, like many other
hermaphroditic species still occur in two sexes. The hermaphrodite is a
modified female that forms two types of gametes. Under laboratory
condition, the progeny of hermaphrodite is limited by the number of sperm.
Often, hermaphrodite produces an excess of oocytes, which can be fertilized
by the sperm of the rare males (about 1:700 in C. elegans) that mate with
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hermaphrodites. Males are known from many hermaphroditic species to

occur in small numbers as a result of meiotic non-disjunction and loss of sex
chromosomes. Males are not known from all hermaphroditic species, but this
might be simply due to the fact that they are so rare that they have been
missed, or that environmental conditions to induce males have not been
identified. Some species with free-living and parasitic generations have been
described as alternating between gonochoristic and hermaphroditic
reproduction.
The third mode of reproduction is parthenogenesis reproduction with
female gametes only in the absence of sperm and thus without fertilization
events. Parthenogenesis appears to represent the second most common
mode of reproduction in nematodes. Different forms of parthenogenesis can
be distinguished by modification or even the complete absence of meiosis.
This mode of reproduction has been found in many free-living nematode taxa
including Plectidae, Panagrolaimidae and Cephalobidae, as well as a variety
of parasitic species.
In contrast, there are also reports of nematodes where sperm are only
required for the initiation of embryogenesis without genetic contribution, a
process known as merospermy or psuedogamy.

Life Cycle
Basic (General) Nematode Life Cycle
Despite the diversity and complexity of many nematode life cycles, all
of them can be related to the same basic pattern.
This pattern is illustrated by the adjacent figure and consists of two
phases, parasitic and pre-parasitic. The parasitic phase takes place inside
the definitive host while the pre-parasitic phase occurs either as a free living
phase in the external environment or inside a second host, called an
intermediate host. This basic life also consists of seven stages, an egg, four
larval stages (L2, L2, L3, L4) and two adult stages comprising separate males
and females. Sometimes the sexually immature adult stages are called L5's
In most species sexual reproduction by adult nematodes is the norm
and occurs within an infected definitive host. Eggs are laid by the female and
pass from this host into the external environment. These eggs must pass
through the three developmental stages (L1, L2, and L3) before the
nematode is again infective for another host.
A first stage larva develops inside an egg, then hatches. Initiation of
the hatching process is controlled by several factors including temperature
and moisture levels in the external environment. Hatching occurs only when
environmental conditions are favorable for survival of the hatched larvae.
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These conditions stimulate the enclosed larvae to assume its own role in
hatching by secreting enzymes to digest the surrounding egg membranes,
then exerting pressure against the weakened membranes to rupture them
and escape.
This newly hatched L1 feeds on bacteria and grows until constrained
by its outer skin or cuticle. At this point further growth is possible only if the
larva grows a new, more flexible, cuticle and casts off its old outer cuticle.
This process is called molting and involves two steps.
1. Synthesis of a new cuticle by the hypodermis. At this stage the larva,
with a new cuticle is completely enclosed by its old cuticle.
2. Exsheathment - a process by which the old cuticle is loosened and
ruptured followed by the larva wriggling out of the casing of the old cuticle.
Nematodes molt four times during each life cycle with a molt occurring
at the end of each larval stage. Therefore, molts separate the first and
second larval stages (L1 and L2), the second and third larval stages (L2 and
L3), the third and fourth larval stages (L3 and L4) and also the fourth larval
stages and immature adults (L4 and L5). The L5 grows to the limit of its new
cuticle, at the same time developing into a sexually mature adult male or
female.

Parasites
Brugia malayi

Common Name : Roundworm

Description
It is one of the three causative agents of lymphatic filariasis in humans.
Lymphatic filariasis, also known as elephantiasis, is a condition characterized
by swelling of the lower limbs. The two other filarial causes of lymphatic
filariasis are Wuchereria bancrofti and Brugia timori, which both differ
from B. malayi morphologically, symptomatically, and in geographical extent.
B. malayi is transmitted by mosquitoes and is restricted to South and
South East Asia. It is one of the tropical diseases targeted for elimination by
the year 2020 by the World Health Organization, which has spurred vaccine
and drug development, as well as new methods of vector control.
Morphology
Adult worms resemble the classic nematode roundworm. Long and
threadlike, B. malayi and other nematode possess only longitudinal muscles
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and move in an S-shape motion. Adults are typically smaller than adult W.
bancrofti, though few adults have been isolated. Female adult worms
(50 mm) are larger than male worms (25 mm).
B. malayi microfilariae are 200-275 m in length and have a round
anterior end and a pointed posterior end. The microfilariae are sheathed,
which stains heavily with Giemsa. The sheath is actually the egg shell, a thin
layer that surrounds the egg shell as the microfilariae circulates in the
bloodstream. The microfilariae retain the sheath until it is digested in the
mosquito midgut.

Transmission
Transmitted via Mosquito vector where the principal vectors include
Mansonia, Anopheles, and Aedes mosquitos. The mosquito serves as a
biological vector it is required for the developmental cycle of the parasite.
There are two modes of transmitting B. malayi:
o Nocturnal periodic form - transmitted by Mansonia and some
Anopheline mosquitoes in open swamps and rice growing areas. These
mosquitoes tend to bite at night and appear to only infect
humans. Natural animal infections are rare and experimental animals
do not retain infection.
o Nocturnal subperiodic form - transmitted by Mansonia in forest
swamps, where mosquitoes bite in the shade at any time. Natural
zoonotic infections are common. Cats, dogs, monkeys, slow lorises,
civet cats, and hamsters have all been successfully experimentally
infected with B. malayi from man and may serve as important
reservoirs.
To establish an infection, the accumulation of many infective mosquito bites
about a hundredis required due to the fact that a competent mosquito
usually transmit only a few infective L3 larvae and less than 10% of those
larvae progress through its life cycle and develops to an adult worm that can
mate.
Life Cycle
The typical vector for Brugia malayi filariasis are mosquito species
from the genera Mansonia andAedes. During a blood meal, an infected
mosquito introduces third-stage filarial larvae onto the skin of the human
host, where they penetrate into the bite wound. They develop into adults
that commonly reside in the lymphatics. The adult worms resemble those
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of Wuchereria bancrofti but are smaller. Female worms measure 43 to 55

mm in length by 130 to 170 m in width, and males measure 13 to 23 mm in
length by 70 to 80 m in width. Adults produce microfilariae, measuring 177
to 230 m in length and 5 to 7 m in width, which are sheathed and have
nocturnal periodicity. The microfilariae migrate into lymph and enter the
blood stream reaching the peripheral blood. A mosquito ingests the
microfilariae during a blood meal. After ingestion, the microfilariae lose their
sheaths and work their way through the wall of the proventriculus and
cardiac portion of the midgut to reach the thoracic muscles. There the
microfilariae develop into first-stage larvae and subsequently into third-stage
larvae. The third-stage larvae migrate through the hemocoel to the
mosquito's prosbocis and can infect another human when the mosquito takes
a blood meal.
Onchocerca volvulus

Common Name : River Blindess

Description
These long thin filarial worms are tissue-dwelling nematode parasites
that live as adults in the circulatory system or connective tissues of
vertebrate hosts. Female worms do not lay eggs but produce live
microfilariae (pre-larvae). The parasites have indirect life-cycles involving the
transmission of larvae by arthropod intermediate hosts (blood or tissue
feeding insect vectors). Infections are common in wild animals and birds, but
several species cause serious diseases in humans and domestic animals,
involving skin lesions, blindness, and gross deformities, such as nodules and
elephantiasis.
Morphology
Filarial worms form adults and microfilariae in vertebrates while larval
development occurs in the arthropod vectors. Adult worms have distinctive
cross-striations (regularly spaced annulations) of their cuticle and they
exhibit marked sexual dimorphism. Female worms are large, measuring 2550cm by 0.3-0.4mm, while male worms are smaller, measuring 2-4cm by
0.2mm. Gravid females produce small microfilariae (pre-larvae), measuring
220-360m by 5-9m, which are released into host tissues. The microfilariae
of various filarial worms can be differentiated on the basis of their
morphology, those of Onchocerca not being sheathed and possessing nuclei
which do not extend to the tip of the tail (compared to those
of Wuchereria, Brugia and Loa which are ensheathed by a thin flexible eggshell membrane).

Transmission
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It is transmitted through repeated bites by blackflies of the genus

Simulium. The disease is called River Blindness because the blackfly that
transmits the infection lives and breeds near fast-flowing streams and rivers
and the infection can result in blindness.

Life Cycle
During a blood meal, an infected blackfly (genus Simulium) introduces
third-stage filarial larvae onto the skin of the human host, where they
penetrate into the bite wound. In subcutaneous tissues the larvae develop
into adult filariae, which commonly reside in nodules in subcutaneous
connective tissues. Adults can live in the nodules for approximately 15 years.
Some nodules may contain numerous male and female worms. Females
measure 33 to 50 cm in length and 270 to 400 m in diameter, while males
measure 19 to 42 mm by 130 to 210 m. In the subcutaneous nodules, the
female worms are capable of producing microfilariae for approximately 9
years. The microfilariae, measuring 220 to 360 m by 5 to 9 m and
unsheathed, have a life span that may reach 2 years. They are occasionally
found in peripheral blood, urine, and sputum but are typically found in the
skin and in the lymphatics of connective tissues. A blackfly ingests the
microfilariae during a blood meal. After ingestion, the microfilariae migrate
from the blackfly's midgut through the hemocoel to the thoracic muscles.
There the microfilariae develop into first-stage larvae and subsequently into
third-stage infective larvae. The third-stage infective larvae migrate to the
blackfly's proboscis and can infect another human when the fly takes a blood
meal.

Trichinella Spiralis

Common Name : Trichina Worm

Description
Trichinella species are the smallest nematode parasite of humans,
have an unusual lifecycle, and are one of the most widespread and clinically
important parasites in the world.
The small adult worms mature in
the intestines of a definitive host such as a pig. Each adult female produces
batches of live larvae, which bore through the intestinal wall, enter the blood
(to feed on it) and lymphatic system, and are carried to striated muscle.
Once in the muscle, they encyst, or become enclosed in a capsule. Humans

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can be infected by eating infected pork, horsemeat, or wild carnivores such

as fox, cat, or bear.
Morphology
Males of T. spiralis measure between 1.4 and 1.6 mm long and are
more flat anteriorly than posteriorly. The anus can be found in the terminal
(side) and they have a large copulatory pseudobursa on each side. The
females of T. spiralis are about twice the size of the males and have an anus
found terminally. The vulva is located near the esophagus. The single uterus
of the female is filled with developing eggs in the posterior portion, while the
anterior portion contained the fully developed juveniles.
Transmission
Trichinellosis can be acquired by ingesting meat containing cycsts of
Trichinella. Once they are exposed to the gastric acid and pepsin, the larvae
are released from the cysts and invade the small bowel mucaso to mature
into adult worms. After 1 week, the females release larvae that migrate to
the striaredd muscles where they encyst. Encystment is completed in 4 to 5
weeks and the encysted larvae may remain viable for several years.
Ingestion of the encysted larvae perpetuates the cycle. Rats an rodents are
primarily responsible for maintaining the endemicity of this infection.
Different animal hosts are implicated in the life cycle of the different
species of Trichinella. Humans are accidentally infected when eating
improperly processed meat of these carnivorous animals (or eating food
contaminated with such meat).
Life Cycle
During a blood meal, an infected blackfly (genus Simulium) introduces
third-stage filarial larvae onto the skin of the human host, where they
penetrate into the bite wound. In subcutaneous tissues the larvae develop
into adult filariae, which commonly reside in nodules in subcutaneous
connective tissues. Adults can live in the nodules for approximately 15 years.
Some nodules may contain numerous male and female worms. Females
measure 33 to 50 cm in length and 270 to 400 m in diameter, while males
measure 19 to 42 mm by 130 to 210 m. In the subcutaneous nodules, the
female worms are capable of producing microfilariae for approximately 9
years. The microfilariae, measuring 220 to 360 m by 5 to 9 m and
unsheathed, have a life span that may reach 2 years. They are occasionally
found in peripheral blood, urine, and sputum but are typically found in the
skin and in the lymphatics of connective tissues. A blackfly ingests the
microfilariae during a blood meal. After ingestion, the microfilariae migrate
from the blackfly's midgut through the hemocoel to the thoracic muscles.
There the microfilariae develop into first-stage larvae and subsequently into
third-stage infective larvae. The third-stage infective larvae migrate to the
blackfly's proboscis and can infect another human when the fly takes a blood
meal.
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Strongyloides stercoralis
Threadworm

Common Name :

Description
The Strongyloides stercoralis nematode can parasitize humans. The
adult parasitic stage lives in tunnels in the mucosa of the small intestine. The
genus Strongyloides contains 53 species, and S. stercoralis is the type
species. S.
stercoralis has
been
reported
in
other mammals,
including cats and dogs. However, it seems that the species in dogs is
typically not S. stercoralis, but the related species S. canis. Non-human
primates are more commonly infected with S. fuelleborni and S. cebus,
although S. stercoralis has been reported in captive primates. Other species
of Strongyloides, naturally parasitic in humans, but with restricted
distributions, are S. fuelleborni in central Africa and S. kellyi in Papua New
Guinea.

Morphology
Whereas males grow to only about 0.9 mm (0.04 in) in length, females
can grow from 2.0 to 2.5 mm (0.08 to 0.10 in). Both genders also possess a
tiny buccal capsule and cylindrical esophagus without a posterior bulb. In the
free-living stage, the esophagi of both sexes are rhabditiform. Males can be
distinguished
from
females
by
two
structures:
the spicules and gubernaculum.
Transmission
The S. stercoralis has an unusual feather of infection called
autoinfection. Autoinfection is the development of L1 into small infective
larvae in the gut of the host. These autoinfective larvae penetrates the wall
of the lower ileum, the colon, or the skin if the perianal region, enter the
circulation; travel to the lungs, and to the small intestines, thus repeating the
cycle. Autoinfection makes strongyloidiasis die to S. stercoralis an infection
with unusual features.
Persistence of infection is the first of these important features. Because
of autoinfection, humans have been known to still be infected up to 65 years
after they were first exposed to the parasite (e.g., World War II or Vietnam
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War veterans). Once a host is infected with S. stercoralis, infection is lifelong

unless effective treatment eliminates all adult parasites and migrating
autoinfective larvae

Life Cycle
The Strongyloides life cycle is more complex than that of most
nematodes with its alternation between free-living and parasitic cycles, and
its potential for autoinfection and multiplication within the host. Two types of
cycles exist: Free-living cycle: The rhabditiform larvae passed in the stool
can either become infective filariform larvae (direct development) or free
living adult males and females that mate and produce eggs from which
rhabditiform larvae hatch. and eventually become infective filariform larvae.
The filariform larvae penetrate the human host skin to initiate the parasitic
cycle (see below). Parasitic cycle: Filariform larvae in contaminated soil
penetrate the human skin, and by various, often random routes, migrate into
the small intestine. Historically it was believed that the L3 larvae migrate via
the bloodstream to the lungs, where they are eventually coughed up and
swallowed. However, there is also evidence that L3 larvae can migrate
directly to the intestine via connective tissues. In the small intestine they
molt twice and become adult female worms. The females live threaded in the
epithelium of the small intestine and by parthenogenesis produce eggs,
which yield rhabditiform larvae. The rhabditiform larvae can either be passed
in the stool (see "Free-living cycle" above), or can cause autoinfection. In
autoinfection, the rhabditiform larvae become infective filariform larvae,
which can penetrate either the intestinal mucosa (internal autoinfection) or
the skin of the perianal area (external autoinfection); in either case, the
filariform larvae may disseminate throughout the body. To date, occurrence
of autoinfection in humans with helminthic infections is recognized only in
Strongyloides stercoralis and Capillaria philippinensis infections. In the case
of Strongyloides, autoinfection may explain the possibility of persistent
infections for many years in persons who have not been in an endemic area
and of hyperinfections in immunosuppressed individuals.

Trichuris trichiura
Whipworm

Common Name : Human

Description
The human whipworm (Trichuris trichiura or Trichocephalus trichiuris) is
a round worm (a type of helminth) that causes trichuriasis (a type
of helminthiasis which is one of the neglected tropical diseases) when it
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infects
a
human large
intestine.
It
is
commonly
known
as
thewhipworm which refers to the shape of the worm; it looks like a whip with
wider "handles" at the posterior end.
Morphology
Trichuris trichiura is typically 54mm x 22mm long, but sizes of the
whipworm ranges from 49-65mm x 20-25mm. It is elongated, and barrelshaped with a polar plug at each end. It appears as 1 cell or unsegmented
in its stage of development when being passed. T. trichiura has distinctive
polar plugs and eggs which are occasionally oriented in a vertical or slanted
position and not readily recognized. Gently tapping the coverslip will usually
reorient the egg. Atypical eggs lacking polar plugs may be seen on rare
occasions. Female and male T. trichiura are easil distinguishable by the
shape of their heads. Females have a straight and thick head while males
have a curly ended head.
Transmission
Infection occurs by the ingestion of eggs and is more common in warm
areas. Whipworms eggs are passed in the feces of infection persons, and if
an infected person defecates outside or if untreated human feces are used
as fertilizers, the eggs will be deposited on the soil where they can mature
into an infective stage. Ingestion of these eggs can happen when hands or
fingers that have contaminated dirt on them are placed in the mouth or by
consuming vegetables or fruits that are not carefully cleaned or cooked. The
eggs hatch in the small intestines, and then move into the wall of the small
intestine to develop. Upon reaching adulthood, the thinner end (front of the
worm) of the worm burrows into the large intestines and the thicker end
hangs into the lumen and mates with nearby worms.

Life Cycle
The unembryonated eggs are passed with the stool. In the soil, the
eggs develop into a 2-cell stage, an advanced cleavage stage, and then they
embryonate; eggs become infective in 15 to 30 days. After ingestion (soilcontaminated hands or food), the eggs hatch in the small intestine, and
release larvae that mature and establish themselves as adults in the colon.
The adult worms (approximately 4 cm in length) live in the cecum and
ascending colon. The adult worms are fixed in that location, with the anterior
portions threaded into the mucosa. The females begin to oviposit 60 to 70
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days after infection. Female worms in the cecum shed between 3,000 and
20,000 eggs per day. The life span of the adults is about 1 year.

Ascaris lumbricoides
Roundworm

Common Name: Large Intestinal

Description
It is the largest and most common human parasitic nematode. It is
responsible for the disease ascariasis in human. It has a worldwide
distribution and prevalent in tropical and subtropical regions like SubSaharan Africa and Southeast Asia. As. lumbricoides eggs are extremely
resistant to strong chemical, desiccation, and low temperature. It is a
monogenetic parasite which requires only a single host to complete its life
cycle.
Transmission
It can be transmitted through ingestion of vegetables which grow in fields
mannered with human faeces. Children playing in mud can transmit eggs to
their mouth through dirty fingers. Its transmission is associated with an
accidental ingestion of soil, contaminated foods and vegetables. It could also
be airborne and inhalation of dust which contains eggs could infect a person.
Morphology
Males: Male As. lumbricoides are 2-4 mm in diameter and 10-30 cm long. Its
posterior end is curved ventrally. They also have a single reproductive
tubule.
Females: Female As. Lumbricoides are 3- 6 mm wide and 20-35 cm long. Its
posterior end is straight and conical. The female has two reproductive
tubules.
Life cycle
Adult worms live in the lumen of the small intestine. A female may
produce approximately 200,000 eggs per day, which are passed with the
feces. Unfertilized eggs may be ingested but are not infective. Fertile eggs
embryonate and become infective after 18 days to several weeks, depending
on the environmental conditions (optimum: moist, warm, shaded soil). After
infective eggs are swallowed, the larvae hatch, invade the intestinal mucosa,
and are carried via the portal, then systemic circulation to the lungs. The
larvae mature further in the lungs (10 to 14 days), penetrate the alveolar
walls, ascend the bronchial tree to the throat, and are swallowed. Upon
reaching the small intestine, they develop into adult worms. Between 2 and 3
14
Nematodes Group 1; 2B PH (A.Y. 2015-2016)

months are required from ingestion of the infective eggs to oviposition by the
adult female. Adult worms can live 1 to 2 years.

Enterobius vermicularis
threadworm, seatworm

Common Names: pinworm,

Description
It is the causative agent of Enterobiasis and is proven to be mans
oldest parasitic infection. Pinworms are the smallest nematodes which could
infect man. It is common in areas with temperate and colder temperature.
Transmission
Pinworm infection usually occurs via ingestion of infectious eggs by
direct anus-to-mouth transfer by fingers. It is caused by frequent nail biting,
poor hygiene, or inadequate hand-washing. Its transmission could also occur
by touching contaminated surfaces, such as clothing, bed linen, and
bathroom fixtures followed by ingestion or even through inhalation or
ingestion of aerosolized eggs.
Morphology
The worms are small, white, and threadlike and are covered by a
resistant coating called cuticle. It has three lips surrounding the mouth and a
bulb on the posterior end of the esophagus.
Females: Female Enterobius vermicularis ranges between 8-13 mm x 0.30.5 mm and are fusiform in shape. They possess a long, pinshaped posterior
end from which the parasite's name is derived.
Males: Male Enterobius vermicularis ranges between 2-5 mm x 0.1-0.2 mm
and has a curved tail.
Life cycle
Eggs are deposited on perianal folds. Enterobiasis may also be acquired
through surfaces in the environment that are contaminated with pinworm
eggs (e.g., curtains, carpeting). Some small number of eggs may become
airborne and inhaled. These would be swallowed and follow the same
development as ingested eggs. Following ingestion of infective eggs, the
larvae hatch in the small intestine and the adults establish themselves in the
colon. The time interval from ingestion of infective eggs to oviposition by the
adult females is about one month. The life span of the adults is about two
months. Gravid females migrate nocturnally outside the anus and oviposit
while crawling on the skin of the perianal area. The larvae contained inside
the eggs develop (the eggs become infective) in 4 to 6 hours under optimal
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Nematodes Group 1; 2B PH (A.Y. 2015-2016)

conditions. Retroinfection, or the migration of newly hatched larvae from the

anal skin back into the rectum, may occur but the frequency with which this
happens is unknown.

Necator americanus and Ancylostoma duodenale

Description
They are commonly found in regions which are moist and warm and
where the skin frequently contacts the soil is optimal for infection, especially
in areas of poor sanitation.
Transmission
Hookworm infection is contracted from contact with soil contaminated
by hookworm, by walking bare foot or accidentally swallowing contaminated
soil. Hookworms cant be spread person to person.
Life cycle
Eggs are passed in the stool, and under favorable conditions (moisture,
warmth, shade), larvae hatch in 1 to 2 days. The released rhabditiform larvae
grow in the feces and/or the soil, and after 5 to 10 days (and two molts) they
become filariform (third-stage) larvae that are infective. These infective
larvae can survive 3 to 4 weeks in favorable environmental conditions. On
contact with the human host, the larvae penetrate the skin and are carried
through the blood vessels to the heart and then to the lungs. They penetrate
into the pulmonary alveoli, ascend the bronchial tree to the pharynx, and are
swallowed. The larvae reach the small intestine, where they reside and
mature into adults. Adult worms live in the lumen of the small intestine,
where they attach to the intestinal wall with resultant blood loss by the host.
Most adult worms are eliminated in 1 to 2 years, but the longevity may reach
several years. Some A. duodenale larvae, following penetration of the host
skin, can become dormant (in the intestine or muscle). In addition, infection
by A. duodenale may probably also occur by the oral and transmammary
route. N. americanus, however, requires a transpulmonary migration phase.
Ancylostoma duodenale

Common name: Old World hookworm

Description
It is associated with miners and probably the cause of anemia in
miners because mines offer an ideal habitat for the development of the egg
due to its constant temperature and humidity. Moist, warm regions of the
world where the skin frequently contacts the soil is optimal for infection,
especially in areas of poor sanitation. It is commonly found in Europe and
South America.
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Nematodes Group 1; 2B PH (A.Y. 2015-2016)

Morphology
It is a single curve which looks like C. Its copulatory bursa is circle in
shape when viewed from the top.
Male: Male measures 5-11 mm which is smaller than the female. The
anterior end have buccal capsule which are armed with two ventral pairs of
teeth. The posterior end of the male has copulatory bursa to attach the
female during the copulation.
Female: Female measures about 9-13 mm. They also have a simple conical
tail. They produce 25,000 eggs per day which are oval in shape and have
empty space between the shell and its content. Eggs are 60 x 40 m in size,
colorless and transparent in color and have a thin egg shell which contains 48 unembronated cell.
Rhabditiform larva (wet mount): Are thin with long buccal cavity and
measures 200-400 m.
Filariform larva: measures 600-700m and has sharply pointed tail.

Necator americanus

Common Name: New World hookworm

Description
It is a predominant soil-transmitted human parasitic nematode. It is the
most common species in humans in the world and are commonly found in
North America and Africa.
Morphology
It has double curves which look like an S. Its copulatory bursa is circle
in shape when viewed from the top. Four teeth or two pairs of dorsal and
ventral cutting teeth are present.
Males: Male N. americanus has needlelike specules have minute barbs at
their tips and are fused distally. They are commonly 7-9 mm in size.
Females: Their size commonly range from 9 to 11 mm and produces 9000
eggs per day. The eggs are bluntly rounded, thin shelled, and are almost
indistinguishable between the different species.

Dracunculus medinensis
worm

Common Name: The Guinea

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Nematodes Group 1; 2B PH (A.Y. 2015-2016)

Description
The guinea worm causes dracunculiasis which is caused by the large
female nematode. This disease is limited to the sub-Saharan Africa. The
disease typically occurs in rural areas where piped water supplies are not
available.
Morphology
The adult female is longer than the male and can grow up to about 1m
in length inside the body of the human host. The D. medinensis worms
inhabit the cutaneous and subcutaneous tissues of infected individuals, the
female reaching a length of up to 700mm, and the male 25mm.
Transmission
The worm inhabits the cutaneous and subcutaneous tissues of infected
individuals and transmitted by drinking contaminated waiter infected by D.
medinensis. Its transmission is highly seasonal and depends on the changes
in water sources.
Life cycle
Humans become infected by drinking unfiltered water containing
copepods (small crustaceans) which are infected with larvae of D.
medinensis. Following ingestion, the copepods die and release the larvae,
which penetrate the host stomach and intestinal wall and enter the
abdominal cavity and retroperitoneal space. After maturation into adults and
copulation, the male worms die and the females (length: 70 to 120 cm)
migrate in the subcutaneous tissues towards the skin surface. Approximately
one year after infection, the female worm induces a blister on the skin,
generally on the distal lower extremity, which ruptures. When this lesion
comes into contact with water, a contact that the patient seeks to relieve the
local discomfort, the female worm emerges and releases larvae. The larvae
are ingested by a copepod and after two weeks (and two molts) have
developed into infective larvae. Ingestion of the copepods closes the cycle.

Treatment of Parasitic Nematodes

Trichinella spiralis
Common Name: Trichina Worm / Pork Worm
Disease: Trichinellosis (formerly called Trichinosis)
Portal of Entry: Gastrointestinal Tract
Diagnosis:
Biopsy specimens, as well as a number of serological tests,
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Nematodes Group 1; 2B PH (A.Y. 2015-2016)

can be used in diagnosis.

A serological ELISA test that detects the parasite in meats
has also been developed.
Transmission:
Ingestion of undercooked pork. (Larvae Ingested)
Signs/Symptoms:
Fever
Swelling around the eyes
Gastrointestinal upset
Small hemorrhages under the fingernails
Prevention:
Make sure pork is not undercooked or contaminated by the
parasite.
Freezing pork for prolonged periods (for example, - 23C for 10
days) kills T. spiralis.
Treatment:
Typically, patients are treated with either mebendazole or
albendazole (anthelmintics).
Symptoms can be relieved by use of analgesics and
corticosteroids.

Ascaris lumbricoides
Common Name: Giant Roundworm
Disease: Ascariasis
Portal of Entry: Gastrointestinal tract, occasionally through the
respiratory tract as well.
Diagnosis:
The diagnosis of ascariasis is usually made via stool
microscopy.
Transmission:
Transmission occurs mainly via ingestion of water or food
contaminated with A. lumbricoides eggs, and occasionally via
inhalation of contaminated dust.
Signs/Symptoms:
Pulmonary & hypersensitivity manifestations (Ex.
Intestinal symptoms (Ex. Abdominal discomfort)
Intestinal obstruction (Ex. Constipation)
Hepatobiliary and Pancreatic symptoms (Ex. Obstructive
Jaundice)
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Nematodes Group 1; 2B PH (A.Y. 2015-2016)

Prevention:
Good sanitation to prevent fecal contamination of soil is
required.
Treatment:
Treatment consists of choosing the right drugs, therapy, follow-up,
and supportive care for each patient, below is the common choices
of drugs.
pyrantel pamoate
mebendazole
albendazole
ivermectin
piperazine citrate
levamizole

Strongyloides stercoralis
Common Name: Threadworm
Disease: Strongyloidiasis
Portal of Entry: Skin (Penetration of the skin by larvae)
Diagnosis:
Strongyloides is usually diagnosed by seeing larvae in stool
when examined under the microscope.
Transmission:
Contact with soil that is contaminated with free-living larvae.
Signs & Symptoms:
Dermatitis
Mild to severe symptom of pneumonia during migration to
air-sacs of lungs.
Inflammation of the intestinal mucosa.
Diarrhea accompanied by emaciation and exhaustion.
In massive infections death may result unless therapeutic
measures are taken.
Prevention:
Wear shoes when you are walking on soil.
Avoid contact with fecal matter or sewage.
Proper sewage disposal and fecal management.
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Nematodes Group 1; 2B PH (A.Y. 2015-2016)

Treatment:
Ivermectin is the drug of first choice for treatment, because
of higher tolerance in patients.
(Thiabendazole was used previously, but, owing to its high
prevalence of side effects (dizziness, vomiting, and nausea) and
lower efficacy; it has been superseded by ivermectin.)

Enterobius vermiculari
Common Name: Human Pinworm
Disease: Pinworm infection (Enterobiasis)
Portal of Entry:
Gastrointestinal tract
Anus
Transmission:
Usually occurs via ingestion of infectious eggs by direct
anus-to-mouth transfer by fingers.
Diagnosis:
Diagnosis of pinworm can be reached from three simple
techniques.
The first option is to look for the worms in the perianal
reqion 2 to 3 hours after the infected person is asleep.
Tape Method & Microscopic Examination
The tape method should be conducted on 3 consecutive mornings,
right after the infected person wakes up and before he/she does
any washing.
Touch the perianal skin with transparent tape to collect possible
pinworm eggs around the anus first thing in the morning. If a
person is infected, the eggs on the tape will be visible under a
microscope.
Analyzing samples from under fingernails under a
microscope.
Signs & Symptoms:
Pruritis ani
Peritoneal pruritis
Prevention:
Washing your hands with soap and warm water after using
the toilet, changing diapers, and before handling food.

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Nematodes Group 1; 2B PH (A.Y. 2015-2016)

Treatment:
Medication is the primary treatment for pinworm infection.The
existing pharmaceutical drugs against pinworms are so effective
that many medical scientists regard hygienic measures as
impractical.
Albendazole or Mebendazole is the first-line treatment of
pinworm infection.
Pyrantel pamoate is used as a second-line medication.

Trichuris trichiura
Common Name: Human Whipworm
Disease: Whipworm Infection (Trichuriasis)
Portal of Entry: Gastrointestinal Tract
Transmission:
Ingestion of infective eggs by mouth contact with hands or
food contaminated with egg-carrying soil.
Diagnosis:
A stool ova and parasites exam reveals the presence of
typical whipworm eggs.
(Typically, the Kato-Katz thick-smear technique is used for
identification of the Trichuris trichiura eggs in the stool sample.)
Signs & Symptoms:
Light infections are usually without symptoms;
Heavier infections can lead to abdominal pain, diarrhea and
bloody stools.
Rectal prolapse is occasionally observed in children with
heavy infections.
Prevention:
Wash, peel, or cook all raw vegetables and fruits before
eating, particularly those that have been grown in soil that
has been fertilized with manure.
Effective sewage disposal systems.
Treatment:
Anthelminthic medications, such as albendazole and
mebendazole, are the drugs of choice for treatment.
Iron supplements may also be prescribed if the infected
person suffers from anemia.

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Nematodes Group 1; 2B PH (A.Y. 2015-2016)

Necator americanus
Common Name: Human Hookworm/New world Hookworm
Disease: Hookworms which may lead to anemia, may also cause growth
stunting in children.
Portal of Entry: Skin
Transmission:
Infective larvae, develop from eggs excreted in feces and penetrate
the skin, usually by the dorsum of the bare feet or between the
toes; vertical transmission from mother to child is possible
Diagnosis:
The standard method for diagnosing the presence of hookworm is
by identifying hookworm eggs in a stool sample using a
microscope. Because eggs may be difficult to find in light
infections, a concentration procedure is recommended.
Prevention:
Do not walk barefoot in areas where hookworm is common and
where there may be fecal contamination of the soil.
Avoid other skin-to-soil contact and avoid ingesting such soil.
Fecal contamination occurs when people defecate outdoors or use
human feces as fertilizer.
The infection of others can be prevented by not defecating
outdoors or using human feces as fertilizer, and by effective
sewage disposal systems.
Signs

and Symptoms:
itching and a localized rash
abdominal pain
diarrhea
loss of appetite
weight loss
fatigue
anemia
The physical and cognitive growth of children can be affected.

Treatment:
Albendazole take 400 mg orally once
Mebendazole take 100 mg orally twice a day for 3 days or 500 mg
orally once
Pyrantel pamoate take 11 mg/kg (up to a maximum of 1 g) orally
daily for 3 days

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Nematodes Group 1; 2B PH (A.Y. 2015-2016)

Ancylostoma duodenale
Common Name: Human Hookworm/ Old World Hookworm
Disease: Hookworm infection which may lead to anemia.
Portal of Entry: Skin
Transmission:
Infective larvae, develop from eggs excreted in feces and
penetrate the skin, usually by the dorsum of the bare feet or
between the toes; vertical transmission from mother to child is
possible
Diagnosis:
The standard method for diagnosing the presence of hookworm is
by identifying hookworm eggs in a stool sample using a
microscope. Because eggs may be difficult to find in light
infections, a concentration procedure is recommended.
Prevention:
Do not defecate in the open, but rather in toilets.
Do not use untreated human excreta or raw sewage as fertilizer in
agriculture
Do not walk barefoot in known infected areas
Signs and Symptoms:
itchiness and a small rash caused by an allergic reaction
diarrhea as the hookworms grow in your intestine
abdominal pain
colic (cramping and excessive crying in infants)
intestinal cramps
nausea
fever
blood in your stool
appetite loss
Treatment:
Albendazole take 400 mg orally once
Mebendazole take 100 mg orally twice a day for 3 days or 500 mg
orally once
Pyrantel pamoate take 11 mg/kg (up to a maximum of 1 g) orally
daily for 3 days
The treatments for this type of hookworm is similar to Necator
americanus.

Dracunculus medinensis
Common Name: Guinea worm, medina worm, serpent worm
24
Nematodes Group 1; 2B PH (A.Y. 2015-2016)

Disease: Guinea worm disease,

dracontiasis)
Portal of Entry: Gastrointestinal Tract

also

called

(dracunculiasis

or

Transmission:
The parasite is transmitted to man by drinking raw water
containing infected cyclopses.
Diagnosis:
Diagnosis of GWD is made by visual identification of the female
Guinea worm protruding from a skin lesion.
Microscopic identification of larvae is also a method of diagnosis.
Prevention:
control of water fleas and early detection of cases
availability of clean drinking water is
filtration of water to remove infected water fleas from suspect
water sources
treatment of contaminated water supplies with pesticides to kill
the fleas.
Signs and Symptoms:
severe itching
nausea
vomiting
diarrhea
dizziness
formation of blisters
Treatment:
There is no specific drug treatment for guinea worm disease.
Soaking the site of the blister in a container of water encourages
the worm to emerge. Once it has broken through the skin, gentle
traction is applied to the worm, speeding its emergence, which
may take several days or weeks. The worm usually is wrapped
around a piece of gauze or a stick to maintain tension and
prevent the worm from retracting into the body.
Topical antibiotics often are applied to the site of the wound to
prevent infection with another organism during the extraction
period.
Aspirin or ibuprofen may be administered to relieve pain and
reduce inflammation.

Brugia malayi
Common Name: Malayan Filaria
Disease: Malayan Filariasis (lymphatic filariasis)
Portal of Entry: Skin
Transmission:
The infection spreads from person to person by mosquito bites.
Diagnosis:
The standard method for diagnosing active infection is the
identification of microfilariae in a blood smear by microscopic
25
Nematodes Group 1; 2B PH (A.Y. 2015-2016)

examination and a thick smear should be made and stained with

Giemsa or hematoxylin and eosin.
For increased sensitivity, concentration techniques can be used.
Prevention:
sleep under a mosquito net
wear long sleeves and trousers
use mosquito repellent on exposed skin between dusk and dawn
Signs and Symptoms:
swelling and the decreased function of the lymph system
hardening and thickening of the skin, which is called elephantiasis
cough
shortness of breath
wheezing
Treatment:
Diethylcarbamazine (DEC) is the drug registered for use in this
disease, however it is associated with many side effects
Ivermectin and DEC appears to be effective combination as they
act synergistically
Tetracycline antibiotics to kill Wolbachia bacteria
Severely
damaged
extremities
may
undergo
surgical
decompression of the lymphatic system

Onchocerca volvulus
Common Name: African Riverblindness nematodes
Disease: River Blindness (Onchocerciasis)
Portal of Entry: Skin
Transmission:
It is transmitted through repeated bites by blackflies of the genus
Simulium.
Diagnosis:
Definitive diagnosis is simply done by seeing adult worms in
excised skin nodules, eye lesions, or by finding microfilariae in
skin shavings or punch biopsies of the skin
Prevention:
Wearing insect repellant such as N,N-Diethyl-meta-toluamide
(DEET) on exposed skin
Wearing long sleeves and long pants during the day when
blackflies bite
Wearing permethrin- treated clothing.
Signs and Symptoms:
Skin inflammation that is very itchy and forms papuleson the skin
nodules in the skin (subcutaneous nodules); scarred, saggy, or
drooping areas of skin,
patchy skin depigmentation (leopard skin),
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Nematodes Group 1; 2B PH (A.Y. 2015-2016)

lymph node inflammation (lymphadenitis),

eye (ocular) lesions,
visual problems (partial or complete blindness),
eosinophilia (unusually high levels of eosinophils in the blood),
"Sowda" is a term used to describe the severe itching and skin
discoloration (darkening), that is often confined to one limb.
Treatment:
Treatment is done by giving the patient ivermectin, an
antiparasitic drug once or twice per year for about 10-15 years
(the life span of adult worms). This drug is effective in killing the
microfilariae but does not kill the adult worms.
Most clinicians recommend that subcutaneous nodules should be
excised, if possible, thereby removing the adult worms.
Doxycycline damages and kills Wolbachiabacteria that are inside
the microfilariae and adult worms, resulting in the death of
microfilariae and ineffective microfilariae produced by the
surviving adult worms.
The use of diethylcarbamazine (a treatment used before
ivermectin became available) is contraindicated. It may cause
severe or fatal patient reactions in individuals with
onchocerciasis.

27
Nematodes Group 1; 2B PH (A.Y. 2015-2016)