Classification and General Characteristics of

Medically Important Parasites

Host-Parasite Interactions

PARASITES: EATING US ALIVE (Video)

Nelson A. Salazar, M.Sc.,DLSHTM, Ph.D.

 Prohibiciones y demas

• Comer o beber en el salon de clase

• No se puede entrar a clase despues de 15 minutos de

haber empezado la misma

• Hay 15 minutos de descanso a la mitad de la clase

• Cualquier situacion que afecte la realizacion de la clase

 Trichuris trichiura 1.0
X Trichuris trichura 0.0

 Entamoeba histolytica 1.0

X Entamoeba hystolytica 0.0

 Ancylostoma duodenale 1.0

X Ancylostoma duodenalis 0.0

 Rhodnius prolixus 1.0

X Rodnius prolisus 0.0

 Necator americanus 1.0

 GENERAL INTRODUCTION

Parasitology
Parasitology deals with the study of parasites which infects and
produce disease in human beings.

Parasite
A parasite is a living organism which depends on the another
living host for its survival

A parasite obtains nutrition from the host, without giving any

benefit to the host

A parasite also produce disease to the host

 Types of Parasites

Ectoparasites
• Remain external to the host. v. g. ticks, fleas, lice
Fly larvas (maggots)

Endoparasites
• Live inside the body of the host. v.g. tapeworms, malaria and
leishmania parasites
Arthropod Parasites of Man
(ECTOPARASITES)

Fig.11. a Ixodes ricinus, female

engorged with blood; b Sarcoptes
scabiei, female; c body louse; d crab
louse; e sandfly (Phlebotomus
papatasi) feeding on human skin; f dog
flea (Ctenocephalides canis).

(Image e: H. M. Seitz, Institut fu¨r Medizinische Parasitologie,

Bonn.)
 Fleas

Fig. 4 A LM of Pulex irritans. B SEM of Pulex irritans.
Flea bites on the back of a human
 FLEA  BITES

Fig. 1 Three flea bites in a row.

 ECTOPARASITES (Lice)
• Pediculus humanus var. capitis

Louse and nit on hair shafts.
Figure 4: Multiple nits present in a young 
female
 ECTOPARASITES (Lice)

Pediculus humanus var. corporis

Body lice nits tend to 
concentrate along the seams 
of clothing
Pediculosis humanus humanus
(human body louse)

Body lice infestation of long duration can lead 
to hyperpigmentation and excoriations. 
Courtesy of John T Crissey, MD
 ECTOPARASITES (Lice)

Lice (pediculosis)

Fig. 1. Pediculosis pubis.

SEM of Phthirus pubis or
crab louse (×30).

A small brown living crab louse is seen 
at the base of hairs (arrow).

Pediculosis pubis. Eyelash

infestation with Pthirus pubis.
Nits can be seen attached to the
eyelashes.
 ECTOPARASITES (Ticks)

Ixodes tick species are transmitters of

bacteria and viruses such as Borrelia
burgdorferi (Lyme disease)
or Flaviviridae (tick-borne encephalitis), but
they are also vectors for the protozoa that
cause babesiosis (Babesia microti).

With its abdomen engorged with a host blood

meal, this image depicts a lateral, or side
view of a female blacklegged, or deer tick,
Ixodes scapularis/CDC
Ixodes scapularis/CDC
 ECTOPARASITES (fly larvas)

Dermatobia hominis. The

Male Cochliomyia hominivorax. The new
world screw-worm is a notorious pest of
domestic stock that also attacks open
wounds on man. The larvae feed on living
as well as dead tissue (x8)
larvae of this fly are a cause of
serious cutaneous myiasis
in Brazil and other tropical areas
of the new world (x2.5)
 Oral myiasis is caused
by the larvae of the fly
family sarcophagidae in
wounds

Fig. 1 Appearance of the patient at presentation. Note the presence of

larvae in the palate (British Dental J.)
 Oral Myiasis

Fig. 2 Removal of the maggots and wound debridement

(British Dental J.)
 Fig. 1. Traumatic wound myiasis.

• On examination wound was foul smelling, covered with necrotic

debris and few maggots could be seen “peeking” from it (Fig. 1).
Fig. 2. Extraction of maggots with tweezers
under L.A. using turpentine oil.

• Oral hygiene was very poor. Extraction of maggots was done under
local anesthetic (L.A.) with suffocation technique using turpentine
(trementina) oil (Fig. 2).
• Around 20–25 live maggots were removed on first day (Fig. 3), 5 each on
2nd and 3rd day. Wound was debrided, lavaged with normal saline and
closed. Initial healing was good, patient did not report for subsequent
followup.

The larvae were identified as 
Musca domestica (Muscidae).

Fig. 3. Collected multiple maggots in

bowl.
 ECTOPARASITES (Fly larvas)

Ophthalmomyiasis

Myiasis is infection with a fly larva,

usually occurring in tropical and
subtropical areas (Dermatobia
hominis and Cochliomyia hominivorax in 
the Americas)
ECTOPARASITES (Fly larvas)

Ophthalmomyiasis is caused by
Dermatobia hominis
Types of Parasites (endoparasites)
Fig. 15.2 Sites of
infection of medically
important parasites
 Parasitic Diseases of the Central Nervous
System (i)

• Cysticercosis (Parenchymal, Intraventricular, Cisternal,

Spinal)(T. solium)

• Echinococcosis
Cystic Echinococcosis(CE)(E. granulosus):Cisternal,
Ventricular, Spinal)
Cerebral Alveolar Echinococcosis (E. multilocularis)
 Parasitic Diseases of the Central Nervous
System (ii)

• Schistosomiasis
S. mansoni and S. haematobium: Spinal infection
S. japonicum: Brain

• Granulomatous Amebic Encephalitis (GAE):

Acanthamoeba and Leptomyxida

• Primary Amebic Meningoencephalitis (PAM):

N. fowleri
 Parasitic Diseases of the Central Nervous
System (iii)

• Toxocariasis: T. canis
Cerebral Parenchymal Toxocariasis
Spinal Toxocariasis

• Cerebral Trichinosis: T. spiralis

Fig. 15.1 Important
parasitic infections of
humans
Fig. 15.w1 Comparative size of
various parasites
 Classification of parasitic protozoa and helminths
that infect humans (i)

KINGDOM PROTOZOA

Group 1 (flagellates)

Phylum Metamonada (flagellates)

Class Trepomonadea (intestinal flagellates)
Order Diplomonadida: Giardia duodenalis

Class Trichomonadea (intestinal and related flagellates)

Order Trichomonadida: Dientamoeba fragilis,
Trichomonas vaginalis
 Classification of parasitic protozoa and helminths
that infect humans (ii)

KINGDOM PROTOZOA

Group 1 (flagellates)

Phylum Percolozoa (flagellates and amoebae)

Class Heterolobosea (free-living and opportunistic
flagellated amoebae and amoebae)
Order Schizopyrenida: Naegleria fowleri

Phylum Euglenozoa (flagellates)

Class Kinetoplastidea (blood- and tissue-inhabiting
flagellates)
Order Trypanosomatida: Leishmania donovani, L.
infantum, L. major, Trypanosoma cruzi, T.
brucei gambiense, T. brucei rhodesiense
 Classification of parasitic protozoa and helminths
that infect humans (iii)

KINGDOM PROTOZOA

Group 2 (amoebae)
Phylum Amoebozoa (amoebae)
Class Amoebaea (amoebae, free-living and opportunistic
parasites)
Order Acanthopodida: Acanthamoeba castellanii,
Balamuthia mandrillaris
Class Archamoebea (intestinal amoebae)
Order Euamoebida: Entamoeba histolytica, E. coli, E.
dispar, E. hartmanni
Classification of parasitic protozoa and helminths
that infect humans (iv)

KINGDOM PROTOZOA

Group 3 (sporozoans)

Phylum: Apicomplexa (sporozoans and dinoflagellates)

Subphylum: Sporozoa
Class: Coccidea (sporozoan parasites)
Order: Eimeriida: Cryptosporidium parvum,
Toxoplasma gondii, Cyclospora cayetanensis

Order: Haemosporida: Plasmodium knowlesi, P. falciparum,

P. malariae, P. ovale, P. vivax
 Classification of parasitic protozoa and helminths
that infect humans (v)

KINGDOM PROTOZOA

Group 4 (ciliates)
Phylum Ciliophora (ciliates)
Class Litostomatea (free-living and parasitic ciliates)
Order Vestibulifera: Balantidium coli
 Classification of parasitic protozoa and helminths
that infect humans (vi)

KINGDOM STRAMENOPILA (FORMERLY CHROMISTA)

Subkingdom Chromobiota

Phylum Bigyra
Class Blastocystea: Blastocystis hominis
 Classification of parasitic protozoa and helminths
that infect humans (vii)

KINGDOM ANIMALIA

Subkingdom 3, Bilateria
Infrakingdom 1, Ecdysozoa
Phylum Nemathelminthes (Nematoda, roundworms)
Class Adenophorea (Aphasmidia)
Superfamily Trichinelloidea

Family Trichinellidae: Trichinella spiralis

Family Trichuridae: Trichuris trichiura
 Classification of parasitic protozoa and helminths
that infect humans (viii)

KINGDOM ANIMALIA

Class Secernentea (Phasmidea)

Superfamily Ancylostomatoidea
Family Ancylostomatidae: Ancylostoma duodenale, A.
braziliense, A. caninum, Necator americanus

Superfamily Ascaridoidea
Family Ascarididae: Ascaris lumbricoides, Toxocara canis,
Toxocara cati
 Classification of parasitic protozoa and helminths
that infect humans (ix)

KINGDOM ANIMALIA

Superfamily Filarioidea
Family Onchocercidae: Brugia malayi, Loa loa,
Wuchereria bancrofti, Onchocerca volvulus

Superfamily Oxyuroidea
Family Oxyuridae: Enterobius vermicularis, E. gregorii

Superfamily Rhabditoidea
Family Strongyloididae: Strongyloides fuelleborni,
Strongyloides stercoralis
 Classification of parasitic protozoa and helminths
that infect humans (x)

KINGDOM ANIMALIA

Infrakingdom 2, Platyzoa
Phylum 2, Platyhelminthes
Class Trematoda (del gr. trimatodis, con aberturas o ventosas)
subclass Digenea (flukes)
Order Strigeida
Family Schistosomatidae: Schistosoma haematobium, S.
japonicum, S. mansoni, S. mekongi, S. intercalatum
Order Echinostomida
Family Fasciolidae: Fasciola hepatica, Fasciolopsis buski,
Fasciola gigantica
 Classification of parasitic protozoa and helminths
that infect humans (xi)
KINGDOM ANIMALIA

Class Cestoidea (Cestoda, tapeworms)

Order Cyclophyllidea
Family Dipylidiidae: Dipylidium caninum

Family Hymenolepididae: Hymenolepis nana,

Hymenolepis diminuta

Family Taeniidae: Taenia saginata, Taenia solium,

Echinococcus granulosus, E. multilocularis
 Parasite-Host Interactions

Parasitism is a type of non mutual relationship between

organisms of different species where one organism, the
parasite, benefits at the expense of the other, the host

Parasito: the Greek παράσιτος (parasitos), "one who eats

at the table of another“

Commensalism: an association in which the commensal

takes the benefit without causing injury to the host. e. g.
Most of the normal floras of the human´s body can be
considered as commensals.
 Parasite-Host Interactions

Vector: A Latin word meaning ‘carrier’, an organism,

often an invertebrate arthropod, that transmits a
pathogen from reservoir to host

Anopheles spp/CDC Aedes aegypti/CDC

Infestation is often reserved only for external

ectoparasitic infestations while the term infection refers
to internal endoparasitic conditions.
 Zoonoses
In 1959, the World Health Organization (WHO) defined
zoonosis as “those diseases and infections, which are
naturally transmitted between vertebrate animals and
man”.
It is of following types:
Protozoal zoonoses, e.g. toxoplasmosis, leishmaniasis,
balantidiasis, and cryptosporodiasis
Helminthic zoonoses, e.g. hydatid disease, taeniasis
Anthropozoonoses: Infections transmitted to man from
lower vertebrate animals, e.g. cystic echinococcosis
Zooanthroponosis: Infections transmitted from man to lower
vertebrate animals, e.g. methicillin-resistant
Staphylococcus aureus, influenza A virus, Cryptosporidium
parvum, and Ascaris lumbricoides.
 Parasite-Host Interactions

Definitive host (final host): the organism in which a

parasite passes its adult and sexual existence.

Intermediate host: the organism in which a parasite

passes its larval or nonsexual existence.

Reservoir host: a host that makes the parasite available

for the transmission to another host and is usually not
affected by the infection
 Classification of Parasites

Endoparasites: parasites which live within the body of the

host and are said to cause an infection. Most of the
protozoan and helminthic parasites causing human disease
are endoparasites.

Chagas disease
 Classification of Parasites

• Free-living parasites: It refers to nonparasitic stages of

active existence, which live independent of the host, e.g.
cystic stage of Naegleria fowleri.
 Parasite stages

Cyst:

• non-dividing
• rigid cell coat
• resistant to H20 + dessication
• can survive outside of host in most Entamoeba coli. Two supernucleate
ambient conditions cysts with 16 nuclei.

• transmission state

Trophozoite:

• dividing (binary fission)

• labile cell membrane
• disease causing state
• cannot survive outside of host
Entamoeba histolytica—Trophozoite. 
Crossing of the blood-brain barrier by PARASITES
Table 1. Interaction of selected blood-borne parasites with the
blood-brain barrier (BBB)

ALCAM, activated leukocyte cell adhesion molecule

BBB, blood-brain barrier
CNS, central nervous system
CXCL10, C-X-C motif chemokine 10
GBP, galactose-binding protein
HAT, human African trypanosomiasis
ICAM-1, intercellular adhesion molecule 1
IFN, interferón
MIC2, micronemal protein 2
MBP, mannose-binding protein
ND, not defined
PAR2, protease-activated receptor-2
PfEMP-1, Plasmodium falciparum erythrocyte membrane protein 1
TNF, tumor necrosis factor
VCAM-1, vascular cell adhesion molecule 1
WBCs, white blood cells

Passage of parasites across the blood-brain barrier. 2012. Virulence 3(2): 202–212
 Host genetics and parasitic infections

FIG. 1. Loci showing associations or linkages with parasitic and immunological

disorders. Loci involved in susceptibility to parasitic diseases are those discussed in the
sections dedicated to individual parasites. Additional loci were identified for malaria from
previous reviews. AfT, African trypanosomiasis; AmT, American trypanosomiasis; As,
ascariasis; CL, cutaneous leishmaniasis; LF, lymphatic filariasis; On; Onchocerca
volvulus; Pf, Plasmodium falciparum; Sh, Schistosoma haematobium; Sj; Schistosoma
japonicum; Sm, Schistosoma mansoni; Tr; Trichuris trichiura; VL, visceral leishmaniasis.
A parasite in a
paratenic
(intermediate) host
does not undergo any
changes into the
following stages of its
development.
Foodborne 
trematodiases can 
cause severe liver and 
lung disease, and on rare 
occasions death. Most 
prevalent in East Asia 
and South America, the 
disease is caused by 
worms that people get 
by eating raw fish, 
shellfish or vegetables 
that have been infected 
with larvae.
Fig. 2. Common diseases
in travellers reporting to the
geoSentinel network.

Nature Reviews Microbiology

2009. 7 :895-901
Fig. 4. The reporting rate ratios (in
cases per million travellers) of
acquiring viral, bacterial and parasitic
gastrointestinal infections, according to
the region of travel
Fig. 62-9 Size ranges of intestinal protozoa. (Balantidium coli trophozoites may
measure up to 200 μm.)
N,N-Diethyl-meta-toluamide, also called
DEET or diethyltoluamide
Fig. 20.1 Intestinal parasites of clinical importance among immigrants.
 PARASITES CAUSING CANCER

The International Agency for Research on Cancer (IARC)

identifies ten infectious agents (viruses, bacteria, parasites)
able to induce cancer disease in humans.

Among parasites, a carcinogenic role is currently

recognized to the digenetic trematodes:

• Schistosoma haematobium, leading to bladder cancer

• Clonorchis sinensis or Opisthorchis viverrini, which
cause cholangiocarcinoma.
 Parasitic Infections in Organ Transplant Recipients

• Nonintestinal Protozoa • Intestinal Protozoa

Toxoplasmosis Microsporidiosis
Cryptosporidiosis
Leishmaniasis Cyclosporiasis
Malaria Amebiasis
Babesiosis
Chagas Disease
Free-Living Amebas • Helminths

Strongyloidiasis
Schistosomiasis
Echinococcosis
Filariasis
 Parasitic Infections of the Eye

Ocular Disease Caused by Protozoans

• Toxoplasmosis
• Chagas Disease
• Malaria Fig. 3. Acanthamoeba keratitis

• Leishmaniasis
• Acanthamoeba infection
• Microsporidiosis
• Giardiasis
• Gnathostomiasis

Fig.2 Congenital ocular toxoplasmosis

 Parasitic Infections of the Eye

Ocular Disease Caused by Nematodes

• Onchocerciasis
• Loiasis
• Dirofilariasis

Ocular Disease Caused by Cestodes Onchocerciasis

• Cysticercosis
• Toxocariasis
• Echinococcosis

Ocular cysticercosis
 Parasitic Infections of the Skin
• Leishmaniasis
Cutaneous
Mucocutaneous

• Cutaneous Amebiasis
 Parasitic Infections of the Skin

Cutaneous Disease caused by

free-living amoeba (Balamuthia
mandrillaris)

Skin lesion of cutaneous larva migrans

Ancylostoma caninum
 REFERENCES

www.who.int
www.paho.org
www.wellcome.ac.uk
www.ins.gov.co
www.cdc.gov/parasites/az/
www.animalplanet/monstersinsideme.com

Atlas de Parasitologia. Universidad Nacional de Colombia.

Parasites: Eating Us Alive (Video)