Causal Agent:

Toxoplasma gondii is a protozoan parasite

that infects most species of warm blooded
animals, including humans, and can cause
the disease toxoplasmosis.

The only known definitive hosts for Toxoplasma gondii are members
of family Felidae (domestic cats and their relatives).
Unsporulated oocysts are shed in the cats feces .
Although oocysts are usually only shed for 1-2 weeks, large
numbers may be shed. Oocysts take 1-5 days to sporulate in the
environment and become infective.
Intermediate hosts in nature (including birds and rodents) become
infected after ingesting soil, water or plant material contaminated
with oocysts .
Oocysts transform into tachyzoites shortly after ingestion. These
tachyzoites localize in neural and muscle tissue and develop into
tissue cyst bradyzoites .
Cats become infected after consuming intermediate hosts harboring
tissue cysts. Cats may also become infected directly by ingestion of
sporulated oocysts. Animals bred for human consumption and wild
game may also become infected with tissue cysts after ingestion of
sporulated oocysts in the environment

Humans can become infected by any of

several routes:
1.
2.

3.
4.

Eating undercooked meat of animals

harboring tissue cysts.
Consuming food or water contaminated with
cat feces or by contaminated environmental
samples (such as fecal-contaminated soil or
changing the litter box of a pet cat).
Blood transfusion or organ transplantation.
Transplacentally from mother to fetus.

In the human host, the parasites form tissue

cysts, most commonly in skeletal muscle,
myocardium, brain, and eyes; these cysts may
remain throughout the life of the host.
Diagnosis is usually achieved by serology,
although tissue cysts may be observed in
stained biopsy specimens .
Diagnosis of congenital infections can be
achieved by detecting T. gondii DNA in amniotic
fluid using molecular methods such as PCR .

Serologic prevalence data indicate that toxoplasmosis is

one of the most common of humans infections
throughout the world.
A high prevalence of infection in France has been
related to a preference for eating raw or undercooked
meat, while a high prevalence in Central America has
been related to the frequency of stray cats in a climate
favoring survival of oocysts and soil exposure.
The overall seroprevalence in the United States among
adolescents and adults, as determined with specimens
collected by the third National Health and Nutrition
Examination Survey (NHANES III) between 1988 and
1994, was found to be 22.5%, with a seroprevalence
among women of childbearing age (15 to 44 years) of
15%.

Acquired infection with Toxoplasma in immunocompetent

persons is generally an asymptomatic infection.
However, 10% to 20% of patients with acute infection may
develop cervical lymphadenopathy and/or a flu-like illness.
The clinical course is usually benign and self-limited;
symptoms usually resolve within a few weeks to months.
In rare cases ocular infection with visual loss can occur.
Immunodeficient patients often have central nervous system
(CNS) disease but may have retinochoroiditis, pneumonitis, or
other systemic disease.
In patients with AIDS, toxoplasmic encephalitis is the most
common cause of intracerebral mass lesions and is thought to
be caused by reactivation of chronic infection.
Toxoplasmosis in patients being treated with
immunosuppressive drugs may be due to either newly
acquired or reactivated latent infection.

Congenital toxoplasmosis results from an acute primary

infection acquired by the mother during pregnancy.
The incidence and severity of congenital toxoplasmosis
vary with the trimester during which infection was
acquired.
Many infants with subclinical infection at birth will
subsequently develop signs or symptoms of congenital
toxoplasmosis.
Ocular Toxoplasma infection, an important cause of
retinochoroiditis in the United States, can be the result of
congenital infection, or infection after birth. In congenital
infection, patients are often asymptomatic until the
second or third decade of life, when lesions develop in
the eye.

Treatment is not needed for a healthy

person who is not pregnant.
Treatment may be recommended for
pregnant women, persons who have
weakened immune systems, or persons
with ocular disease or severe illness.

Blood parasites of the genus Plasmodium.

There are approximately 156 named species of
Plasmodium which infect various species of
vertebrates.
Five species are considered true parasites of
humans, as they utilize humans almost
exclusively as a natural intermediate host: P.
falciparum, P. vivax, P. ovale P. malariae, and
P. knowlesi

The time taken for the completion of the tissue

phase is variable, depending on the infecting
species; (8 - 25 days for P. falciparum, 8 - 27
days for P. vivax, 9 - 17 days for P. ovale, 15 30 days for P. malariae) and this interval is
called as pre-patent period.
In case of P. vivax and P. ovale, some
sporozoites may go into hibernation - the
cryptobiotic phase- in which they are called as
hypnozoites.

Malaria generally occurs in areas where environmental

conditions allow parasite multiplication in the vector.
Malaria today is usually restricted to tropical and subtropical
areas and altitudes below 1,500 m., although in the past
malaria was endemic in much of North America, Europe and
even parts of northern Asia, and today is still present on the
Korean peninsula. However, this present distribution could be
affected by climatic changes and population movements.
Plasmodium falciparum is the predominant species in the
world. P. vivax and P. ovale are traditionally thought to
occupy complementary niches, with P. ovale predominating in
Sub-Saharan Africa and P. vivax in the other areas; but their
geographical ranges do overlap. These two species are not
always distinguishable on the basis of morphologic
characteristics alone, and the use of molecular tools will help
clarify their diagnosis and exact distribution. P. malariae has
wide global distribution, being found in South America, Asia,
and Africa, but it is less frequent than P. falciparum in terms of
association with cases of infection. P. knowlesi is found in
southeast Asia.

Incubation period for P. knowlesi is about

12 days - the shortest known malaria of all
the known malarias that infect humans
and primates
P knowlesi has a 24 hour asexual cycle

Since untreated malaria can progress to severe forms that may be

rapidly (<24 hours) fatal, malaria should always be considered in
patients who have a history of exposure (mostly: past travel or
residence in disease-endemic areas).
The most frequent symptoms include fever and chills, which can be
accompanied by headache, myalgias, arthralgias, weakness,
vomiting, and diarrhea.
Other clinical features include splenomegaly, anemia,
thrombocytopenia, hypoglycemia, pulmonary or renal dysfunction,
and neurologic changes.
The clinical presentation can vary substantially depending on the
infecting species, the level of parasitemia, and the immune status of
the patient. Infections caused by P. falciparum can progress to
severe, potentially fatal forms with central nervous system
involvement (cerebral malaria), acute renal failure, severe anemia, or
adult respiratory distress syndrome. Complications of P. vivax
malaria include splenomegaly (with, rarely, splenic rupture), and
those of P. malariae include nephrotic syndrome.

1.

2.

3.

4.

All trimesters: Chloroquine; Quinine;

Artesunate / Artemether / Arteether
2nd trimester: Mefloquine;
Pyrimethamine / sulfadoxine
3rd trimester: Mefloquine;
Pyrimethamine / sulfadoxine
Contra indicated: Primaquine;
Tetracycline; Doxycycline; Halofantrine

Penyakit rabies termasuk dalam kategori

penyakit zoonotic (penyakit yang ditularkan dari
hewan kepada manusia) & disebabkan oleh
virus
Menurut WHO, meskipun saat ini telah tersedia
vaksin untuk mencegah penyakit rabies, tetapi
penyakit rabies tersebut masih menimbulkan
masalah kesehatan yang cukup banyak di
berbagai negara Asia & Afrika, dimana tingkat
kematiannya mencapai 95 %

Masa inkubasi

Biasanya berkisar antara 3-8 minggu, tetapi

dapat juga menjadi sependek 9 hari ataupun
selama 7 tahun.
Lamanya waktu inkubasi tersebut tergantung
pada beberapa hal.

Seperti tingkat parahnya luka.

Lokasi dari gigitan

Kerentanan seseorang terhadap infeksi.

Pada manusia, gejala penyakit rabies

biasanya ditandai dengan demam, batuk
atau sakit tenggorokan. Dan dalam jangka
waktu beberapa hari diserta dengan gejala
lain yang lebih berat seperti halusinasi &
kejang.