Helminthology

Parasitology Dept.

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Definitions

Helminthology is the science about

helminthes (worms).
It is a subject of parasitology, which is the
science about parasites.
Helminthes are divided into:
Nemathelminthes and Platyhelminthes
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Definitions

 Due to living sites : Ectoparasites and

Endoparasites
 Due to living habits: Facultative and
Obligate parasites
 Due to life cycle: Periodic and Permanent
parasites
 Due to the host: Monoxen and Polyxen
parasites
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Terminology

 Host: definitive, reservoir, intermediate,

paratenic
 Vector: biologic and mechanic
 Parasitism
 Commensalisms
 Symbiosis
 Mutualism
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Nemathelminths
Nematodes

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Nematodes

 Half million species

 50% free living
 Animal & plant parasites
 Animal
• vertebrate & invertebrate hosts
• infection by ingestion or
• penetration
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Nematodes

 Generally elongated, cylindrical & tapered

at each end (99%)
 Fluid filled pseudocoelom longitudinal
muscle only
 No vasculature or respiratory system
 Usually sexual dimorphism (some
parthenogenesis)
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Nematodes

 Males usually smaller than females

 Most between 1mm and 150mm
 Colourless translucent to opaque with
an elastic cuticle

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Intestinal Worms

Adult worms live in human intestines.

Some are called ‘soil transmitted
helminthes’, i.e.:
1. Ascaris lumbricoides
2. Ancylostomatidae (Hookworm)
3. Strongyloides stercoralis
4. Trichuris trichiura
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Ascaris lumbricoides
Morphology

 Family Ascarididae
 Large intestinal round worm
 Mouth with 1 dorsal & 2 ventral lips
 Female 20-30cm, linear tail end
 Male 15-25cm, hooked tail end (consists of
spicule protrudes out of cloaca)
 Uterus of mature female 20+ million eggs
 Sheds 200,000 golden brown ovoid eggs per day
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Ascaris lumbricoides
Morphology

 Egg consists of three layers (walls):

albuminoid (protein), hyaline, and lipoid
 Due to the albumin layer: corticated or
decorticated eggs
 Due to the content: fertilized, unfertilized, or
infectious eggs
 Eggs resistant to desiccation

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Ascaris lumbricoides
Morphology

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Ascaris lumbricoides
Morphology

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Ascaris lumbricoides
Morphology

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Ascaris lumbricoides
Life Cycle

 World-wide distribution
 Ascaris lumbricoides requires no
intermediate host but only the final host
 The essential host is human being, but it
also able to grow in swine and primate

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Ascaris lumbricoides
Life Cycle

Adult worms in small Eggs cleavage under

optimal condition in soil
intestine, produce eggs embryonated eggs
which are excreted with
stool Ingested/swallowed by
human
tracheal migration
Hatched in the upper part
of small intestine
Lung passage
Invade blood vessels
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Ascaris lumbricoides
Route of Infection

The principal route is oral infection by eating

raw vegetables and pickles to which mature eggs
attach.
The eggs can be transported to distant places
while adhering to the surface of flies and
cockroaches, or may be widely spread by the wind.
Infection is also possible by ingesting foods or
drinks contaminated with eggs or through fingers in
contact with soil.

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Toxocara spp.

 Family Ascarididae
 Common among dogs (Toxocara cani) and cats
(Toxocara cati)
 T. cati is also called Ascaris mystax
 Spread all over the world
 When they are parasitic in human, they cause so-
called visceral larva migrans, being unable to
mature and migrating as larvae into various
organs of the human body
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Toxocara spp.
Morphology

 Looks similar to the young A. lumbricoides :

8-13 cm in the female, 5-8 cm in the male
 Remarkable difference: a pair of cervical
alae; T. cati’s is broader than T. cani’s
 The egg is spherical or short oval, with a
chain of protein coat as outermost layer

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Toxocara spp.
Life cycle

 Almost the same as that of A. lumbricoides

 Difference: in addition to the final host the
paratenic hosts are widely present, which
are animals of other families than canine,
including humans
 The route of migration in the body of the
dog differs by the maturity and the
tolerance of the dog
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Toxocara spp.
Life cycle

 In 2-3 month-old dog, the larva follows

same route as that of A. lumbricoides,
called tracheal migration. Thus the eggs
are seen in the feces.
 In adult dog, the larva follows somatic
migration. However, an adult worm may be
seen with eggs in the feces, if the host is
somehow compromised.
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Anisakis

 Family Ascarididae
 Widespread in seas all over the world
 Major final host is marine mammals, e.g.
dolphins
 Infection in human is mainly found in the
countries where sea foods are eaten raw

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Ancylostomatidae
General

 Also called hookworm

 Includes about 100 species
 Densely distributed all over the world,
especially in the tropics and subtropics
 Of greater medical importance are:
Ancylostoma duodenale, Necator
americanus, A. braziliense, A. ceylanicum,
A. caninum
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Ancylostoma duodenale
Morphology

 Reddish white worm, form

C-like appearance in
alcohol 70%
 Female measures 10-13
mm in length, male is 8-11
mm with a characteristic
copulatory bursa at the
tail end
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Ancylostoma duodenale
Morphology

 On the ventral side

of the mouth, there
are two pairs of
teeth

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Ancylostoma duodenale
Morphology

 The egg is about 60 x 40

m in size, thin eggshell,
nearly colorless and
transparent
 Contain egg cells under
cleavage, many in the
fresh stool are in the
four-cell stage

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Ancylostoma duodenale
Morphology

 Rhabditiform larva is 0.3 mm long, opened mouth

and grows feeding on bacteria and organic
matter in the feces
 Filariform larva is 0.7 mm long, named as the
infective larva, sheated, thick cuticle, anterior
one-third is being occupied by the esophagus
 Filariform larva is quite resistant to
environmental stress, surviving without ingesting
any nutritives for 6-9 wks in the tropics, lives 1-2
cm under the ground
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 Necator americanus
Morphology

 A little smaller than the

preceding species
 Female is 9-11 mm long
and male is 7-9 mm long,
copulatory bursa is exist
 Form S-like appearance in
alcohol 70%
 cutting plates (chitin)

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Necator americanus
Morphology

 Egg is similar with the preceding species

 Rhabditiform larva is quite
undifferentiated with those of other
Ancylostomatidae
 Filariform larva is thicker and shorter,
with closed oral cavity is clearly seen as
a mouth spear

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Zoonotic Ancylostomatidae
Morphology

 Ancylostoma braziliense : a
pair of large ventral teeth
in the oral cavity
 Ancylostoma ceylanicum :
a pair of large outer ventral
teeth and a pair of small
inner ventral teeth
 Ancylostoma caninum :
three pairs of ventral teeth
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Ancylostoma duodenale
Life Cycle

 The principal host is human

 Filariform larva invades humans mainly via an
oral route, but sometimes via a cutaneous
route
 The larvae invade the intestinal walls, and
stay for 2-3 days
 They return to the lumen, become adult and
then ready to lying eggs

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Ancylostoma duodenale
Life Cycle

 A part of the larvae that invade the intestinal

walls enter blood vessels, proceed to the lung,
and return to the small intestine via tracheal
migration
 In the case of cutaneous infection, the larvae
invades the skin, proceed in the blood or lymph
stream to the heart and lungs, then go out to
the small intestine via tracheal migration

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Necator americanus
Life Cycle

 The principal host is humans

 The route of infection is mainly transcutaneous
 The larva invades the skin to stay there for a
few days
 Then moves to the lung carried by the blood or
lymph stream
 After staying in the lung for about a week to
grow sufficiently, it reaches the small intestine
via tracheal migration
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Necator americanus
Life Cycle

 It grows in the intestinal lumen, and

become an adult after another molting
 The whole process takes about two
months
 The larva dies when it enters the stomach
from the mouth, but in case it invades oral
mucosa, it can follow the same course as
that of cutaneous infection
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Strongyloides stercoralis
General

 Family Strongyloididae
 Facultative parasite
 Widely distributed on earth, most
densely in those areas characterized by
high temperature and humidity and poor
hygienic conditions

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Strongyloides stercoralis
Morphology

 The egg is 70 x 40 m with an extremely thin

eggshell
 Female adult of parasitic generation: thin and
long, about 2 mm long, two sets of genital organs,
with lack of seminal receptacles (because no
sperm is required for parthenogenesis)
 Female adult of free living generation: thicker and
shorter, seminal receptacles (+)
 Male adult: smaller, about 0.7-1 mm long, the tail
end curls on the ventral side
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Strongyloides stercoralis
Morphology

 Rhabditiform larva: only

can be differentiated
with those of
Ancylostomatidae
through electron
microscopy
 Filariform larva: 0.4-0.7
mm in length, a half is
occupied with
esophagus, forked tail

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Strongyloides stercoralis
Life Cycle

 Direct Cycle: filariform larva invades human

skin, proceed in the blood stream to the heart
and lung, then return to the small intestine via
tracheal migration
 Indirect cycle: when outside conditions are
favorable, rhabditiform larvae grow become
male and female free living form, and after
copulation and lying eggs, adults die, and the
eggs give rise rhabditiform larvae, and become
infective form after two molts
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Strongyloides stercoralis
Route of Infection

 Internal autoreinfection: if a host has

constipation or immune deficiency
 External autoreinfection: in poor hygienic
host, whose perianal is contaminated by
rhabditiform, the larvae grow become
infected larvae and then invade the
perianal skin or mucosa, proceed to the
lung, etc.
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Trichuris trichiura
Whipworm

 Family Trichinellidea
 World-wide distribution
 High frequency in Indonesia: 80%
 Habitat: human cecal mucosa

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Trichuris trichiura
Morphology

 Divided into two

parts: thin anterior
and thick posterior
 Female: 3.4-5 cm
long with a linear
caudal end
 Male: 3-4.5 cm with
a curled caudal end
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Trichuris trichiura
Morphology

 Barrel-shaped egg,
50-54 x 20-30 m,
pores at both ends

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Trichuris trichiura
Life Cycle

 Mainly humans serve as host

 No intermediate host is required
 Settles in cecum, here the thin
anterior part is partially inserted
into the mucosa, while the thick
posterior part is free in the lumen

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Trichuris trichiura
Life Cycle

Eggs passed outside Mature in 10-14 days

with the feces under favorable
condition

Ingested by human
Grow adult worms being

Descends the intestinal Larva hatches at the

canal to the cecum upper part of small
intestine
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Capillaria philippinensis
General

 Family Trichuridae
 Final host: mainly human being,
occasionally other fish-eaten mammals
 I’mediate host: freshwater fishes
 Habitat is the jejunum of the host
 Spread in the tropical countries, e.g.
Souteast Asia
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Capillaria philippinensis
Morphology

 Adults are very thin, female is 5-7cm,

male is 2-4cm long
 Egg is similar to those of Trichuris
eggs, with light differences: both ends
are less protruding, radial lines
eggshell

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Capillaria philippinensis
Morphology

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C. philippinensis
Life Cycle

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Enterobius vermicularis
General

 Family Oxyuridae
 Also called Oxyuris vermicularis
 Human pinworm
 Widespread in the world, from the tropics to the
frigid zones
 Children living in the group are infected most
frequently
 Habitat is the cecum

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Enterobius vermicularis
Morphology

 Female is 8-13 mm long

 Male is 2-5 mm long
 Cuticular elevation
forms cephalic alae
 Female has spindle-
shaped and pointed tail,
the greater part o/t body
is occupied by the
uterus filled with eggs
 Male has curled tail end
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Enterobius vermicularis
Morphology

 Egg is usually
containing a completed
larva
 50-60 x 20-30 m
 One side o/t eggshell is
flatter than the other
 Nearly colorless and
transparent eggshell
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Enterobius vermicularis
Life Cycle

 Mature eggs swallowed hatches i/t upper small

intestine
 Larva goes down the small intestine and arrives at
the cecum after 3 molts  become adult after
another molts
 Male worm dies after copulation
 Female descends to the rectum and waits for the
occasion to lay eggs  get out o/t anus
 After laying eggs (5,000-17,000 eggs) on the perianal
skin, female dies
 Eggs grow quickly and become larvae in 6-7 hours 55
Enterobius vermicularis
Life Cycle

Female wander out o/t

Adult worm i/t cecum anus  dies after
lying eggs on the
perianal skin
Larva goes down to the
large intestine Eggs hatch/get mature

Egg ingested hatches i/t

small intestine Transmission
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Trichinella spiralis
General

 Family Trichinellidae
 Definitive host: human and other carnivorous
animals
 World-wide distribution, especially in pork-
eaten areas
 Adult worm lives in small intestine, larva lives
(encapsulates) in striated muscles which are
always in motion
 Vivipar

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Trichinella spiralis
Morphology

 Adults look like pieces of thread

 Female 2.2-3 mm, and male 1.2-1.5 mm
long with a pair of conical/copulatory
papillae as sexual tool
 Larva coils and encapsulate in the
striated muscle

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Trichinella spiralis
Morphology

Female Trichinella spiralis

Male tail T. spiralis

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Trichinella spiralis
Morphology

Larva in the muscles

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Trichinella spiralis
Life Cycle

 Male dies after copulation

 Female dies after completion of giving 500-
1,000 larvae over a period of 4-6 wks
 The larvae invade the intestinal mucous, then
enter lymphatic and blood vessels in the
intestinal walls  going through the heart
and pulmonary circulation  distributed all
over the body
 Larva coils and encapsulates in the striated
muscles 62
Trichinella spiralis
Life Cycle

 Each cyst has one coiled larva

 The cyst wall is made by the host
 Larvae survive for several years, possibly 25-
30 ys
 After being eaten by another host, a larva
becomes an adult in the small intestine, and
dies leaving larvae in muscles
 The worm repeats such a life cycle by
changing host one after another
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Trichinella spiralis
Route of Infection

 The most popular source of

infection for human is swine
 The swine become infected in
swine-breeding farms from waste
meat in feed
 The disease is also transmitted by
meat of dogs, cats, and bears
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Gnathostoma spinigerum
General

 Zoonoses
 Widely distributed from the tropical to the
temperate zones, mainly in Asia
 Requires two intermediate hosts
 Final host: tigers, dogs, cats
 1st intermediate host: copepods (cyclops)
 2nd intermediate host: crustaceans, fish,
amphibians, birds
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Gnathostoma spinigerum
Morphology

 Adult has a thick

and short body
 Female: 1.5-3.3 cm,
male: 1.2-3 cm
 Head-bulb with
hooks aligned in 4-8
concentric lines

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Gnathostoma spinigerum
Morphology

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Gnathostoma spinigerum
Morphology

 Eggs are 62-79 x 36-

42 m
 Originally colorless
 Bulge (operculum)
at one end, where
the hatching occurs
 Fertilized eggs
contain eggcells
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Gnathostoma spinigerum
Morphology

1st stage larva

2nd stage larva

3rd stage larva

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Thelazia
General

 Family Thelaziidae
 Also called “ The Oriental Eye Worm”
 Thelazia callipaeda is found in East countries
 Thelazia californiensis is found in California
 Final host: mainly dogs and cats, occasionally humans
and other mammals
 Vector: insects (Amiota okadai)
 Ovoviviparity
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Thelazia
Morphology

 Adult is thin and

long, female is 6.2-17
mm, male is 4.5-13
mm with curled tail
end, milk-white in
color
 Chitinoid capsule in
the anterior part o/t
body
 Egg is about 56 x 35
m in size 72
Thelazia
Life Cycle

Adult in conjunctival sac of Gives larvae continually

final host by ovoviviparity

Amiota licks tears in eye of

final host, leaves the
larvae in the conjunctiva Swallowed by Amiota

Invades the ovary or

Larva migrates to the
testis of Amiota
mouth part
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Angiostrongylus cantonensis
General

 Family Angiostrongylidae
 Also called as rat lungworm or
rodent lungworm
 Zoonoses
 Major final host is rodent (Rattus
norvegitus and Rattus rattus)
 Habitat is the pulmonary artery
of rodents
 Intermediate host: snail
(Achatina, Pila)
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Angiostrongylus cantonensis
Morphology

 Adult is thin and long

 Female is 2.5-4cm, helical pattern along the
entire length o/t body (made up of
intestinal tract intertwined w/ uterus)
 Male is about 2cm with copulatory bursa
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