Parsite Infection and Infestation in People

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Human

arasites

Parasites are organisms that live on or inside another

organism (the host) and cause harm to the host.

Parasitic infections are widespread in rural parts

of Africa, Asia, and Latin

America and less common

industrialized countries. A person who visits a

developing country can unwittingly acquire a

parasitic

infection

of which

a doctor

may not

automatically

diagnose the infection when the

person returns home.

Parasites usually enter the body through the mouth or skin. Parasites that

enter through the mouth are

swallowed and can remain in the intestine

burrow through the intestinal wall and invade other organs.

Parasites that

enter through the skin

can be

introduced through the bites of infected insects

(the vector)

ake their way into

the body

through the soles of the feet when a

person walks barefoot

Additionally

there are opportunistic parasites who lay in wait in infested swimming holes, pools, or bathes

ust waiting

for their human or animal host to wade or dive in

A doctor who

uspects

he presence of a parasitic infection

may take

samples of blood, stool,

urine for analysis in the laboratory. The doctor may

also take a sample of tissue that may contain the

parasite. Repeated sample

collections and examinations may be essential to finding the parasite.

Some parasites, particularly those that are single celled, reproduce inside the

host. Other parasites have

complex life cycles, producing eggs or larvae that

spend time in the environment or in an insect vector

before becoming infective.

If egg laying parasites live in the digestive tract, their eggs may be found in

the

person’s stool when a

sample is examined under a microscope. Antibiotics,

laxatives, and antacids

can reduce the number of

parasites enough to make

their detection in a stool sample more difficult.

Food, drink, and water are often tainted wit parasites in regions of the world

with poor sanitation and

unhealthy practices. Thus, wise advice for travelers

is to “cook it, boil it, peel it, or forget it” when eating

in developing areas.

Because some organisms survive freezing, ice cubes sometimes spread

disease unless made from purified water.

Types of Parasitic Infections

Amebiasis

: Amebiasis is an infection of the large intestine or other organs

caused by the single

celled

parasite Entamoeba histolytica.

This condition is moderately common in areas where sanitation is poor and

fecal contagion

of food and

water occurs. If can also be acquired through

certain

sexual practices.

Entamoeba histolytica initially

infects the intestine,

although it

sometimes reaches

other

organs, such as the liver. Amebic

infections

are common in Latin America, Africa, and the Indian subcontinent.

Entamoeba histolytica exists in two forms: as an active parasite (trophozoite)

and as a

dormant

parasite

(cyst). Infection is initiated when cysts are swallowed.

The cysts hatch,

releasing

trophozoites

that multiply,

causing ulcers on the

lining of the intestine, and

produce diarrhea. Some of the trophozoites form

cysts, which are excreted in the feces along

with trophozoites. Outside the

body, the fragile trophozoites

die, but the cysts are hardy. Cysts

can be

spread directly from person to person or indirectly through food

or water.

In places with poor sanitation, transmission of amebiasis occurs through

ingestion of fecally

contaminated

food or water. Fruits and vegetables may

be contaminated when grown in soil

fertilized by human stool,

washed in

polluted water, or prepared by someone who is infected.

Amebiasis also

may occur and spread

in places with proper sanitation if incontinence and

poor

hygiene are present (for example, day care

centers, or mental institutions).

Amebiasis can be

spread

by sexual contact.

Symptoms

Only a few people infected with Entamoeba species develop symptoms. In

merica

most cases of

symptomatic amebiasis occur among immigrants

and, less commonly,

people who have visited developing

countries.

Infected people who develop symptoms characteristically have intermittent

diarrhea, increased gas

(flatulence), and cramping abdominal pain. In more

severe cases, the abdomen is tender when touched,

and

the stool contains

mucus and blood. The person may also have a fever. Wasting of the body

(emaciation)

and anemia can occur in people with chronic infection. Sometimes

a large lump (ameboma)

forms and blocks the intestine. On occasion the

trophozoites perforate the

intestinal wall and enter the

abdominal cavity,

causing harsh abdominal pain and an abdominal infection (peritonitis) that

requires

immediate medical

attention.

In some people, Entamoeba histolytica forms an abscess in the liver.

Symptoms include fever,

sweats,

chills, weakness, weight loss, and pain

or discomfort in the area over the liver.

Occasionally, Entamoeba histolytica spreads to other organs (including the

lungs and brain).

The skin may

also become infected, especially around the

buttocks, genitals, or wounds

caused

by abdominal surgery or

injury.

Ascariasis

: Ascariasis is an infection caused by Ascaris lumbridoides, an

intestinal roundworm.

Ascariasis is the most common roundworm infection in people, occurring in

over 1 billion people

worldwide.

The infection is most common in areas with

poor sanitation, where it persists largely

because of

indiscriminate defecation

and other unsanitary practices. In the United States, infections

are most

often

encountered in people who have traveled to areas with poor sanitation.

Infection begins when a person swallows food contaminated with Ascaris eggs.

Food usually

becomes

contaminated through contact with soil or other objects.

Ascaris eggs are hardy and

can survive in the

soil for years.

Once swallowed, Ascaris eggs hatch and release larvae into the intestine.

Each larva migrates through

the wall of the small intestine and is carried through

the lymphatic vessels and bloodstream to the lungs.

Once inside the lungs, the

larvae passes into the air sacs (alveoli), moves up the respiratory tract, and

swallowed. The larva matures in the small intestine, where it remains as an

adult worm. Adult worms

range from 6 to 20 inches in length and from one

tenth to 2 tenths of an inch in diameter.

Symptoms and Diagnosis

Many people who have ascariasis do not develop symptoms, although

the movement of larvae through

the lungs can cause fever, coughing, and

wheezing.

Tapeworm Infection

: Tapeworm infection is an intestinal disease caused by

one

of several species

tapeworms, including Taenia saginata (beef tapeworm),

Taenia solium (pork

tapeworm) and

Diphyllobothrium latum (fish tapeworm).

Tapeworms are large, flat worms that live in the intestine and can grow 15

to 30

feet in length.

Egg bearing sections of the worm (proglottids) are passed

in the

stool. If untreated human waste

is released into the environment, the eggs

may

be ingested by

intermediate hosts, such as pigs,

cattle, or (in the case of

fish

tapeworms) small crustaceans, which are in turn ingested by fish.

The eggs

hatch

in the intermediate host, and then the larvae invade the intestinal wall

and are

carried through the bloodstream to skeletal muscle and other tissues,

where they

form

cysts. People

get the parasite by eating the cysts in raw or

undercooked

meat or fish. The cysts

hatch and develop into

adult worms,

which latch onto the

person’s intestinal wall. The worms then

grow in length.

People may also act as an intermediate host for the pork tapeworm, Taenia

solium. Pork tapeworm

eggs

reach the stomach when a person swallows them

food or water contaminated with human feces

or from contact with the

unclean

hands of a person infected with adult worms. The eggs may also

reach the

stomach when proglottids are regurgitated from the intestine.

Once the larvae

are released, they penetrate the intestinal wall and travel to

muscles, internal

organs,

the

brain, or tissue under the skin, where they form

cysts (cysticerci).

This form of the disease is called

cysticercosis.

Symptoms and Diagnosis

Although tapeworms in the intestine often cause no symptoms, some people

experience upper

abdominal

discomfort, diarrhea, and loss of appetite.

Occasionally, a person with tapeworms

may feel a piece of the

worm move

out

through the anus. Rarely, tapeworms acquired from fish

cause anemia.

Cysts in the brain and meninges (the tissues covering the brain) in people with

cysticercosis may cause

inflammation, resulting in headache, confusion, other

neurologic symptoms, and commonly, seizures.

A doctor diagnoses intestinal tapeworm infection by finding worm segments or

eggs in a stool sample.

Cysticercosis is more difficult to diagnose; however,

cysts

in the brain can be seen with computed

tomography (CT) or magnetic

resonance

imaging (MRI)

scanning. Blood tests for antibodies to

identify

the

pork

tapeworm

may be

helpful.

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for

Internal

Parasites

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