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{{Taxobox
| name              = ''Ascaris lumbricoides''
| image              = Ascaris_lumbricoides.jpeg
| image_width        = 250px
| image_caption      = An adult female ''Ascaris'' worm
| regnum            = [[Animal]]ia
| phylum            = [[Nematoda]]
| classis            = [[Secernentea]]
| ordo              = [[Ascaridida]]
| familia            = [[Ascarididae]]
| genus              = [[Ascaris]]
| species            = '''''A. lumbricoides'''''
| binomial          = ''Ascaris lumbricoides''
| binomial_authority = [[Carl Linnaeus|Linnaeus]], [[10th edition of Systema Naturae|1758]]
}}
__NOTOC__
{{Ascariasis}}
{{About0|Ascariasis}}
{{CMG}}}}; '''Associate Editor-In-Chief:''' Imtiaz Ahmed Wani
 
==Overview==
'''''Ascaris lumbricoides''''' is the '''giant roundworm''' of [[humans]], growing to a length of up to {{Convert|35|cm|in|abbr=on}}.<ref name="titleeMedicine - Ascaris Lumbricoides : Article by Aaron Laskey">{{cite web |url=http://www.emedicine.com/EMERG/topic840.htm |title=eMedicine - Ascaris Lumbricoides : Article by Aaron Laskey |accessdate=2008-02-03 |work=| archiveurl= http://web.archive.org/web/20080127165320/http://www.emedicine.com/EMERG/topic840.htm| archivedate= 27 January 2008 <!--DASHBot-->| deadurl= no}}</ref> It is one of several species of [[Ascaris]]. An [[ascaridida|ascarid nematode]] of the phylum [[Nematoda]], it is the largest and most common [[parasitic worm]] in humans. This organism is responsible for the disease [[ascariasis]], a type of [[helminthiasis]] and one of the group of [[neglected tropical diseases]]. An estimated one-sixth of the human population is infected by ''A. lumbricoides'' or another [[Nematode|roundworm]].<ref name="pmid20109051">{{cite journal |last1=Harhay |first1=Michael O |last2=Horton |first2=John |last3=Olliaro |first3=Piero L |title=Epidemiology and control of human gastrointestinal parasites in children |journal=Expert Review of Anti-infective Therapy |volume=8 |issue=2 |pages=219–34 |year=2010 |pmid=20109051 |pmc=2851163 |doi=10.1586/eri.09.119 }}</ref> Ascariasis is prevalent worldwide, especially in [[tropical]] and [[subtropical]] countries.
== Lifecycle ==
[[File:Ascaris lumbricoides life cycle.tif|thumb|Image showing lifecycle inside and outside of the human body of one fairly well described helminth: ''A. lumbricoides'']]
''A. lumbricoides'', a roundworm, infects humans when an ingested fertilised egg becomes a [[larva|larval worm]] that penetrates the wall of the [[duodenum]] and enters the [[blood stream]]. From there, it is carried to the [[liver]] and [[heart]], and enters [[pulmonary circulation]] to break free in the [[pulmonary alveolus|alveoli]], where it grows and [[molt]]s. In three weeks, the [[larva]] passes from the [[respiratory system]] to be coughed up, swallowed, and thus returned to the [[small intestine]], where it matures to an adult male or female worm. [[Fertilization]] can now occur and the female produces as many as 200,000 eggs per day for a year. These fertilized eggs become infectious after two weeks in soil; they can persist in soil for 10 years or more.<ref name="Murray">Murray, Patrick R.; Rosenthal, Ken S.; Pfaller, Michael A. ''Medical Microbiology'', Fifth Edition. United States: Elsevier Mosby, 2005{{pn|date=August 2015}}</ref>
 
The eggs have a [[lipid]] layer which makes them resistant to the effects of [[acid]]s and [[alkali]]s, as well as other chemicals. This resilience helps to explain why this [[nematode]] is such a ubiquitous [[parasite]].<ref>Piper R (2007). ''Extraordinary Animals: An Encyclopedia of Curious and Unusual Animals'', Greenwood Press.{{pn|date=August 2015}}</ref>
 
== Morphology ==
[[File:Ascaris lumbricoides4.jpg|right|thumb|Fertile egg as can be seen in a microscope]]
[[File:Ascaris lumbricoides.jpg|right|thumb|Fertile egg in human faeces (detail)]]
[[File:Ascaris lumbricoides non-fertile egg.jpg|right|thumb|Infertile egg]]
''A. lumbricoides'' is characterized by its great size. The male's posterior end is curved ventrally and has a bluntly pointed tail. Females are wide and long. The [[vulva]] is located in the anterior end and accounts for about one-third of its body length. [[uterus|Uteri]] may contain up to 27 million eggs at a time, with 200,000 being laid per day. Fertilized eggs are oval to round in shape and are long and wide with a thick outer shell. Unfertilized eggs measure long and wide.<ref name="Roberts">Roberts, Larry S.; Janovy, John Jr. ''Foundations of Parasitology'', Eighth Edition. United States: McGraw-Hill, 2009{{pn|date=August 2015}}</ref>
{| class="wikitable" border="2" cellpadding="5" cellspacing="0" align="center"
|-
! '''Genus and Species'''
! '''Ascaris lumbricoides'''
|-
| width="200" align="center" | '''Common Name'''
| width="400" align="center" | Giant Intestinal [[Roundworm]]
|-
| width="200" align="center" | '''Etiologic Agent of:'''
| width="400" align="center" | Ascariasis
|-
| width="200" align="center" | '''Infective stage'''
| width="400" align="center" | Embryonated Egg
|-
| width="200" align="center" | '''Definitive Host'''
| width="400" align="center" | Man
|-
| width="200" align="center" | '''Portal of Entry'''
| width="400" align="center" | Mouth
|-
| width="200" align="center" | '''Mode of Transmission'''
| width="400" align="center" | Ingestion of Embryonated egg through contaminated food or water
|-
| width="200" align="center" | '''Habitat'''
| width="400" align="center" | Small Intestine
|-
| width="200" align="center" | '''Pathogenic Stage'''
| width="400" align="center" | Adult Larva
|-
| width="200" align="center" | '''Mode of Attachment'''
| width="400" align="center" | Retention in the mucosal folds using pressure
|-
| width="200" align="center" | '''Mode of Nutrition'''
| width="400" align="center" | Feeding of [[Chyme]]
|-
| width="200" align="center" | '''Pathogenesis'''
| width="400" align="center" | Larva – [[pneumonitis]], [[Löffler's syndrome|Loffler’s syndrome]];
Goes through a Blood-Lung Phase ([[Hookworm]] and [[Strongyloides stercoralis]] also have a blood-lung phase);
Adult worm– Obstruction, [[Liver abscess]], [[Appendicitis]].
|-
| width="200" align="center" | '''Laboratory diagnosis'''
| width="400" align="center" | Direct Fecal Smear; Concentration methods such as [[Kato-Katz technique|Kato-Katz]]
|-
| width="200" align="center" | '''Treatment'''
| width="400" align="center" | [[Albendazole]], [[Mebendazole]], or Pyrantel Pamoate
|-
| width="200" align="center" | '''Diagnostic Feature - Adult'''
| width="400" align="center" | Female - prominent genital girdle
|-
| width="200" align="center" | '''Diagnostic Feature - Egg'''
| width="400" align="center" | Coarse mammilated albuminous coating
|-
|}
 
==Gallery==
<gallery>
 
 
Image: Ascariasis01.jpeg| Magnified 128X, this photomicrograph revealed some of the ultrastructural features displayed by a fertile Ascaris lumbricoides egg. A. lumbricoides is the largest nematode (roundworm) parasitizing the human intestine. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
 
Image: Ascariasis02.jpeg| Magnified 125X, this photomicrograph revealed the presence of a fertile Ascaris sp. egg that was found in an unstained formalin-preserved stool sample. See PHIL 411 for an example of an unfertilized Ascaris lumbricoides egg. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis03.jpeg| Depicted in this 1960 photograph were two Ascaris lumbricoides nematods, i.e., roundworms. The larger of the two was the female of the species, while the normally smaller male was on the right. Adult female worms can grow over 12 inches in length. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis04.jpeg| This micrograph reveals both fertilized (A) and unfertilized (B) Ascaris eggs, and a Trichuris egg (C); Mag. 125X. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis05.jpeg|This diagram depicts the various stages in the life cycle of the intestinal roundworm nematode Ascaris lumbricoides. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis06.jpeg|These are 3 fertilized A. lumbricoides eggs with the one on the right being decorticated, for its outer layer is absent. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis07.jpeg|This micrograph depicts an embryonated Ascaris lumbricoides egg with no outer mammillated layer, i.e., “decorticated”. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis08.jpeg|This photomicrograph depicts a fertilized egg of the parasite Ascaris lumbricoides. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis09.jpeg|Magnified 128X, this photomicrograph revealed some of the ultrastructural features displayed by an infertile, decorticated Ascaris lumbricoides egg. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis10.jpeg|Magnified 128X, this photomicrograph revealed some of the ultrastructural features displayed by an infertile, Ascaris lumbricoides egg. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis11.jpeg|Magnified 128X, this photomicrograph revealed some of the ultrastructural features displayed by a fertilized, decorticated Ascaris lumbricoides egg. A. lumbricoides is the largest nematode (roundworm) parasitizing the human intestine. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis12.jpeg|Magnified 128X, this photomicrograph revealed some of the ultrastructural features displayed by a fertilized, decorticated Ascaris lumbricoides egg. A. lumbricoides is the largest nematode (roundworm) parasitizing the human intestine. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis14.jpeg|Under a magnification of 125x, this photomicrograph of an unstained mounted formalin-preserved fecal sample revealed the presence of a number of parasitic worm eggs, which included the eggs of a trematode, Fasciolopsis buski, an Ascaris sp. nematode. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis15.jpeg|Infertile egg of Ascaris lumbricoides. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis16.jpeg|This photomicrograph revealed some of the ultrastructural features displayed by an infertile Ascaris lumbricoides egg. A. lumbricoides is the largest nematode (roundworm) parasitizing the human intestine. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
Image: Ascariasis18.jpeg|This micrograph reveals a fertilized egg of the round worm Ascaris lumbricoides; Mag. 400X. <SMALL><SMALL>''[http://phil.cdc.gov/phil/home.asp From Public Health Image Library (PHIL).] ''<ref name=PHIL> {{Cite web | title = Public Health Image Library (PHIL) | url = http://phil.cdc.gov/phil/home.asp}}</ref></SMALL></SMALL>
 
 
</gallery>
 
== Epidemiology ==
 
More than 2 billion people are affected by this infection.<ref name="Murray" />  The [[USA|United States]] has a reported prevalence of 0.8% of the total population as of 1987. ''A. lumbricoides'' eggs are extremely resistant to strong chemicals, [[desiccation]], and low temperatures. The eggs can remain [[:wikt:viable|viable]] in the soil for several months or even years.<ref name="Roberts"/>
 
Eggs of ''A. lumbricoides'' have been identified in archeological [[coprolite]]s in the Americas, Europe, Africa, the Middle East, and New Zealand, the oldest ones being more than 24,000 years old.<ref>{{cite book |author=Dridelle R |title=Parasites. Tales of Humanity's Mostly Unwelcome Guests |publisher=Univ. of California, 2010| page=26 |isbn=978-0-520-25938-6}}</ref>
 
== Infections ==
{{main|Ascariasis}}
 
Infections with these parasites are more common where sanitation is poor,<ref name="titleDPDx - Ascariasis">{{cite web |url=http://www.dpd.cdc.gov/dpdx/html/Ascariasis.htm |title=DPDx - Ascariasis |accessdate=2008-02-03 |work=| archiveurl= http://web.archive.org/web/20080224051907/http://www.dpd.cdc.gov/DPDx/HTML/Ascariasis.htm| archivedate= 24 February 2008 <!--DASHBot-->| deadurl= no}}</ref> and [[human feces|raw human feces]] are used as [[nightsoil|fertilizer]].
 
===Symptoms===
Often, no symptoms are seen with an ''A. lumbricoides'' infection.  However, in the case of a particularly bad infection, symptoms may include bloody sputum, cough, fever, abdominal discomfort, intestinal ulcer, passing worms, etc.<ref>{{MedlinePlusEncyclopedia|000628|Ascariasis}}</ref><ref>http://www.stanford.edu/group/parasites/ParaSites2005/Ascaris/JLora_ParaSite.htm#Symptoms{{full|date=August 2015}}</ref> Ascariasis is also the most common cause of [[Löffler's syndrome]] worldwide. Accompanying symptoms include pulmonary infiltration, eosinophilia, and radiographic opacities <ref>{{cite journal |last1=Löffler |first1=W |title=Transient Lung Infiltrations with Blood Eosinophilia |journal=International Archives of Allergy and Applied Immunology |volume=8 |issue=1-2 |pages=54–9 |year=1956 |pmid=13331628 |doi=10.1159/000228268 }}</ref>
 
===Prevention===
Preventing any [[fecal-oral route|fecal-borne disease]] requires educated hygienic habits/culture and effective fecal treatment systems. This is particularly important with ''A. lumbricoides'' because its eggs are one of the most difficult pathogens to kill (second only to [[prion]]s), and the eggs commonly survive 1–3 years. ''A. lumbricoides'' lives in the [[intestine]] where it lays eggs. Infection occurs when the eggs, too small to be seen by the unaided eye, are eaten. The eggs may get onto vegetables when improperly processed [[human feces]] of infected people are used as fertilizer for food crops. Infection may occur when food is handled without removing or killing the eggs on the hands, clothes, hair, raw vegetables/fruit, or cooked food that is (re)infected by handlers, containers, etc. Bleach does not readily kill ''A. lumbricoides'' eggs, but it will remove their sticky film, to allow the eggs to be rinsed away. ''A. lumbricoides''  eggs can be reduced by hot composting methods, but to completely kill them may require [[rubbing alcohol]], [[iodine]], specialized chemicals, [[cooking]] heat, or "unusually" hot [[composting]] (for example, over {{Convert|50|C|F}} for 24 hours<ref>http://weblife.org/humanure/chapter7_18.html{{full|date=August 2015}}</ref>)
===Details of infection process===
Infections happen when a human swallows water or food contaminated with unhatched eggs, which hatch into [[juvenile (organism)|juvenile]]s in the [[duodenum]]. They then penetrate the [[mucosa]] and [[submucosa]] and enter [[venule]]s or [[lymphatic]]s. Next, they pass through the right [[heart]] and into [[pulmonary circulation]]. They then break out of the [[blood capillary|capillaries]] and enter the air spaces. Acute tissue reaction occurs when several [[worm]]s get lost during this migration and accumulate in other organs of the body. The juveniles migrate from the lung up the [[respiratory system|respiratory tract]] to the [[pharynx]] where they are swallowed. They begin producing eggs within 60–65 days of being swallowed. These are produced within the [[small intestine]], where the juveniles mature. It might seem odd that the [[worm]]s end up in the same place where they began. One [[hypothesis]] to account for this behavior is that the migration [[mimic]]s an intermediate host, which would be required for juveniles of an ancestral form to develop to the third stage. Another possibility is that tissue migration enables faster growth and larger size, which increases reproductive capacity.<ref>{{cite journal |last1=Read |first1=A. F. |last2=Sharping |first2=A. |title=The evolution of tissue migration by parasitic nematode larvae |journal=Parasitology |volume=111 |issue=3 |pages=359–71 |year=1995 |pmid=7567104 |doi=10.1017/S0031182000081919 }}</ref>
 
== Diagnosis and treatment ==
 
Most [[diagnosis|diagnoses]] are made by identifying the appearance of the [[worm]] or eggs in [[feces]]. Due to the large quantity of eggs laid, [[physicians]] can [[diagnose]] using only one or two [[fecal smear]]s.{{fact|date=August 2015}}
 
Infections can be treated with drugs called [[ascaricide]]s. The treatment of choice is [[mebendazole]]. The drug functions by binding to [[tubulin]] in the worms' intestinal cells and body-wall muscles. [[Nitazoxanide]] and [[ivermectin]] can also be used.<ref name="Roberts"/>
 
== References ==
{{Reflist}}
 
== External links ==
* [http://daveproject.org/duodenum-ascaris-lumbricoides/2004-05-10/ ''Ascaris lumbricoides'' Video - DAVE Project]
* [http://ascarislumbricoides.org/ ''Ascaris lumbricoides'' Poll - Research]
* [http://www.dpd.cdc.gov/dpdx/HTML/ImageLibrary/Ascariasis_il.htm Ascaris lumbricoides image library]
 
{{Helminthiases}}
 
{{DEFAULTSORT:Ascaris Lumbricoides}}
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Gastroenterology]]

Latest revision as of 20:29, 29 July 2020

style="background:#Template:Taxobox colour;"|Ascaris lumbricoides
An adult female Ascaris worm
An adult female Ascaris worm
style="background:#Template:Taxobox colour;" | Scientific classification
Kingdom: Animalia
Phylum: Nematoda
Class: Secernentea
Order: Ascaridida
Family: Ascarididae
Genus: Ascaris
Species: A. lumbricoides
Binomial name
Ascaris lumbricoides
Linnaeus, 1758

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This page is about microbiologic aspects of the organism(s).  For clinical aspects of the disease, see Ascariasis.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]}}; Associate Editor-In-Chief: Imtiaz Ahmed Wani

Overview

Ascaris lumbricoides is the giant roundworm of humans, growing to a length of up to 35 cm (13.779527545 in).[1] It is one of several species of Ascaris. An ascarid nematode of the phylum Nematoda, it is the largest and most common parasitic worm in humans. This organism is responsible for the disease ascariasis, a type of helminthiasis and one of the group of neglected tropical diseases. An estimated one-sixth of the human population is infected by A. lumbricoides or another roundworm.[2] Ascariasis is prevalent worldwide, especially in tropical and subtropical countries.

Lifecycle

File:Ascaris lumbricoides life cycle.tif
Image showing lifecycle inside and outside of the human body of one fairly well described helminth: A. lumbricoides

A. lumbricoides, a roundworm, infects humans when an ingested fertilised egg becomes a larval worm that penetrates the wall of the duodenum and enters the blood stream. From there, it is carried to the liver and heart, and enters pulmonary circulation to break free in the alveoli, where it grows and molts. In three weeks, the larva passes from the respiratory system to be coughed up, swallowed, and thus returned to the small intestine, where it matures to an adult male or female worm. Fertilization can now occur and the female produces as many as 200,000 eggs per day for a year. These fertilized eggs become infectious after two weeks in soil; they can persist in soil for 10 years or more.[3]

The eggs have a lipid layer which makes them resistant to the effects of acids and alkalis, as well as other chemicals. This resilience helps to explain why this nematode is such a ubiquitous parasite.[4]

Morphology

File:Ascaris lumbricoides4.jpg
Fertile egg as can be seen in a microscope
File:Ascaris lumbricoides.jpg
Fertile egg in human faeces (detail)
File:Ascaris lumbricoides non-fertile egg.jpg
Infertile egg

A. lumbricoides is characterized by its great size. The male's posterior end is curved ventrally and has a bluntly pointed tail. Females are wide and long. The vulva is located in the anterior end and accounts for about one-third of its body length. Uteri may contain up to 27 million eggs at a time, with 200,000 being laid per day. Fertilized eggs are oval to round in shape and are long and wide with a thick outer shell. Unfertilized eggs measure long and wide.[5]

Genus and Species Ascaris lumbricoides
Common Name Giant Intestinal Roundworm
Etiologic Agent of: Ascariasis
Infective stage Embryonated Egg
Definitive Host Man
Portal of Entry Mouth
Mode of Transmission Ingestion of Embryonated egg through contaminated food or water
Habitat Small Intestine
Pathogenic Stage Adult Larva
Mode of Attachment Retention in the mucosal folds using pressure
Mode of Nutrition Feeding of Chyme
Pathogenesis Larva – pneumonitis, Loffler’s syndrome;

Goes through a Blood-Lung Phase (Hookworm and Strongyloides stercoralis also have a blood-lung phase); Adult worm– Obstruction, Liver abscess, Appendicitis.

Laboratory diagnosis Direct Fecal Smear; Concentration methods such as Kato-Katz
Treatment Albendazole, Mebendazole, or Pyrantel Pamoate
Diagnostic Feature - Adult Female - prominent genital girdle
Diagnostic Feature - Egg Coarse mammilated albuminous coating

Gallery

Epidemiology

More than 2 billion people are affected by this infection.[3] The United States has a reported prevalence of 0.8% of the total population as of 1987. A. lumbricoides eggs are extremely resistant to strong chemicals, desiccation, and low temperatures. The eggs can remain viable in the soil for several months or even years.[5]

Eggs of A. lumbricoides have been identified in archeological coprolites in the Americas, Europe, Africa, the Middle East, and New Zealand, the oldest ones being more than 24,000 years old.[7]

Infections

Main article: Ascariasis

Infections with these parasites are more common where sanitation is poor,[8] and raw human feces are used as fertilizer.

Symptoms

Often, no symptoms are seen with an A. lumbricoides infection. However, in the case of a particularly bad infection, symptoms may include bloody sputum, cough, fever, abdominal discomfort, intestinal ulcer, passing worms, etc.[9][10] Ascariasis is also the most common cause of Löffler's syndrome worldwide. Accompanying symptoms include pulmonary infiltration, eosinophilia, and radiographic opacities [11]

Prevention

Preventing any fecal-borne disease requires educated hygienic habits/culture and effective fecal treatment systems. This is particularly important with A. lumbricoides because its eggs are one of the most difficult pathogens to kill (second only to prions), and the eggs commonly survive 1–3 years. A. lumbricoides lives in the intestine where it lays eggs. Infection occurs when the eggs, too small to be seen by the unaided eye, are eaten. The eggs may get onto vegetables when improperly processed human feces of infected people are used as fertilizer for food crops. Infection may occur when food is handled without removing or killing the eggs on the hands, clothes, hair, raw vegetables/fruit, or cooked food that is (re)infected by handlers, containers, etc. Bleach does not readily kill A. lumbricoides eggs, but it will remove their sticky film, to allow the eggs to be rinsed away. A. lumbricoides eggs can be reduced by hot composting methods, but to completely kill them may require rubbing alcohol, iodine, specialized chemicals, cooking heat, or "unusually" hot composting (for example, over 50 °C (122 °F) for 24 hours[12])

Details of infection process

Infections happen when a human swallows water or food contaminated with unhatched eggs, which hatch into juveniles in the duodenum. They then penetrate the mucosa and submucosa and enter venules or lymphatics. Next, they pass through the right heart and into pulmonary circulation. They then break out of the capillaries and enter the air spaces. Acute tissue reaction occurs when several worms get lost during this migration and accumulate in other organs of the body. The juveniles migrate from the lung up the respiratory tract to the pharynx where they are swallowed. They begin producing eggs within 60–65 days of being swallowed. These are produced within the small intestine, where the juveniles mature. It might seem odd that the worms end up in the same place where they began. One hypothesis to account for this behavior is that the migration mimics an intermediate host, which would be required for juveniles of an ancestral form to develop to the third stage. Another possibility is that tissue migration enables faster growth and larger size, which increases reproductive capacity.[13]

Diagnosis and treatment

Most diagnoses are made by identifying the appearance of the worm or eggs in feces. Due to the large quantity of eggs laid, physicians can diagnose using only one or two fecal smears.[citation needed]

Infections can be treated with drugs called ascaricides. The treatment of choice is mebendazole. The drug functions by binding to tubulin in the worms' intestinal cells and body-wall muscles. Nitazoxanide and ivermectin can also be used.[5]

References

  1. ↑ "eMedicine - Ascaris Lumbricoides : Article by Aaron Laskey". Archived from the original on 27 January 2008. Retrieved 2008-02-03.
  2. ↑ Harhay, Michael O; Horton, John; Olliaro, Piero L (2010). "Epidemiology and control of human gastrointestinal parasites in children". Expert Review of Anti-infective Therapy. 8 (2): 219–34. doi:10.1586/eri.09.119. PMC 2851163. PMID 20109051.
  3. ↑ 3.0 3.1 Murray, Patrick R.; Rosenthal, Ken S.; Pfaller, Michael A. Medical Microbiology, Fifth Edition. United States: Elsevier Mosby, 2005Template:Pn
  4. ↑ Piper R (2007). Extraordinary Animals: An Encyclopedia of Curious and Unusual Animals, Greenwood Press.Template:Pn
  5. ↑ 5.0 5.1 5.2 Roberts, Larry S.; Janovy, John Jr. Foundations of Parasitology, Eighth Edition. United States: McGraw-Hill, 2009Template:Pn
  6. ↑ 6.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.09 6.10 6.11 6.12 6.13 6.14 6.15 "Public Health Image Library (PHIL)".
  7. ↑ Dridelle R. Parasites. Tales of Humanity's Mostly Unwelcome Guests. Univ. of California, 2010. p. 26. ISBN 978-0-520-25938-6.
  8. ↑ "DPDx - Ascariasis". Archived from the original on 24 February 2008. Retrieved 2008-02-03.
  9. ↑ MedlinePlus Encyclopedia Ascariasis
  10. ↑ http://www.stanford.edu/group/parasites/ParaSites2005/Ascaris/JLora_ParaSite.htm#Symptoms[full citation needed]
  11. ↑ Löffler, W (1956). "Transient Lung Infiltrations with Blood Eosinophilia". International Archives of Allergy and Applied Immunology. 8 (1–2): 54–9. doi:10.1159/000228268. PMID 13331628.
  12. ↑ http://weblife.org/humanure/chapter7_18.html[full citation needed]
  13. ↑ Read, A. F.; Sharping, A. (1995). "The evolution of tissue migration by parasitic nematode larvae". Parasitology. 111 (3): 359–71. doi:10.1017/S0031182000081919. PMID 7567104.

External links

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