Capillaria philippinenensis Common name: pudoc worm Discovered: Dr. Nelia P.

Salazar, 1962 Bacara, Ilocos Norte 1st epidemic: Tagudin, Ilocos Sur, Barrio West Pudoc, 1967, 20-49 years old IH: glass fishes (ipon Hypselotris bipartita) IS: 2nd stage larva DS: adult, egg in stool MOT: ingestion of 2nd stage larva in the gastrointestinal tract of the dish Life cycle: 1. Ingestion of 2nd stage larva 2. Passes out eggs (embryonate in soil and water) 3. Ingested by fish 4. Larva, intestine, ingestion 5. Adult (intestine), lay eggs Symptoms: 1. Abdominal pain and diarrhea (8-20 times a day) 2. Borborygmus boiling sound in the stomach 3. Severe weight loss followed by weakness and vomiting 4. Fever- dehydration 5. Anorexia, due to loss of appetite Pathology 1. Enteropathy - Severe protein loss - - malabsorption of fats and sugars - Destruction of intestinal villi 2. Non tissue invading - Produces microulcers in the epithelium and the generation of cells (adults) 3. Histologically - Villi flattened or denuded resulting to severe diarrhea - Sprue like or mushy stool 4. Due to diarrhea - Dehydration, weakness, shock death - Adult female produces larva can cause hyperinfection / autoinfection due to increased number of worms Diagnosis: 1.Recovery of adults and eggs a. Typical Oviparous single row 8 10 eggs

b. Atypical Viviparous 2-3 rows 40 45 eggs 2. Concentrated technique Sedimentation technique

Treatment: Mebendazole Albendazole Fluid and electrolyte replacement Anti diarrhea, anti helminthic Prevention PSWD Avoid eating raw fish Treat infected individual Health education

Trichinella spiralis Common name : muscle worm, trichina worm Life span: 5 -10 years H: small intestine, stomach, striated muscle IS/DS: encysted larva MOT: ingestion of encysted larva through insufficiently cooked meat FH: rat pig AH: man Reservoir: dogs, cats, bears, fox, walrus FH/IH- harbor adult and larval stage in the body Life cycle: 1. Host ingest ecysted larva, stomach, small intestine, subepithelium of villi (mature then mate) 2. Fertilization, female lay eggs then larva (hatch in uterus) 3. Female worm lay larva (viviparous) 4. Mucosa, penetrate lymphatics, circulation, muscles 5. 3 weeks ecncapsulate/ encyst Calcification: 6-12 months Attracted to fast moving muscles: eyes, diaphragm, tongue, thorax Symptoms: 1. Enteric phase - Intestinal invasion - Incubation period - Food poisoning ( nausea, diarrhea, malase or weakness, abdominal pain) 2. Invasion phase

Larval migration Fever, dyspnea (shortness of breath). Dysphagia ( difficulty in swallowing, chewing, speech), periorbital edema

Larva spearlike burrowing tip

3. Enycstment / encapsulation - 2 3 weeks after infection Toxemia - Myocardial and neurological complications - Congestive heart failure 4. Meningitis and menigoencephalitis - Cerebral lesions - Exhausted pneumonia - Ocular disturbances - Deafness - Coma, death Prognosis: Good if treated, diagnosed early Bad death due to heart failure, pneumonia, brain involvement and encephalitis, septicemia Factor: Location of larva Age and physical condition of patient Severity of infection Involvement of heart and respiratory systems

BLOOD NEMATODES (filarial worms) Wuchereria bancrofti Common name: Bancrofts filarial worm Lifespan: 5 years H: lymph vessels, lymph glands, lymph nodes (adults), peripheral blood (microfilaria) IS: filiform DS: microfilaria MOT: mosquito bite Vectors: Aedes aegypti ( morning) Aedes poecilus (night) Mansonia Anopheles FH: man Life cycle: In man 1. Mosquito (filiform) 2. Man, skin, lymph vessels, lymph nodes (adults) 3. Mate, releases microfilaria In mosquito 1. Microfilaria, muscle, develop in to L1 ( sausage shaped larva) ,thoracic muscle L2 (pigtail larva), L3 (filiform larva) 2. Muscle of mosquito (damage it) 3. Proboscis 4. Injects filiform Symptoms / pathology Clinical course : 4 years a. Asymptomatic b. Acute c. Chronic 1st year Entrance to system of man without symptoms Asymptomatic Microfilaria goes to blood endemic normal Junior (acute phase) Visible clinical symptoms Fever (filarial fever) due to inflammation of lymph glands Swelling of legs 2 year 3rd year 4th year
nd

Diagnosis: 1. Muscle/ tissue biopsy 2. Bentonite flocculation test - Antibody antigen reaction 3. Becks Xeno diagnosis - Animal (rabbit, rat) - After 14 days kill, then examine 4. Bachman intradermal (skin test) - Antigen specific= Trichina worm antigen Treatment: Albendazole Mebendazole Thiabendazole Prevention Cook meat Freezing will kill larva Proper meat inspection Rodent control Health education Salting , smoking dyring meat not effective Require 2 hosts ( pumatay at yung kumain nung patay) Viviparous - 1,500 larva during its lifetime

Enlargement of extremeties elephantiasis Incurable disease

During 2nd year (blood) complete blockage of lymphatics (non curable) enlarged parts (hardened fibrosis) TPE tropical pulmonary eosinophilia / Weingartners syndrome - To quote filariasis - Granulomas and allergic reactions - No clinical manifestations - 2nd year - Microfilaria in tissues Diagnosis: 1. Nocturnal periodicity (presence or appearance at night) 2. Knotts concentration technique - 1 ml blood + 2% formalin or acetic acid - Before 12am, and after 12 am (10pm, 2-3am) - Peripheral blood (veins and arteries) 3. Thick drop 4. Nucleopore filter 5. Ultrasonography - Live worms in lymph nodes - Assess the damage 6. Biopsy Treatment: Ivoric technique Diethyl carbamazine Prevention 1. Treat the infected individual 2. Vector control 3. Spray insecticide 4. Personal protective measurement in house Periodicity 1. Nocturnal bancrofti 2. Diurnal loa loa 3. Subperiodic night and day; malayi 4. Non periodic- no definite time

IS: filiform DS: microfilaria (2 week development) MOT: flies Vector: Mansonia bonnae, Mansonia uniformis, Telamid flies (day biting) deer flies : Crypseps dimidiate, silacea atlanticus Symptoms / Pathology - Women breast - Upper extremeties - Lower extremeties (no scrotum) Bancrofti Malayi 2 terminal nuclei Kinky microfilaria 2ndary kinks Free tail end Loa Loa Nuclei extend to the tip Exciting parasite Filarial oculi humani Eye worm

3 terminal nuclei

Life cycle: 1. Fly bite , man , SCT (causes egg swelling, maturation multiply) 2. Very much attracted to light kaya eyes (microfilaria and adults) goes to your eyes white 3. Fly body larva thorax head filiform Symptoms and pathology 1. SCT - Back and forth migration - Swelling 2. Visceral organ - Chicken egg mass 3. Ocular - Very painful - Severe anxiety and nervousness 4. Eosinophil - 40 70 increase 5. Severe allergic reactions in adults 6. Bug eye / bulge eye/ bung eye Diagnosis: 1. Demonstration microfilaria in blood 2. Knotts technique 3. Removal of adult in conjunctiva 4. Biopsy swelling Treatment: Diethyl carbamazine Histamine

Wuchereria malayi Common name: Brugia malayi, Malayan filarial worm Lifespan: 4-7 years FH: man

Onchocerca volvolus Common name: blinding worm Lifespan: 5 years H: SCT human juices, temporal and occipital regions of scalp IS: filiform DS: microfilaria MOT: black fly : Simulium domnosum. Simulium neavi Disease: Blinding filariasis, river blindness, coastal erysipelas Pool feeing- induce blood and tissue juices Inodule 20 female 30 male (Japan) - Conclusion: stay in groups - Encapsulated: sungit damot Symptoms/ pathology Non sheathed microfilaria - Terminal nuclei - Free terminal tail end 1. Adults causes anodule onchocerchoma 2. Skin Hypertrophic hyperpigmentation, Dalmatian, polka dots a. SOWDA localized black spots b. Leopardski craw or gale filaromia, elevated with pus c. Peau de orange red superficial spots 3. Groin - Genital elephantiasis Hanging groin - Loses skin elasticity in the pelvic region 4. Eyes - Major - Microfilaria attacks optical nerve total blindness Diagnosis: 1. Tumor biopsy- reveal adult 2. Skin nips / skin biopsy microfilaria 3. Biopsy corneal conjunctiva 4. Serological test - Mazzotis reaction - Diagnostic test - 50MG DEC pruritus itchy Treatment: 1. Nodulectomy in children 2. DEC 3. Suramin attacks adults Prognosis: 1. Skin and groin okie lang 2. Eyes bad Angiostrongylus cantonensis - rat lung worm - AH: man - Disease: Meningco encephalitis - Barbers pole appearance Gnathostoma spinigerum - Stomach worm Dracunculus medinensis - serpent worm - guinea worm /medina worm