Causal Agents: Schistosomiasis is caused by digenetic blood trematodes. The three main species infecting humans are Schistosoma haematobium, S. japonicum, and S. mansoni. Two other species, more localized geographically, are S. mekongi and S. intercalatum. In addition, other species of schistosomes, which parasitize birds and mammals, can cause cercarial dermatitis in humans. Life Cycle: Eggs are eliminated with feces or urine . Under optimal conditions the eggs hatch and release miracidia , which swim and penetrate specific snail intermediate hosts . The stages in the snail include 2 generations of sporocysts and the production of cercariae . Upon release from the snail, the infective cercariae swim, penetrate the skin of the human host , and shed their forked tail, becoming schistosomulae . The schistosomulae migrate through several tissues and stages to their residence in the veins ( , ). Adult worms in humans reside in the mesenteric venules in various locations, which at times seem to be specific for each species . For instance, S. japonicum is more frequently found in the superior mesenteric veins draining the small intestine , and S. mansoni occurs more often in the superior mesenteric veins draining the large intestine . However, both species can occupy either location, and they are capable of moving between sites, so it is not possible to state unequivocally that one species only occurs in one location. S. haematobium most often occurs in the venous plexus of bladder , but it can also be found in the rectal venules. The females (size 7 to 20 mm; males slightly smaller) deposit eggs in the small venules of the portal and perivesical systems. The eggs are moved progressively toward the lumen of the intestine (S. mansoni and S. japonicum) and of the bladder and ureters (S. haematobium), and are eliminated with feces or urine, respectively . Pathology of S. mansoni and S. japonicum schistosomiasis includes: Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fibrosis, portal hypertension, and occasional embolic egg granulomas in brain or spinal cord. Pathology of S. haematobium schistosomiasis includes: hematuria, scarring, calcification, squamous cell carcinoma, and occasional embolic egg granulomas in brain or spinal cord. Human contact with water is thus necessary for infection by schistosomes. Various animals, such as dogs, cats, rodents, pigs, hourse and goats, serve as reservoirs for S. japonicum, and dogs for S. mekongi. Geographic Distribution: Schistosoma mansoni is found in parts of South America and the Caribbean, Africa, and the Middle East; S. haematobium in Africa and the Middle East; and S. japonicum in the Far East. Schistosoma mekongi and S. intercalatum are found focally in Southeast Asia and central West Africa, respectively. Causal Agents: Schistosomiasis is caused by digenetic blood trematodes. The three main species infecting humans are Schistosoma haematobium, S. japonicum, and S. mansoni. Two other species, more localized geographically, are S. mekongi and S. intercalatum. In addition, other species of schistosomes, which parasitize birds and mammals, can cause cercarial dermatitis in humans. Life Cycle: Eggs are eliminated with feces or urine . Under optimal conditions the eggs hatch and release miracidia , which swim and penetrate specific snail intermediate hosts . The stages in the snail include 2 generations of sporocysts and the production of cercariae . Upon release from the snail, the infective cercariae swim, penetrate the skin of the human host , and shed their forked tail, becoming schistosomulae . The schistosomulae migrate through several tissues and stages to their residence in the veins ( , ). Adult worms in humans reside in the mesenteric venules in various locations, which at times seem to be specific for each species . For instance, S. japonicum is more frequently found in the superior mesenteric veins draining the small intestine , and S. mansoni occurs more often in the superior mesenteric veins draining the large intestine . However, both species can occupy either location, and they are capable of moving between sites, so it is not possible to state unequivocally that one species only occurs in one location. S. haematobium most often occurs in the venous plexus of bladder , but it can also be found in the rectal venules. The females (size 7 to 20 mm; males slightly smaller) deposit eggs in the small venules of the portal and perivesical systems. The eggs are moved progressively toward the lumen of the intestine (S. mansoni and S. japonicum) and of the bladder and ureters (S. haematobium), and are eliminated with feces or urine, respectively . Pathology of S. mansoni and S. japonicum schistosomiasis includes: Katayama fever, hepatic perisinusoidal egg granulomas, Symmers’ pipe stem periportal fibrosis, portal hypertension, and occasional embolic egg granulomas in brain or spinal cord. Pathology of S. haematobium schistosomiasis includes: hematuria, scarring, calcification, squamous cell carcinoma, and occasional embolic egg granulomas in brain or spinal cord. Human contact with water is thus necessary for infection by schistosomes. Various animals, such as dogs, cats, rodents, pigs, hourse and goats, serve as reservoirs for S. japonicum, and dogs for S. mekongi. Geographic Distribution: Schistosoma mansoni is found in parts of South America and the Caribbean, Africa, and the Middle East; S. haematobium in Africa and the Middle East; and S. japonicum in the Far East. Schistosoma mekongi and S. intercalatum are found focally in Southeast Asia and central West Africa, respectively. Causal Agent: The nematode (roundworm) Gnathostoma spinigerum and Gnathostoma hispidum, which infects vertebrate animals. Human gnathostomiasis is due to migrating immature worms. Life Cycle: Adapted from a drawing provided by Dr. Sylvia Paz Díaz Camacho, Universidade Autónoma de Sinaloa, Mexico. In the natural definitive host (pigs, cats, dogs, wild animals) the adult worms reside in a tumor which they induce in the gastric wall. They deposit eggs that are unembryonated when passed in the feces . Eggs become embryonated in water, and eggs release first-stage larvae . If ingested by a small crustacean (Cyclops, first intermediate host), the first-stage larvae develop into second-stage larvae . Following ingestion of the Cyclops by a fish, frog, or snake (second intermediate host), the second-stage larvae migrate into the flesh and develop into third-stage larvae . When the second intermediate host is ingested by a definitive host, the third-stage larvae develop into adult parasites in the stomach wall . Alternatively, the second intermediate host may be ingested by the paratenic host (animals such as birds, snakes, and frogs) in which the third-stage larvae do not develop further but remain infective to the next predator . Humans become infected by eating undercooked fish or poultry containing third-stage larvae, or reportedly by drinking water containing infective second-stage larvae in Cyclops . Geographic Distribution: Asia, especially Thailand and Japan; recently emerged as an important human parasite in Mexico Causal Agents: The trematodes Fasciola hepatica (the sheep liver fluke) and Fasciola gigantica, parasites of herbivores that can infect humans accidentally. Life Cycle: Immature eggs are discharged in the biliary ducts and in the stool . Eggs become embryonated in water , eggs release miracidia , which invade a suitable snail intermediate host , including the genera Galba, Fossaria and Pseudosuccinea. In the snail the parasites undergo several developmental stages (sporocysts , rediae , and cercariae ). The cercariae are released from the snail and encyst as metacercariae on aquatic vegetation or other surfaces. Mammals acquire the infection by eating vegetation containing metacercariae. Humans can become infected by ingesting metacercariae-containing freshwater plants, especially watercress . After ingestion, the metacercariae excyst in the duodenum and migrate through the intestinal wall, the peritoneal cavity, and the liver parenchyma into the biliary ducts, where they develop into adults . In humans, maturation from metacercariae into adult flukes takes approximately 3 to 4 months. The adult flukes (Fasciola hepatica: up to 30 mm by 13 mm; F. gigantica: up to 75 mm) reside in the large biliary ducts of the mammalian host. Fasciola hepatica infect various animal species, mostly herbivores. Geographic Distribution: Fascioliasis occurs worldwide. Human infections with F. hepatica are found in areas where sheep and cattle are raised, and where humans consume raw watercress, including Europe, the Middle East, and Asia. Infections with F. gigantica have been reported, more rarely, in Asia, Africa, and Hawaii. Causal Agents: The nematode (roundworm) Angiostrongylus cantonensis, the rat lungworm, is the most common cause of human eosinophilic meningitis. In addition, Angiostrongylus (Parastrongylus) costaricensis is the causal agent of abdominal, or intestinal, angiostrongyliasis. Life Cycle: Adult worms of A. cantonensis live in the pulmonary arteries of rats. The females lay eggs that hatch, yielding first-stage larvae, in the terminal branches of the pulmonary arteries. The first-stage larvae migrate to the pharynx, are swallowed, and passed in the feces. They penetrate, or are ingested by, an intermediate host (snail or slug). After two molts, third-stage larvae are produced, which are infective to mammalian hosts. When the mollusk is ingested by the definitive host, the third- stage larvae migrate to the brain where they develop into young adults. The young adults return to the venous system and then the pulmonary arteries where they become sexually mature. Of note, various animals act as paratenic (transport) hosts: after ingesting the infected snails, they carry the third-stage larvae which can resume their development when the paratenic host is ingested by a definitive host. Humans can acquire the infection by eating raw or undercooked snails or slugs infected with the parasite; they may also acquire the infection by eating raw produce that contains a small snail or slug, or part of one. There is some question whether or not larvae can exit the infected mollusks in slime (which may be infective to humans if ingested, for example, on produce). The disease can also be acquired by ingestion of contaminated or infected paratenic animals (crabs, freshwater shrimps). In humans, juvenile worms migrate to the brain, or rarely in the lungs, where the worms ultimately die. The life cycle of Angiostrongylus (Parastrongylus) costaricensis is similar, except that the adult worms reside in the arterioles of the ileocecal area of the definitive host. In humans, A. costaricensis often reaches sexual maturity and release eggs into the intestinal tissues. The eggs and larvae degenerate and cause intense local inflammatory reactions and do not appear to be shed in the stool. Geographic Distribution: Most cases of eosinophilic meningitis have been reported from Southeast Asia and the Pacific Basin, although the infection is spreading to many other areas of the world, including Africa and the Caribbean. Abdominal angiostrongyliasis has been reported from Costa Rica, and occurs most commonly in young children. Causal Agent: More than 30 species of trematodes (flukes) of the genus Paragonimus have been reported which infect animals and humans. Among the more than 10 species reported to infect humans, the most common is P. westermani, the oriental lung fluke. Life Cycle: The eggs are excreted unembryonated in the sputum, or alternately they are swallowed and passed with stool . In the external environment, the eggs become embryonated , and miracidia hatch and seek the first intermediate host, a snail, and penetrate its soft tissues . Miracidia go through several developmental stages inside the snail : sporocysts , rediae , with the latter giving rise to many cercariae , which emerge from the snail. The cercariae invade the second intermediate host, a crustacean such as a crab or crayfish, where they encyst and become metacercariae. This is the infective stage for the mammalian host . Human infection with P. westermani occurs by eating inadequately cooked or pickled crab or crayfish that harbor metacercariae of the parasite . The metacercariae excyst in the duodenum , penetrate through the intestinal wall into the peritoneal cavity, then through the abdominal wall and diaphragm into the lungs, where they become encapsulated and develop into adults (7.5 to 12 mm by 4 to 6 mm). The worms can also reach other organs and tissues, such as the brain and striated muscles, respectively. However, when this takes place completion of the life cycles is not achieved, because the eggs laid cannot exit these sites. Time from infection to oviposition is 65 to 90 days. Infections may persist for 20 years in humans. Animals such as pigs, dogs, and a variety of feline species can also harbor P. westermani. Geographic Distribution: Paragonimus spp. are distributed throughout the Americas, Africa and southeast Asia. Paragonimus westermani is distributed in southeast Asia and Japan. Paragonimus kellicotti is endemic to North America. Causal Agent: Metagonimus yokogawai, a minute intestinal fluke (and the smallest human fluke). Life Cycle: Adults release fully embryonated eggs each with a fully-developed miracidium, and eggs are passed in the host’s feces . After ingestion by a suitable snail (first intermediate host), the eggs hatch and release miracidia which penetrate the snail’s intestine . Snails of the genus Semisulcospira are the most frequent intermediate host for Metagonimus yokogawai. The miracidia undergo several developmental stages in the snail, i.e. sporocysts , rediae , and cercariae . Many cercariae are produced from each redia. The cercariae are released from the snail and encyst as metacercariae in the tissues of a suitable fresh/brackish water fish (second intermediate host) . The definitive host becomes infected by ingesting undercooked or salted fish containing metacercariae . After ingestion, the metacercariae excyst, attach to the mucosa of the small intestine and mature into adults (measuring 1.0 mm to 2.5 mm by 0.4 mm to 0.75 mm) . In addition to humans, fish-eating mammals (e.g., cats and dogs) and birds can also be infected by M. yokogawai . Geographic Distribution: Mostly the Far East, as well as Siberia, Manchuria, the Balkan states, Israel, and Spain. [...].. .Causal Agents: The cestode Diphyllobothrium latum (the fish or broad tapeworm), the largest human tapeworm Several other Diphyllobothrium species have been reported to infect humans, but less frequently;... areas where active transmission does not occur, resulting in human diphyllobothriasis For example, cases of D latum infection associated with consumption of imported fish have been reported in Brazil Causal Agents: Filariasis is caused by nematodes (roundworms) that inhabit the lymphatics and subcutaneous tissues Eight main species infect humans Three of these are responsible for most of the morbidity... develop into first-stage larvae and subsequently into third-stage larvae The third-stage larvae migrate to the midge's proboscis and can infect another human when the midge takes another blood meal Causal Agents: The nematode (roundworm) Capillaria philippinensis causes human intestinal capillariasis Two other Capillaria species parasitize animals, with rare reported instances of human infections They... occurs in Thailand Rare cases have been reported from other Asian countries, the Middle East, and Colombia Rare cases of human infections with C hepatica and C aerophila have been reported worldwide Causal Agents: The cestodes (tapeworms) Taenia saginata (beef tapeworm) and T solium (pork tapeworm) Taenia solium can also cause cysticercosis Life Cycle: ... up to 18 months in the case of Onchocerca Brugia malayi Mansonella streptocerca Loa loa Onchocerca vovulus Mansonella ozzardi Wuchereria bancrofti Mansonella perstans Geographic Distribution: Among the agents of lymphatic filariasis, Wuchereria bancrofti is encountered in tropical areas worldwide; Brugia malayi is limited to Asia; and Brugia timori is restricted to some islands of Indonesia The agent... The larvae migrate to the appropriate site of the host's body, where they develop into microfilariae-producing adults The adults dwell in various human tissues where they can live for several years The agents of lymphatic filariasis reside in lymphatic vessels and lymph nodes; Onchocerca volvulus in nodules in subcutaneous tissues; Loa loa in subcutaneous tissues, where it migrates actively; Brugia malayi... blood, except for those of Onchocerca volvulus and Mansonella streptocerca, which are found in the skin, and O volvulus which invade the eye The microfilariae infect biting arthropods (mosquitoes for the agents of lymphatic filariasis; blackflies [Simulium] for Onchocerca volvulus; midges for Mansonella perstans and M streptocerca; and both midges and blackflies for Mansonella ozzardi; and deerflies [Chrysops] . Causal Agents: Schistosomiasis is caused by digenetic blood trematodes. The three. are found focally in Southeast Asia and central West Africa, respectively. Causal Agents: Schistosomiasis is caused by digenetic blood trematodes. The three