53
1 COMMON PARASITES OF MILITARY IMPORTANCE BY KAPT MOHAMMAD BIN HARUN HEALTH SERVICES DIVISION MAF HQ

Common parasites of military importance

Embed Size (px)

DESCRIPTION

 

Citation preview

Page 1: Common parasites of military importance

1

COMMON PARASITES OF MILITARY IMPORTANCE

BY

KAPT MOHAMMAD BIN HARUN

HEALTH SERVICES DIVISION

MAF HQ

Page 2: Common parasites of military importance

2

CONTENTS1.1. Introduction of ParasitesIntroduction of Parasites a.a. Definition of Parasites.Definition of Parasites.

b.b. Types of Parasites.Types of Parasites.c.c. Classification of Parasites.Classification of Parasites.d.d. Lifecycle of Parasites.Lifecycle of Parasites.e.e. Groups of Parasites.Groups of Parasites.

2.2. List of Parasites of Medical Importance.List of Parasites of Medical Importance.3.3. Common Parasites of Military Importance.Common Parasites of Military Importance. a. Pathogenic Intestinal Parasites.a. Pathogenic Intestinal Parasites.

b. Malaria Parasites.b. Malaria Parasites. c. Blood flukes.c. Blood flukes. d. Filarial Parasitesd. Filarial Parasites e. Haemoflagelates parasites e. Haemoflagelates parasites f. Arthropods of Military Importance. f. Arthropods of Military Importance.

4.4. Activities to Modify Risk of Infection.Activities to Modify Risk of Infection.5.5. Conclusion.Conclusion.

Page 3: Common parasites of military importance

3

1.1. An animal or organism – lives on or in another organism and An animal or organism – lives on or in another organism and

derives it nourishments there from.derives it nourishments there from.

2.2. An obligate parasite – A parasite which is completely An obligate parasite – A parasite which is completely dependent upon the host (organism which harbour parasite dependent upon the host (organism which harbour parasite and is usually larger than the parasite).and is usually larger than the parasite).

3.3. A facultative parasite – An organism which is capable of living A facultative parasite – An organism which is capable of living both freely and as a parasite. both freely and as a parasite.

(Last J.M, 4(Last J.M, 4thth Edition A Dictionary of Epidemiology) Edition A Dictionary of Epidemiology)

DEFINITION OF PARASITES (1)

Page 4: Common parasites of military importance

4

DEFINITION OF PARASITES (2)

1.1. Parasites are organism that live inside humans or Parasites are organism that live inside humans or other organisms, who act as hosts.other organisms, who act as hosts.

2.2. They are dependents on their hosts – unable to They are dependents on their hosts – unable to produce food or energy for themselves.produce food or energy for themselves.

3.3. Parasites are harmful to humans or other organism Parasites are harmful to humans or other organism because: because:

* they consume needed food* they consume needed food

* eat away body tissue and cells* eat away body tissue and cells

* eliminate toxics waste which makes people sick.* eliminate toxics waste which makes people sick.

Page 5: Common parasites of military importance

5

TYPES OF PARASITES

1.1. Endoparasites - A parasites which lives within the Endoparasites - A parasites which lives within the body of the host. Example: body of the host. Example: Plasmodium vivax, Plasmodium vivax, Enterobuis vermicularis, Brugia malayiEnterobuis vermicularis, Brugia malayi. .

2.2. Ectoparasites - A parasites which lives on the Ectoparasites - A parasites which lives on the outside of the host. Example: Fleas, Tsetse Flies outside of the host. Example: Fleas, Tsetse Flies and lice.and lice.

Page 6: Common parasites of military importance

6

CLASSIFICATION OF PARASITES

1.1. Parasites are classified according to the International Parasites are classified according to the International Code of Zoological Nomenclature.Code of Zoological Nomenclature.

2.2. Major divisions of animal kingdom – Phylum, Class, Major divisions of animal kingdom – Phylum, Class, Order, Family, Genus and Species.Order, Family, Genus and Species.

3.3. Main criteria – morphology and genetic structure of Main criteria – morphology and genetic structure of parasites.parasites.

4.4. Each parasites is designated under the binomial (two Each parasites is designated under the binomial (two names) system, names) system, genus and speciesgenus and species: eg: : eg: Entamoeba histolytica.Entamoeba histolytica.

Page 7: Common parasites of military importance

7

LIFECYCLE OF PARASITES

1.1. A parasite is dependent for its survival on transmissions A parasite is dependent for its survival on transmissions from host to host.from host to host.

2.2. Lifecycle patterns: simple - involving a single host. Lifecycle patterns: simple - involving a single host. : complex - involving 2 or more : complex - involving 2 or more intermediate hosts intermediate hosts

3.3. Importance of lifecycle: diagnostic stage - diagnosisImportance of lifecycle: diagnostic stage - diagnosis : infective stage - initiates : infective stage - initiates

infectioninfection : control program against : control program against

parasitesparasites

Page 8: Common parasites of military importance

8

GROUPS OF PARASITES

Parasites can be categorized into:Parasites can be categorized into:

1.1. Protozoa. eg: Protozoa. eg: Plamodium vivaxPlamodium vivax, , Entamoeba histolyticaEntamoeba histolytica, , Toxoplasma gondii, and Pneumocystis cariniiToxoplasma gondii, and Pneumocystis carinii..

2.2. Helminths. eg: Helminths. eg: Wuchereria bancroftiWuchereria bancrofti, Trichuris Trichiura, , Trichuris Trichiura, Enterobius Enterobius andand vermicularis. vermicularis.

3.3. Arthropods. Fleas, Tsetse Flies and lice.Arthropods. Fleas, Tsetse Flies and lice.

Page 9: Common parasites of military importance

9

LIST OF PARASITES OF MEDICAL IMPORTANCE

1.1. Entamoeba histolytica 12. Taenia saginataEntamoeba histolytica 12. Taenia saginata2.2. Naegleria fowleri 13. Hymenolepis nanaNaegleria fowleri 13. Hymenolepis nana3.3. Acanthamoeba sp. 14. Schistosoma spp.Acanthamoeba sp. 14. Schistosoma spp.4.4. Giardia lambliaGiardia lamblia 15. Trichuris trichiura 15. Trichuris trichiura5.5. Leishmania donovani 16. Hymenolepis nanaLeishmania donovani 16. Hymenolepis nana6.6. Trypanosoma cruzi 17. Enterobius vermicularisTrypanosoma cruzi 17. Enterobius vermicularis7.7. Plasmudium falciparum 18. Brugia malayiPlasmudium falciparum 18. Brugia malayi8.8. Plasmodium vivax 19. Ascaris lumbricoidesPlasmodium vivax 19. Ascaris lumbricoides9.9. Plasmodium ovale 20. Tsetse FliesPlasmodium ovale 20. Tsetse Flies10.10. Plasmodium malariae 21. LicePlasmodium malariae 21. Lice11.11. Toxoplasma gondii 22. Sarcoptes scabieiToxoplasma gondii 22. Sarcoptes scabiei

Page 10: Common parasites of military importance

10

COMMON PARASITES PARASITES COMMON PARASITES PARASITES

OF MILITARY IMPORTANCEOF MILITARY IMPORTANCE

1.1. Entamoeba histolytica 11. Leishmania sp.Entamoeba histolytica 11. Leishmania sp.2. Giardia lamblia 12. Trypanosoma sp. 2. Giardia lamblia 12. Trypanosoma sp. 3.3. Plasmodium falciparum 13. Soft Ticks Plasmodium falciparum 13. Soft Ticks4.4. Plasmodium vivax 14. Tsetse FliesPlasmodium vivax 14. Tsetse Flies5.5. Plasmodium ovale Plasmodium ovale 6.6. Plasmodium malariaePlasmodium malariae7.7. Schistosoma sp. (Blood flukes)Schistosoma sp. (Blood flukes)8. Wuchereria bancrofti8. Wuchereria bancrofti9. Brugia malayi9. Brugia malayi10. Brugia timori10. Brugia timori

Page 11: Common parasites of military importance

11

PATHOGENIC INTESTINAL PARASITEPATHOGENIC INTESTINAL PARASITE – – Introduction Introduction (1)(1)

Entamoeba hystolyticaEntamoeba hystolytica• Worldwide distribution with higher incidence in developing Worldwide distribution with higher incidence in developing

countries.countries.• This amoeba is the human intestinal tract parasite.This amoeba is the human intestinal tract parasite.• Humans are primary host for this pathogen.Humans are primary host for this pathogen.• It is spread via the anal to oral route.It is spread via the anal to oral route.

• Acquired form contaminated water, or foodstuffs Acquired form contaminated water, or foodstuffs contaminated by untreated sewage.contaminated by untreated sewage.

Entamoeba histolytica cyst (infective stage)

Entamoeba histolytica trophozoites

Page 12: Common parasites of military importance

12

Entamoeba hystolytica – The life cycle Entamoeba hystolytica – The life cycle (2)(2)

Page 13: Common parasites of military importance

13

Entamoeba histolytica – The Source of Infection in MilitaryEntamoeba histolytica – The Source of Infection in Military (3)(3)

• In military environment - parasite usually acquired by soldiers In military environment - parasite usually acquired by soldiers from: drinking water contaminated with fecal material from from: drinking water contaminated with fecal material from infected person (river/lake), infected person (river/lake),

• Food intake, contaminated with cysts of Food intake, contaminated with cysts of E.histolytica.E.histolytica.

• This happen because: when soldiers are tired, not enough This happen because: when soldiers are tired, not enough facility to cook, lack of knowledge about hygiene.facility to cook, lack of knowledge about hygiene.

Page 14: Common parasites of military importance

14

Entamoeba histolyticaEntamoeba histolytica of Military Importance of Military Importance (4)(4)• The most pathogenic amoeba for humans (soldiers). The most pathogenic amoeba for humans (soldiers). • Infectious diseases – can be spread(Waterborne & Food borne Ds). Infectious diseases – can be spread(Waterborne & Food borne Ds). • Worldwide distribution – military more expose to this parasite (jungle Worldwide distribution – military more expose to this parasite (jungle

exercise, UN mission, war).exercise, UN mission, war).• E. histolyticaE. histolytica causes amoebic dysentery – the trophozoites invade causes amoebic dysentery – the trophozoites invade

intestinal wall, leading to formation of amoebic ulcers: intestinal wall, leading to formation of amoebic ulcers: characterized characterized by bloody stools and diarrhea accompanied by abdominal pain.by bloody stools and diarrhea accompanied by abdominal pain.

• Trophozoites penetrate the intestinal wall – spread to blood streams Trophozoites penetrate the intestinal wall – spread to blood streams cause liver abcesses or spread to lungs and brain - resulting in cause liver abcesses or spread to lungs and brain - resulting in death.death.

Page 15: Common parasites of military importance

15

Giardia lambliaGiardia lamblia -Introduction -Introduction (1)(1)• Giardia lamblia Giardia lamblia is a flagellate of world-wide distribution.is a flagellate of world-wide distribution.• It is the most common flagellate of the intestinal tract causing It is the most common flagellate of the intestinal tract causing

GiardiasisGiardiasis. . Giardiasis Giardiasis is an infection of the upper small bowel, which is an infection of the upper small bowel, which may cause diarrhoea.may cause diarrhoea.

• G. lamblia G. lamblia is transmitted through ingestion of cysts in contaminated is transmitted through ingestion of cysts in contaminated water or food.water or food.

• It is a major cause of waterborne intestinal disease.It is a major cause of waterborne intestinal disease.• Has a high rate of person to person transmission.Has a high rate of person to person transmission.• Groups at increased risk - food handlers, travelers to endemic areas Groups at increased risk - food handlers, travelers to endemic areas

(such as St Petersburg, Russia), hikers and campers who neglect to (such as St Petersburg, Russia), hikers and campers who neglect to adequately purify their water. adequately purify their water.

Page 16: Common parasites of military importance

16

Giardia lambliaGiardia lamblia – The Lifecycle – The Lifecycle (2)(2)

Page 17: Common parasites of military importance

17

Giardia lambliaGiardia lamblia – The Source of Infection in Military – The Source of Infection in Military (3)(3)

• The source of infection is from the contaminated waterThe source of infection is from the contaminated water with with cysts of cysts of Giardia lambliaGiardia lamblia which can be ingested from the river, lake, which can be ingested from the river, lake, pond or from the well in rural area.pond or from the well in rural area.

• The other sources of infection are from food or dirty handsThe other sources of infection are from food or dirty hands which contaminated with the cysts of which contaminated with the cysts of G. lambliaG. lamblia..

• Giardiasis is the waterborne diseaseGiardiasis is the waterborne disease – military may expose to this – military may expose to this disease because the attitude of themselves who neglect to disease because the attitude of themselves who neglect to adequately purify their water – adequately purify their water – lack of hygiene knowledgelack of hygiene knowledge, , shortage shortage of time in the war, lack of facilities to cook their food or waterof time in the war, lack of facilities to cook their food or water ..

• The military are always expose to the endemic areaThe military are always expose to the endemic area. Going for . Going for UN mission around the world. Military traveling to other countries UN mission around the world. Military traveling to other countries and get infection to this parasite - called travelers disease.and get infection to this parasite - called travelers disease.

Page 18: Common parasites of military importance

18

Giardia lambliaGiardia lamblia of Military Importance of Military Importance (4)(4)

• Why the parasites are importance?Why the parasites are importance?

• Parasites can cause many causalities in militaryParasites can cause many causalities in military. Operations . Operations can’t be execute with diarrhoeal soldiers. can’t be execute with diarrhoeal soldiers.

• Humans are the only important reservoir of the infectionHumans are the only important reservoir of the infection. . Parasites loves soldiers with attitude of neglect the hygiene Parasites loves soldiers with attitude of neglect the hygiene especially in the jungle or rural area.especially in the jungle or rural area.

• G. lambliaG. lamblia has a high rate of person to person transmission has a high rate of person to person transmission..

• The main symptoms of disease are abdominal pain, flatulence, and The main symptoms of disease are abdominal pain, flatulence, and episodic diarrhoea with malabsorptive syndrome (steatorrhea) and episodic diarrhoea with malabsorptive syndrome (steatorrhea) and periodical soreness in severe cases.periodical soreness in severe cases.

• The parasites can be a disaster to military in the endemic areaThe parasites can be a disaster to military in the endemic area . . Many soldier get sick and can’t going for war. Many soldier get sick and can’t going for war.

Page 19: Common parasites of military importance

19

Malarial Parasites -Introduction (1)

CASEVAC/MEDEVAC via air ambulance

Exercise Planning : 2 Scenarios1. Scenario 1: Burn2. Scenario 2: Appendicitis

• Malarial parasites are known as Plasmodium spp. which cause the important tropical disease, Malaria. Malaria is a global problem with 1-3 million deaths per year caused by falciparum malaria.

• Plasmodium sp. are sporozoan obligate intracellular

parasites of liver and red blood cells - blood parasites.• 4 species which infect both humans and animals:

• Plasmodium falciparum• Plasmodium vivax• Plasmodium ovale • Plasmodium malariae

Page 20: Common parasites of military importance

20

Malarial Parasites – The life cycle (2)

                                                        

         

Schema of the Life Cycle of Malaria

Page 21: Common parasites of military importance

21

Malarial Parasites – The source of Infection and Transmission in Military (3)

CASEVAC/MEDEVAC via air ambulance

Exercise Planning : 2 Scenarios1. Scenario 1: Burn2. Scenario 2: Appendicitis

• Jungle is the main source of malarial parasites infection- ¾ of Malaysia covered by jungle.• The humidity, moderate temperature and clear water in the tropical rain forests can enhance the survival of the parasites.• The Anopheles mosquitoes is the main vector of these parasites.• Why soldiers are the easiest group acquired the infection? - working environment ; in the jungle - expose to mosquitoes bites. - lack of facility of battling the malaria - war, jungle exercise. - lack of knowledge of anti-malaria drugs - chemoprophylaxis. • The transmission of parasites requires two hosts, a. Intermediate invertebrate host (vector): Anopheles mosquitoes.b. Definitive vertebrate host: Humans (soldiers)

Female anopheline mosquito

Page 22: Common parasites of military importance

22

Malarial Parasites of Military Importance (4)

CASEVAC/MEDEVAC via air ambulance

Exercise Planning : 2 Scenarios1. Scenario 1: Burn2. Scenario 2: Appendicitis

• The parasite cause the most important communicable disease in the field for Malaysian soldier.• Malarial parasites has resulted in large number of casualties when operating in endemic area. Eg; Many causalities in US Forces when deployments in Vietnam, Africa, Middle East & Korea - weaken the fighting strength. • Certain parasites species are resistant to anti malarial drug - could be one of the enemy during war! - eg; P.falciparum is resistant to chloroquine and other antimalarial drugs. • Parasites attack still become disaster and psychological stress in most military troops – no vaccine available to cure & can cause to death. • Parasites available for research in term of prevention by military.

Page 23: Common parasites of military importance

23

Blood Flukes(Schistosoma sp.) – Introduction (1)

• The Schistosoma sp. are blood trematodes.• There are 5 species of Schistosoma:• S. mansoni, S. haematobium, S. japonicum, S. mekongi, S. intercalatum. All with similar life cycle involving freshwater snails.• Distribution of parasites – S. haematobium (Africa, M/East, India), S.mansoni (Africa, Brazil, Surinam, Venezuela, Caribbean islands), S.japonicum (China, Philippines), S. mekongi (Laos, Cambodia), S.intercalatum (Central Africa).• Only trematodes that live in the blood stream of warm blooded hosts.• Have two hosts definitive host (human) and intermediate (snail).

• Over 200 million people are infected and over at least 75 countries with 500 million or more exposed to infection.

• The disease caused is called Schistosomiasis or Bilharzia.

Page 24: Common parasites of military importance

24

Schistosoma sp. – The Lifecycle (2)

Page 25: Common parasites of military importance

25

How people acquired the parasites infection – contact with water in the endemic area

Schistosoma sp. – Source of Parasites infection (3)

Page 26: Common parasites of military importance

26

Schistosoma sp. Source of Infection in Military (4)

• Source of infection from the river, lake, valley or any place in the jungle with swampy area where snails can be found.• Military can easily acquired this parasites infection - working environment ; always contact with water during exercise or in war.• In the PBB mission especially in Africa and middle East ; endemic area – military can easily acquired infection.• The infective stage of parasite is cercaria can penetrate the military body through skin – results of contact with water where the snails are present.

Page 27: Common parasites of military importance

27

Schistosoma sp. of Military Importance (4)

• The parasites has resulted many casualties when operating in endemic area. • Parasites attack can become psychological stress in most military troops.• Military more expose to the source of infection – river, lake, swampy area with present of snails. • Parasites available for research in term of prevention by military.

Page 28: Common parasites of military importance

28

Filarial Parasites – Introduction (1)• It is estimated that over 140 million people are infected with one or more species of filaria.• Parasites Inhabit a range of locations within the body; lymph glands, deep connective tissue, subcutaneous tissues or mesenteries. Invasions of these tissues cause typical symptom of a human filarial infection. In some cases these result in fleshy deformities known as elephantiasis. • There are 5 commonly pathogenic species infecting man:•Wuchereria bancrofti, Brugia malayi, Brugia timori, Onchocerca volvulus and Loa loa.

•W. bancrofti is distributed throughout the tropical regions of Asia, Africa, China, the Pacific and isolated locations in the Americas. •Endemic range of Brugia malayi is confined to South and South-East Asia from India in the west to Korea in the east

Brugia timori is found in the lesser Sunda islands of the Indonesian archipelago, such as Timor

They inhabit a range of locations

Page 29: Common parasites of military importance

29

Filarial Parasites – The Lifecycles (2)

Culcicine Anopheline Aedes polynesiensis

Page 30: Common parasites of military importance

30

Filarial Parasite – Wuchereria bancrofti (3)

•Wuchereria bancrofti is a nematode causing lymphatic filariasis throughout the tropics and subtropics.

•Transmitted by the mosquito,Culex quinquefasciatus, Anopheles gambiae and Anopheles funestus.

•Humans are the only known reservoir host of W. bancrofti. •Infection rates in some communities in East Africa exceed 30% of adults causing revolting swellings of the legs or genital system, known as elephantiasis in man. •The adult worm occurs in tightly coiled nodular masses in the major lymphatic ducts.

Page 31: Common parasites of military importance

31

Filarial Parasite – Brugia malayi (4)

• Brugia malayi is a nematode causing lymphatic filariasis in South East Asia.• Two strain of B. malayi: • 1. Nocturnal periodic strain – Asia, microfilariae highest concentration between hours 10pm and 2 am.• 2. Subperiodic strain – Malaysia, Indonesia and Philippines, microfilariae detected between noon and 8pm.• Nocturnally periodic Brugian filariasis – transmitted by various Anopheles sp. and Masonia mosquitoes – bites during night.• Nocturnal sub-periodic B.malayi – transmitted exclusively by Mansonia sp.

Mansonoa bonneae are important vectors in Malaysia – breeding in swamp forest and bitting by night.

Page 32: Common parasites of military importance

32

Filarial Parasites – The source of infection in military (5)

• Military can acquired this infection from swampy tropics and subtropics forests. These the major habitats of the parasites and the their vectors (Anopheles, Culex and Mansonia mosquitoes).

Eg: Mansonoa bonneae are important vectors in Malaysia – breeding in swamp forest and bitting by night.• UN and other military mission to Africa, South-east Asia, Indonesia, Philippines, Timor Timor, Vietnam are the other sources of infection that military can acquired of these parasites.

Eg: During Vietnam war, many American soldiers infected by the parasites including filarial parasite – soldiers had been quarantine and not allow to donate their blood.

The same practice also in Malaysia - Soldiers going back from mission are quarantine.

Page 33: Common parasites of military importance

33

Filarial Parasites of Military Importance (6)

• The infection of these parasites can cause many causalities in military. Parasites Inhabit a range of locations within the body; lymph glands, deep connective tissue, subcutaneous tissues or mesenteries. In some cases these result in fleshy deformities known as elephantiasis.• During Viet Nam War thousands of returning US troops carried the parasites - induced disease. Nearly 54,000 soldiers returning from Operation Dessert Storm carried parasites disease including this parasite!• Military are the troops on the move, especially by sending them to the mission. This means military have great expose to this parasite’s infection in other countries. • This parasites can be spread easily by the mosquitoes vector and can cause disaster and psychological stress to military. Patients are asymptomatic and the attack are drastic!• The parasites can be transmitted from one person infected to others by the mosquitoes vectors. Parasites can be spread and cannot be controlled easily!• The parasites are useful to military because it can be used as experiment organisms for R & D by means of the prevention to parasite disease.

Page 34: Common parasites of military importance

34

Haemoflagellates parasites (Leishmania sp.) Intoduction (1)

•Two genera are medical importance: Leishmania sp. and Trypanosoma sp.

• Leishmania sp is endemic in many parts of Africa, Asia and South America. It is transmitted by Phlebotomus species, Sandfly. • 7 species infecting human: L.donovani complex, L.major, L. tropica, L. aethiopica, L. mexicana complex, L. braziliensis complex, L. peruviana•Leishmaniasis is a vector-borne parasitic disease endemic in parts of the tropics, subtropics, and Southern Europe. The World Health Organization estimates that 1.5 million cases of CL and 500,000 cases of visceral leishmaniasis (VL) occur each year.

Page 35: Common parasites of military importance

35

Haemoflagellates parasites (Leishmania sp.) Intoduction (2)

• They cause diseases collectively known as Leishmaniasis. 3 types of Leishmaniasis : visceral, cutaneous and mucocutaneous leishmaniasis. • Visceral leishmaniasis – sometimes known as kala-azar –caused by L. donovani complex; L.donovani, L.donovani infantum and L. donovani chagasi.

• Cutaneous leishmaniasis – a vector- borne parasitic disease, is a risk for military personnel who travel to tropics, subtropics and Southern Europe where disease is endemic. It caused by L.tropica, L.major and L. aethiopica, L.mexicana. • Mucocutaneous leishmania – L. braziliensis.

Page 36: Common parasites of military importance

36

Haemoflagellates parasites (Leishmania sp) – The Lifecycles (3)

Page 37: Common parasites of military importance

37

Haemoflagellates parasites (Trypanosoma sp.) Introduction (4)

•3 species of haemoflagellates Trypanosoma are responsible for disease in humans:• T. rhodesiense & T. gambiense • Salivarian trypanosomes – parasites complete dev. in salivary system of vector.-disease known as Trypanosomiasis. (sleeping sickness in Africa). - Distribution of parasites – T. rhodesiense(E. Africa), T. gambiense (W. Africa).-Transmitted of trypomastigotes by bitting flies of Genus Glossina (tsetse fly).

Page 38: Common parasites of military importance

38

Haemoflagellates parasites Trypanosoma sp. – Introduction (5)

Two form of trypomastigotes of T.rhodesiense & T.gambiense

The infective stage is trypomastigotes which can invade the lymphatic tissue, heart, various organs- organs enlarge. Infection of central nervous system – leading to coma and death within several years.

Trypanosoma sp.

Page 39: Common parasites of military importance

39

Haemoflagellates parasites – Introduction (6)

• Trypanosoma cruzi• Stercorian trypanosomes – complete their dev. in posterior region of vector, infective forms appear in the insects faeces.

• This the aetiological agent of South and Central America.• Cause a disease known as Chagas’ disease.•The vectors are the blood sucking bug of the genera Triatoma, Panstroglus, Rhodnius.• Multiplication of T.cruzi at site of infection can produce inflamed swelling – chagoma. Oedema of upper & lower eyelid may occur along with conjuctivitis – Ramona’s sign. •

Insect Triatominae

– Kissing bugT. Cruzi in blood sample Multiplication of T. cruzi in the

muscle

Page 40: Common parasites of military importance

40

Haemoflagellates parasites (Trypanosoma sp.)The Lifecycles (7)

                                                                       

Generalised life cycle of the Trypanosoma sp. which cause African trypnaosomiasis.

Page 41: Common parasites of military importance

41

Haemoflagellates parasites -The source of infection in Military (8)

1. Military acquired the infection of these parasites fm the endemic area in many parts of Africa, Asia and South America.

2. All forms of infection starts when a female sandfly (Phlebotomus sp.) takes a blood meal from an infected host. The countries with dessert eg; (Iraq, Kuwait and Afghanistan) usually the habitat for the sandfly, is also the main source for the infection this parasites.

Page 42: Common parasites of military importance

42

Haemoflagellates parasites of Military Importance (9)

1. The parasites, cause many causalities to the soldiers. Eg: There are 22 cases of chronic skin lesions of CL in US military personnel deployed during 2002-2003 to Afghanistan, Iraq and Kuwait.

2. Parasites are easily transmitted from one infected soldier to others by sandfly (vector-borne parasitic disease) - is a risk for military personnel who travel to the endemic area.

3. The World Health Organization estimates that 1.5 million cases of CL and 500,000 cases of VL occur each year – This amount of cases also can give bad impact to military.

Page 43: Common parasites of military importance

43

Arthropods as an Ectoparasites - Introduction (1)

1. The 2 most important classes of Arthropods are Insecta and Arachnida.

2. Insecta – mosquitoes, flies, bugs, fleas.

Arachnida – ticks, mites, spiders and scorpions.

3. Arthropods may transmit disease by following methods:

• Mechanical transmission : diseases producing agent does not multiply in the arthropod. eg: Salmonella trasmission by the house fly.

• Biological transmission – arthropod is an integral part of the life cycle of parasites; Wuchereria bancrofti and Plasmodium sp in mosquitoes.

(Zaman V. and Keong A.L, 3rd Edition Handbook of Medical Parasitology)

Page 44: Common parasites of military importance

44

Arthropods of Military Importance - (2)

1. Soft Ticks• Class: Arachnida.

• Genus: Ornithodoros.• Worldwide distribution: Europe, Africa, Asia and the Americas.

• Life cycles: hemimetabolous, eggs hatching six legged larvae – moult to eight legged nymphs. Larval instars requiring a blood meal to proceed for life cycle.

• Disease – the most important disease is tick borne relapsing fever. Which occurs world wide and is spread by spirochaete infected Ornithodoros.

Page 45: Common parasites of military importance

45

2. Mosquitoes

• Class: Insecta

• Order: Diptera

• Genus: Anopheles, Culex, Aedes, Mansonia.• Mosquitoes are the blood feeders (ectoparasites).

• Also as vector to certain disease (Vectorborne disease).

• Anopheles sp – vector for malaria parasites.

• Culex sp – vectors for Wuchreraria bancrofti, Japanese Encephalitis.

• Aedes sp a - vectors of Bancrofti filariasis and arboviruses such as yellow fever and dengue.

• Mansonia sp – Brugia malayi.

Arthropods of Military Importance - (3)

Page 46: Common parasites of military importance

46

3. Tsetse Flies

• Class: Insecta

• Order: Diptera

• Genus: Glossina• Tsetse flies are the blood feeders (ectoparasites) to cows and

humans.

• Also as vector to certain disease (Vectorborne disease).

• Tsetse flies are Vectors for African sleeping sickness (T. rhodesiense and T.gambiense).

Arthropods of Military Importance - (4)

Page 47: Common parasites of military importance

47

ACTIVITIES TO MODIFY RISK OF INFECTION

1. Foodborne And Water Borne Infection• Avoid undercooked food, non bottled

beverage sand non pasteurized dairy products.

• Avoid consuming food sold by street vendors• Avoid salads and raw seafood• Peel fruit• Used bottled water for drinking, making ice

cubes and brushing teeth.• Wash hands with soap and water or alcohol

and sanitizers before each meal.• Carbonated beverages are safe.• Vaccines are available for hepatitis A and

typhoid.

Page 48: Common parasites of military importance

48

ACTIVITIES TO MODIFY RISK OF INFECTION

2. Vectorborne Infection• Wear the uniform with the pants tucked into

boots, sleeves worn down and undershirt tucked into the pants.

• Minimize outdoor exposure during periods of insect activity.

• Use 33% extended-duration DEET.• Impregnate uniform with permethrin.• Used insect netting sprayed with permethrin• Check for ticks regularly.• Use malaria chemo prophylaxis if indicated.• Vaccines are available for Yellow fever and

Japanese B encephalitis.

Page 49: Common parasites of military importance

49

ACTIVITIES TO MODIFY RISK OF INFECTION

3. Respiratory infection• Wash hands regularly or use alcohol hand

gel.• Avoid hand contact to the face.• Do not share drinking or eating utensils.• Use appropriate control measures when

dealing with infected or potentially infected individuals

• Submit to pre-and post deployment tuberculin skin testing.

• Vaccines are available for measles, mumps, rubella, diphtheria, pertussis,meningococcus influenza, varicella, smallpox and anthrax.

Page 50: Common parasites of military importance

50

ACTIVITIES TO MODIFY RISK OF INFECTION

4. Zoonotic infection• Do not pet or feed animals (especially dogs).• Avoid direct contact with animals or animal

products.• Do not stray animals as pets.• Use appropriate control measures when

dealing with infected or potentially infected individuals

• Vaccines is available for rabbies.• Vaccines are available for measles, mumps,

rubella, diphtheria, pertussis,meningococcus influenza, varicella, smallpox and anthrax.

Page 51: Common parasites of military importance

51

ACTIVITIES TO MODIFY RISK OF INFECTION

5. Water exposure• Avoid swimming in fresh water, especially if it

is stagnant or slowly flowing• Doxycycline chemo prophylaxis available.

6. Soil exposure• Water toe covered footwear.• Avoid sitting in sandy areas with uncovered

skin.• Avoid ingesting soil.• Vaccine is available for tetanus.

Page 52: Common parasites of military importance

52

CONCLUSION

1. Parasites are the organism that derives the lives on or in another organism and derives it lives on or in another organism and derives it nourishments from their host.nourishments from their host.

2.2. Parasites can cause many casualty in the Parasites can cause many casualty in the military operation.military operation.

3.3. Parasites have their own importance whether Parasites have their own importance whether in medical or in military.in medical or in military.

4.4. The effective prevention of parasites infection The effective prevention of parasites infection can conserve the military fighting strength.can conserve the military fighting strength.

5.5. Soldiers must practice all the time the Soldiers must practice all the time the activities to modify the risk of infection. activities to modify the risk of infection.

Page 53: Common parasites of military importance

53

QUESTIONS

AND

ANSWER