Helminthiasis

Helminthiasis is a large group of diseases caused by ingress of parasitic worms into the human body. Most pathogens affect the gastrointestinal tract, live in different parts of the intestine, go into the bile ducts and bladder.

But larvae and developing forms of worms are able to move through the body and various organs, helminthiosis can develop in the lung tissue, in the brain. The disease is dangerous by creating a mechanical obstruction in the intestine, intoxication of the body with toxic substances, secreted worms, increased allergization.

Helminthiases occur in chronic form, cause depletion, avitaminosis, a sharp decrease in immunity. Children are more often ill because of inability to protect themselves with the help of hygienic rules. But often there are signs of helminthiasis in adults. Sex does not matter.

Prevalence of

According to WHO official statistics, enterobiosis, hookworm disease, ascaridosis, trichocephalus and toxocarosis occupy the main place in the structure of helminthiasis. Almost 1.2 billion people become infected with ascariasis every year. More than 90% of the population is sick in the Philippines and Iran.

Types of helminthiases that cause anxiety epidemiologists: the current trend is the growth of population affection by enterobiosis, ascaridosis, toxocariasis, trichinosis. Despite the preventive work, there is still no significant improvement in the situation in the foci of biogelmintosis( echinococcosis, opisthorchiasis, thieniasis, diphyllobothriasis).

How are parasitic diseases caused by worms classified?

Classification of helminthiases provides for dividing by disease according to the types of pathogen, vectors, place of residence in the environment. By the method of transmission of the pathogen distinguish:

• contagious helminthiases - direct infection occurs from the patient;
• biogelmintoses - if carriers are animals, the cycle of development of the worm passes through the intermediate host in which it lives in the stage of the larva or reproduces, then is transmitted to the final host-person( rarely a person is an intermediate host);
• geogelmintoses - for development, an intermediate host is not needed, eggs or parasite larvae develop to infectious stage in the soil, the transmission mechanism is carried through the ground, unwashed vegetables and fruits, with hands.

Biohelminthiases are also called: anthroponoses, if the patient is only a person( enterobiosis, hymenolepiasis, strongyloidiasis), zoonoses - both wild and domestic animals, as well as humans or only animals( echinococcosis, trichinosis) become ill.

Helminthiasis is distinguished by lesion localization:

• luminal ( intestinal) - example, ascariasis, strongyloidiasis, trichocephalus;
• hepatobiliary system - representatives: clonorhoz, opisthorchiasis, fascioliasis;
• pulmonary - toxinosis, paragonimoses;
• tissue - trichinosis, filariasis, schistosomiasis, toxocariasis.

The rarer of the extraintestinal lesions - the implantation into the eye tissue is capable of causing: dirofilariasis, hirudinosis, toxocariasis, trichinosis, schistosomiasis, echinococcosis. Helminthiasis is called larval or larval, if there are no mature worms in the human body, but only larvae.

In such a situation, the cycle of the parasite does not end, a sexually mature specimen is not formed from the larva( scientists speak of a "biological dead end").A person is regarded as an intermediate host. A similar course is characterized by filariasis, trichinosis, capillarial disease, toxocariasis, sparganosis, echinococcosis.

Kinds of causative agents of helminthiases

The structure is distinguished:

• of roundworms( class Nematoda - representatives are ascarids, pinworms, trichinella, vlasoglav);
• tape( Cestoidea - bovine, pork and dwarf chain, wide ribbon, echinococcus);
• flukes( Trematoda - fluke cat and liver).

The most common are the first two classes. Less often a person becomes infected with acanthocephala( Acanthocephala) and annelid worms( Annelida).In the list of worms-parasites more than 400 species of helminths, 50 of them are the most dangerous for humans. The names of the diseases correspond to the name of the pathogen( nematodes, cestodias, trematodes).From the worms medicine is of interest to all the familiar leeches, there are 16 species( the disease of hirudinosis).

Features of infection

Very few species of helminths are able to reproduce in the human body. This property is possessed by an oyster. The fact is that the allocated eggs must undergo a certain cycle of development to the stage of infectiousness.

The person most often becomes infected mainly through food, water. With some diseases( ankylostomiasis, schistosomiasis), pathogens are able to penetrate the skin( filariasis), it gets dusty when breathing.

The source of infection with biogelmintosis is the body, where parasitic worms reach maturity and give off eggs( larvae).Biohelminthoses include:

• diphyllobothriasis,
• opisthorchiasis,
• teniosis,
• clonorhoz,
• teniarinhoz,
• echinococcus,
• trichinosis,
• fascioliasis.

To achieve the invasiveness stage, they need to change 1-2 intermediate hosts( fish, crustaceans, mollusks).Do with insufficiently heat-treated food, dishes from meat or fish, drinking raw water.

For infestation with geogelmintoses, non-observance of personal protection rules is typical, which include hygiene, washing vegetables and fruits. In this way, ascaridosis, strongyloidosis, ankylostomidosis, trichocephalosis spread.

Contact helminthases go from one person to another. This occurs when touching, using common household items, dishes, towels and other linen. It is characteristic for enterobiasis, cysticercosis, hymenolepidosis, strongyloidiasis.

Mechanisms of defeat

In the development of lesions in helminthiasis distinguish the early stage and late. In the early( acute) stage - the main action is the allergization of the organism due to the received products of vital activity of helminths, larval forms, activation of internal factors of inflammation. A typical allergic reaction is formed on helminth antigens.

It is established that parasites release substances that suppress the growth of normal microflora in the human intestine. The ratio in favor of an increase in the share of opportunistic and pathogenic strains is disrupted.

In the late( chronic) stage of helminthiosis - violations concern the effects of a particular pathogen, localization, quantity, intensity of growth, the nature of nutrition. Parasites form immune complexes, suppress human protective forces. This is especially true for tissue helminthiasis.

Consequences of helminths destruction on the body

Helminthiases are not in vain included in the risk factors for any chronic disease. Their negative effect concerns different organs and systems. The production of insulin-like growth factor decreases with an increase in the tumor necrosis factor. This causes a delay in the physical and mental development of children, leads to the development of tumors( there is a parasitic theory of cancer).

Red blood cells are constantly lost, as these cells are most saturated with oxygen and are "loved" by parasites. There is anemia, which is supplemented by loss of vitamins and tissue hypoxia. When localized in the bile duct( liver trematodosis), the amount of amino acids in the patient's blood drops.

Helminthiases in adults contribute to the release of unnecessary cytokines, so suppress immunity that patients are more likely to get tuberculosis than others. It is very important to consider that helminthiases reduce the protective effect of vaccines. Therefore, vaccinated people get sick.

Symptoms of

The acute stage of helminthiosis usually occurs after 2 weeks or a month after infection. In rare cases, it occurs after 1.5 months. The specific latent stage is determined by the type of parasite: with ascariasis, clinical manifestations can occur on day 2-3, with filariasis incubation lasting from 6 to 18 months.

is violated. The initial symptoms of helminthiasis in adults are:

• temperature increase;
• skin rashes of different shapes;
• inflammation of the eye mucosa( conjunctivitis);
• swelling on the face;
• loose stool;
• moderate pain along the bowel;
• cramping colic in the hypochondrium right;
• for respiratory tract infection - cough, shortness of breath, chest pain while breathing, blood in sputum.

Intestinal helminthiases have their own characteristics:

• enterobiosis is accompanied by severe itching in the anal area in the evening and at night;
• trichocephalus - leads to hemorrhagic colitis;
• ascaridosis - with massive infection is complicated by intestinal obstruction, pancreatitis, mechanical jaundice.

The acute stage lasts from one week to four months. In the absence of treatment for helminthiosis in adults, a latent( latent) period may occur, or a transition to a chronic stage immediately. How symptoms of helminthiasis appear in childhood can be found in this article.

Clinic of chronic stage of helminthiosis depends on the possibility of pathogens to multiply from larvae. With laryngeal helminthiases, severe allergic manifestations remain in the first place, up to anaphylactic shock from rupture of cysts.

If the larvae are absent, the flow is related to the number of individuals of the parasites, their size, localization. Nematodoses and cestodoses affect the intestines, so patients have repeated attacks of abdominal pain, rumbling, nausea, diarrhea.

Fascioliasis - accompanied by biliary colic, weakness, disability. Ankylostomiasis - cause iron deficiency anemia, hypoproteinemia in the blood. Diphyllobothriasis is a common cause of stomach ailments, hyperchromic anemia.

The larval helminthiases with multiple lesions of organs( lungs, kidneys, heart, eyes, brain) are the most severe course. A similar course is possible with single-chamber echinococcosis, cysticercosis. Another option is the active growth of embryos or eggs of the parasite, metastasis to other organs with alveococcosis.

Tropical parasites that cause schistosomiasis, filariasis, are distinguished by a heavy current. The duration of the chronic stage is difficult to determine, there is a re-infection.

How is the diagnosis carried out?

Signs of helminthiasis in the acute stage are revealed when the patient is examined. The most constant indicator is the eosinophilia of the blood( sometimes this is the only symptom) - the number of eosinophils increases from 20-30 to 80-90%, while the leukocytosis sharply increases.

These indicators reflect the massive nature of the infection and the intensity of the body's allergic mood. In the case of severe course, eosinophilia decreases, neutrophils grow. Such a sign is a prognosis of trouble. Anemia is indicated by the drop in red blood cells and hemoglobin.

Patients with an airway disease are diagnosed with a pneumonia on the radiograph, migrating shadows of infiltrates are possible. On the attachment of myocarditis speaks shortness of breath during movements, tachycardia, palpitations, changes on the ECG.It is necessary to check the function of the liver. Perhaps a decrease in protein in the blood, iron, glucose.

When the brain is affected, neurologic focal symptoms appear( paresis, paralysis).Biological material for the laboratory diagnosis of helminthiosis can be urine, feces, bile, cough expectoration, rectal mucus, muscle tissue, blood.

It is important to study the analysis of stool patients. Identification of eggs of worms is an indisputable proof of parasitic invasion. Here it should be borne in mind that not all helminths give intestinal forms, possibly parasitizing males without females. Then there are no eggs in the stool. After infection, it should take 3 months, and clinical manifestations are already available.

Enterobiosis is detected when examining a flush with a tampon, a spatula, a tape print from the folds of the skin around the anus.Ши C д C C д C C C C Cши C C C C C C Cши Cши Cши Cши C C C C C C C C C C C C C C C C C C C C C C C C C C C C C CSome private clinics have included home-based analysis in the list of nursing services. The process is accompanied by a visit to the home of a trained specialist and the rapid delivery of material to the laboratory.

Some parasites( ascarids) are identified by the method of roentgenography of the intestine in the form of tangles or light strips against the background of contrast. The method of ELISA( enzyme immunoassay) is the reaction of antigen + antibody to the introduction of standard serum into the blood.

The type of serum is selected according to the intended parasite. With the help of a special coloration of the final solution and application of the photoelectric colorimeter, the quantitative index of the specific reaction can be calculated.

The method is suitable for examining large groups of children( screening variant) and adults. Serological methods are RNGA( indirect hemagglutination reaction), RSK( complement fixation reaction).

Differential diagnosis of

Physicians clinicians have to constantly reckon with the manifestations of helminthiases in the diagnosis of various diseases, especially in areas with a known high level of distribution.

• Enterobiosis, trichocephalosis - should be excluded if suspected of acute appendicitis, cystitis, vulvovaginitis in women.
• Echinococcosis - similar in clinic with abscess and liver cyst, cancer of the liver and lung, tuberculosis of the spine, osteochondrosis.
• Trichinosis - will need to be distinguished from acute appendicitis, dermatomyositis, myocarditis, systemic collagenoses.
• Strongyloidosis - is excluded in the diagnosis of Crohn's disease, with acute pancreatitis, irritable bowel syndrome, various enterocolitis, with eosinophilic pneumonia.

Treatment options for

Treatment of helminthiosis in adults is accompanied by testing by the epidemiological service of foci of distribution, detection of parasites, monitoring of the implementation of personal hygiene rules by the staff of institutions.

It is necessary not only to get rid of the parasites present in the body, the products of their activity, but also to prevent re-infection. Therapy of helminthiases is carried out depending on the specific pathogen, the stage of the disease and posindromno.

Specific drugs for helminthiases:

• against nematodes - Albendazole, Bephenia hydroxynaphthoate, Levamisole, Piperazine adipate, Pirantel;
• against cestodosa - Niclosamide, Albendazole;
• for trematosis - Tetrachlorethylene, Bexachloroparaxylene, Bithionol), medications of mixed nature( Mebendazol, Albendazole).

Posindromnaya therapy of helminthiosis includes:

• antibacterial drugs;
• pancreatic enzymes;
• enterosorbents;
• probiotics;Cши Cши дши Cши д C C C C C C C C C C Cши C C C Cши C Cши C C C C C Cши C Cши Cши д C C Cши C Cши Cши C C C C C
• complexes of vitamins;Ши C C Cши C C Cши C C C C C C C C C C C C C C C C C C C C C C C C C C C C Cши C Cши C C Cши C Cши C C C C C C C
• immunostimulants.

In serious condition, intravenously administered cardiac drugs, corticosteroids, non-hormonal anti-inflammatory drugs. When echinococcosis is used a surgical operation to remove the cyst or liver abscess. In the body treated by the patient for 6-12 months remain antibodies to helminths. This helps to avoid re-infection during this period.

Is it possible to cure helminthiasis in folk ways?

For those who are fond of folk remedies, we will advise several recommendations of healers. But to be sure that the cure has come, you can not do without putting the tests.

All methods are based on the assumption that helminths need to create unpleasant conditions for life, and they "will go out on their own".

For this purpose, it is suggested to alternate purgative enemas or a laxative remedy: eating half a bulb at night, microclysters of carrot juice, taking garlic juice with milk, eating a decoction of pomegranate peel, eating in the morning on an empty stomach of a tablespoon of grated horseradish. Recommended courses are from 3 to 7 days.

Prevention

In territories with a high level of helminthiosis, the population is given a "Preventive checklist".It includes:

• personal hygiene rules;
• recommendations on working with children;
• course treatment of domestic animals;
• control over the purchase of meat, fish, and cooking;
• regular examination of children in organized groups.

Prophylactic treatment with Albendazole is proposed. Work on the de-worming of the population is estimated by the outbreak coverage of other infections( influenza, ARVI).

Indirectly, the impact on immunity and vaccination resistance can be judged by regional increases in the incidence of measles, chickenpox among adults. Helminthiases negatively affect the course of any pathology, therefore, timely detection should be approached seriously.