-1-

Ascaris lumbricoides

Kingdom Animala

Phylum Nematoda .
Class Secernenta
Order Ascaridia
Family Ascarididae
Genus Ascaris
As.Lumbricoides is the giant roundworm of human, belonging to
the phylum Nematoda. It is the largest and most common parasitic
worm in human. It is responsible for the disease ascariasis in human.
One sixth of the human population is estimated to be infected by this
parasite.Ascariasis is prevalent worldwide and more so in Tropical
and Subtropical countries.Ascariasis can occur at all ages, but is more
prevalent in 5-9 years old group. The incidence is higher in poor rural
population.

Morphology
Adult;

As.Lumbricoides is characterized by its great size. Males are 2-4mm

in diameter and 10-30 cm long. The male posterior end is curved
ventrally with two spicules,but no copulatory bursa. Females are 3-
6mm wide and 20-35cm long. The vulva is located in the anterior end
and accounts for about a third of its body length. Uteri may contain
up to 27 million eggs at a time with 200,000 being laid per day. The
posterior end is straight and conical. The mouth at the anterior end
of both male and female has three finely denticulate lips, one dorsal
and two ventro-latreral.

The adult worms live in the small intestine of infected person, mainly
in jejunum and upper part of ileum .They are pale pink or flesh
colored when freshly passed in stool, but become white outside the
body.

Eggs

Fertilized eggs are oval to round in shape and are 45-75micrometers

long and 35-50 micrometers wide with a thick outer shell.
Unfertilized eggs measure 88-94 micrometers long and about 44
micrometers wide.

Ascaris lumbricoides eggs are extremely resistant to strong

chemical,desiccation,and low teprature.The eggs can remain viable
in the soil for several months or even years.

infection
Infections with these parasites are more common where sanitation is
poor and raw human feces are used as fertilizer.

The infection occurs when the fertilized eggs containing the infective
rhabditiform larvae are swallowed with water or food contaminated
with unhatched juvenile (Rhabditiform larva inside egg) .

Frequent mode of transmission is through: -2-

Vegetable grow in fields mannered with human feces.

 Childrens playing about in mud can transmit eggs to their
mouth through dirty fingers.
And perhabs,where soil contamination is heavy,due to
indiscriminate defecation, the eggs sometimes get airborne
along with wind-swept dust and inhaled. The inhaled eggs get
swallowed.

Life cycle
Ascaris lumbricoides,or(Roundworm),infections in humans occur
when an ingested infective egg release a larval worm(The
rhabditiform larva) about 250 micrometer length and 14
micrometer in diameter, which are active and motile. The gastric
juice cannot kill the embryo due to the presence of thick egg-
shell,but this egg-shell is softened by the digestive juice in the
duodenum.

The larval worm penetrate the wall of the duodenum and enters
the blood stream. From here, it is carried to the liver and heart
and enters pulmonary circulation to break free in the alveoli,
where it grow and molts. In three weeks the larva pass from the
respiratory system to be coughed up, swallowed, and thus
returned to the small intestine, where they mature to adult male
or female worms. Fertilization can now occur and the female
produces as many as 200,000 eggs per day for a year. After pass
with feces, these fertilized eggs become infectious after two
weeks in soil. It can persist in soil for 10 years or more.

The development of embryos in soil is facilitated by:

A heavy clayey soil .

Moist shady location . -3-
 Temperature of 20-30 c which are optimal for rapid
development of the embryo .

The eggs have a lipid layer, that 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.

Pathology
The majority of infections(85%) appear to be asymptomatic, in
that no gross pathology seen. Clinical manifestation can be caused
either by migrating larvae or adult worms.

Pathogenic effects of migrating larvae:

Sever symptoms of Ascariasis may be associated with the

migrating larvae, particularly in the lung, if large numbers of these
larvae are migrating through the lung simultaneously. This may
give rise to a sever hemorrhagic pneumonia more commonly, as is
the case with most infections. The complication here is that many
of the parasite proteins are highly allergenic. Because of this ,the
presence of the migrating larvae in the lungs is often associated
with allergic hypersensitivity reactions such as:

Asthmatic attacks.
Pulmonary infiltration.
Urticaria .
Edema of the lips.

(If larva enters the general circulation , it very rarely ,may

occlude a small vein in heart or brain )

-4-
 -5-

Pathogenic effects of adult parasites:

A-pathology associated with the adult parasites in the intestine.

The most common of infections are due to the adult parasite,

and consist of rather generalized digestive disorders, such as;

A vague abdominal discomfort.

Nausea.
Colic.

These symptoms are dependent to some extent of the parasite

burden of the host, which in severe cases may consist of many
hundreds or even thousands of parasites, although these are
extreme cases.

In the case of these heavy infections the presence of many of

these large parasites may contribute to malnutrition in the host ,
especially if the host (often children) are undernourished anyway .

A more serious, and potentially fatal, condition may arise in these

more heavy infections, where the mass of worms may block the
intestine and need to be surgically removed .

B-Pathology due to (( wandering)) Adult worms outside of the

intestine .

Adult parasites often leave the small intestine to enter other

organs(sometimes in response to anti-helminthes drugs ,used to
treat other intestinal nematode infections), where they may cause
various types of pathology ,sometimes with severe consequences.
For example adult Ascaris worms may migrate to the bile duct,
which may then become blocked, causing jaundice and general
interference in fat metabolism. Adult parasites may also migrate
 to appendix ,or through the intestinal wall, both conditions which
may cause a fatal peritonitis as they may well carry intestinal
bacteria to these sites. They may , alarmingly, sometimes migrate
forward through the intestinal tract ,to be either vomited up or
emerging through the nose. More seriously, if they enter the
trachea they may cause suffocation.

Finally the worms may be clumped together into a mass filling the
lumen , leading to volvules or intestinal obstruction .

Prevention
Preventing any fecal borne disease requires educated hygienic
habits / culture and fecal treatment system once a year. This is
important with ascaris because its eggs are usually the most
difficult pathogen to kill (besides prion) , and the eggs are
commonly survive 1-3 years .

- Infection may occur when food is handled without removing or

killing the eggs on the hands , clothes , hair , raw vegetables / fruits ,
or cooked food that is (re) infected by handlers , container , etc .

- It is very important to know that the bleach will not (necessarily) kill
the ascaris eggs but it will remove their sticky film , to allow the eggs
to be rinsed away.

. Ascaris eggs can be reduced by most composting ,but to

completely kill them may require:

*Rubbing alcohol .

*Specialized chemicals . -6-

*Cooking heat .

*Or unusually hot composting[ for example over 120 Fehr.

 For 24 hr .

Diagnosis
Most diagnosis are made by identifying the appearance of the
worm or eggs in feces . Due to the large quantity of eggs laid .

Larvae may be found in gastric or respiratory secretion in

pulmonary disease .

Prion; A disease-causing agent that is neither bacterial nor

fungal nor viral and contains no genetic material .

-7-