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The message is not so much that the worms will inherit the Earth, but that all things play a role in nature, even the lowly worm.

—Gary Larson


The nematodes discussed in this chapter cause disease through their presence in the tissues and lymphohematogenous system of the human body. Some migrate through the human gastrointestinal tract on their way there, but because this is a temporary part of their life cycle, they are not considered to be “intestinal” nematodes.

Four of them— Toxocara canis, Baylisascaris procyonis, Trichinella spiralis, and Ancylostoma braziliense—are zoonotic, meaning natural parasites of domestic and wild animals. Although they are capable of infecting humans, they cannot complete their life cycle in the human host. Humans, therefore, serve only as “accidental hosts,” injured bystanders rather than major participants in the life cycle of these parasites.

The remaining four major tissue nematodes— Wuchereria bancrofti, Brugia malayi, Onchocerca volvulus, and Loa loa—are members of a single superfamily (Filarioidea). All are anthroponotic, meaning they use humans as their definitive host. The thin, thread-like adults live for years in the subcutaneous tissues and lymphatic vessels, where they discharge their live-born offspring called “microfilariae.” These progeny circulate in the blood or migrate in the subcutaneous tissues until they are ingested by a specific blood-sucking insect. Within this insect, they transform into filariform larvae capable of infecting another human when the vector again takes a blood meal. We will also touch briefly on Dracunculus medinensis, the guinea worm, which is on the verge of eradication.

Table 55–1 summarizes these nematodes, diseases they cause, their definitive host, and usual routes of human infection.

TABLE 55–1General Characteristics of Tissue Nematodes



T canis is a large intestinal ascarid of canines, including dogs, foxes, and wolves (Figure 55–1). Occasionally, a related organism found in cats (Toxocara cati) can behave in a similar fashion. (Note: Do not confuse this worm with the similar-sounding protozoan Toxoplasma gondii. Both derive their name from the ...

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