Capillaria philippinensis Created and Presented by: Lindsey Petrovich Amanda Reinesch

TAXONOMY KINGDOM: Animalia Roundworm Nematode Intestinal Parasite PHYLUM: Nematoda CLASS: Aphasmidea ORDER: Anoplida FAMILY: Capillariidae – Capillaria Roundworm Nematode Intestinal Parasite

GEOGRAPHIC DISTRIBUTION * Philippines * Thailand Rare cases have been reported from other Asian countries, Iran, Middle East, Japan, Egypt and Colombia. 

Interesting Facts First discovered in 1963 in Northern Luzon, Philippines Appearance in humans was sudden and unexpected Witch Doctors hired to drive out curse placed on people by River God River God was responsible for Capillaria philippinensis.

MORPHOLOGY Adult Male Adult Female Egg 2.3-3.2 mm long 23-28 μm wide Small caudal alae Spineless spicule sheath Adult Female 2.5-4.3 mm long 29-47 μm wide Esophagus is half as long as body Produce Capillaria-type eggs that lack pits Egg 36-45 μm long 20 μm wide Peanut shaped Striated shell Caudal alae - cuticular extensions on either side of, or surrounding, genital cavity that opens (blue arrow) Spicule – small, hard body that serve as the skeletal element

LIFE CYCLE DEFINITIVE HOST: INTERMEDIATE HOST: VECTOR: fish-eating birds INTERMEDIATE HOST: Fish VECTOR: None ACCIDENTAL HOSTS: Human Acquire by eating small species of raw infected fish Direct and Indirect Life Cycles Migratory birds (definitive host) are the reason for the spreading to Asian countries and Middle East.

LIFE CYCLE Unembryonated eggs are passed in human/bird stool. Unembryonated eggs become embryonated in the external environment. Fresh water fish ingest embryonated eggs, larvae hatch, penetrate the intestine, migrate to tissues. Ingestion of raw or undercooked fish results in infection of human host. Adult worms reside in human small intestine, burrow in mucosa. Female adult worms deposit unembryonated eggs. - Some eggs become embryonated in intestine, release larvae, cause autoinfection, leading to hyperinfection Parasite of fish-eating birds. - (Birds eat small fish) Hyperinfection – meaning a massive amount of adult worms

PATHOGENESIS In Humans Causes intestinal capillariasis Damages cells of intestinal wall Worms repeatedly penetrate mucosa of small intestine and reenter lumen (jejunum) Leads to progressive degeneration of mucosa and submucosa Interferes with absorption of nutrients (fats and sugars) and maintenance of proper electrolyte (potassium) balance

PATHOGENESIS In Humans SYMPTOMS: Watery diarrhea Abdominal pain Edema Weight loss Weakness Malaise Anorexia Emaciation Borborygmus (stomach growling) Depressed levels of potassium and albumin in blood Malaise - a condition of general bodily weakness or discomfort, vague or unfocused of mental uneasiness, lethargy, or discomfort Emaciation – abnormal thinness caused by lack of nutrition or by disease

DIAGNOSIS In Humans Finding eggs, larvae, and/or adults in: Stool samples Unembryonated eggs Severe infections have eggs, larvae, and adults Intestinal biopsies Often fatal if left untreated Patients die from: Loss of electrolytes Heart Failure Secondary Bacterial Infections

TREATMENT In Humans Anthelmintics - Mebendazole - Albendazole - Thiabendazole Prefer Albendazole and Mebendazole because it works better than Thiabendazole.

CONTROL For Humans Avoid eating small raw fish whole Education

REFERENCES: http://en.wikipedia.org/wiki/Capillaria_philippinensis http://medinfo.psu.ac.th/pr/MedBoard/Img/20080605080200.jpg http://www.dpd.cdc.gov/dpdx/HTML/Frames/A-F/Capillariasis/body_Capillariasis_page2.htm http://www.dpd.cdc.gov/dpdx/HTML/Frames/A-F/Capillariasis/body_Capillariasis_mic1.htm http://www.dpd.cdc.gov/dpdx/HTML/Frames/A- F/Capillariasis/body_Capillariasis_page1.htm#Geographic%20Distribution http://upload.wikimedia.org/wikipedia/commons/b/be/Ph_locator_map_luzon.png http://www.stanford.edu/class/humbio103/ParaSites2005/Capillariasis/capillaria%20images/bird.JPG http://www.stanford.edu/class/humbio103/ParaSites2006/Enterobius/Mebendazole%20Tablets%20USP%20 100mg%20100mg.jpg http://www.richygold.com/my_images/albendzole.jpg http://curezone.com/upload/Blogs/Zoebess/raw_fish.jpg http://www.encognitive.com/images/digestive-system-2.jpg