1. Phylum Apicomplexa

2. Characteristics of Apicomplexa
Shape of cell maintained by pellicle.

3. Characteristics of Apicomplexa
Shape of cell maintained by pellicle.
Locomotion characterized as gliding. Cilia absent, but some species produce flagellated or ameboid gamest.

4. Characteristics of Apicomplexa
Shape of cell maintained by pellicle.
Locomotion characterized as gliding. Cilia absent, but some species produce flagellated or ameboid gamest.
Asexual and sexual reproduction.

5. Characteristics of Apicomplexa
Shape of cell maintained by pellicle.
Locomotion characterized as gliding. Cilia absent, but some species produce flagellated or ameboid gamest.
Asexual and sexual reproduction.
Unique system of organelles, the apical complex in anterior region of cell.

6. Characteristics of Apicomplexa
Shape of cell maintained by pellicle.
Locomotion characterized as gliding. Cilia absent, but some species produce flagellated or ameboid gamest.
Asexual and sexual reproduction.
Unique system of organelles, the apical complex in anterior region of cell.
All intracellular parasites at some stage in the life cycle.

8. Classification Perkinsasidea- parasites of oysters.
Conoidasida- gregarines and coccidians.
Aconoidasida- malaria parasites and piroplasms, usually blood parasites of vertebrates, with an arthropod host.

9. Protozoan Reproduction
Amoeba reproduce by binary fission essentially mitosis.
Other types of fission:

10. Protozoan Reproduction
Repeated fission: Process by which colonies are made; like binary fission except daughter cells don’t separate!

11. Volvox

12. Protozoan Reproduction
Multiple fission: nucleus divides (multinucleated) before cytoplasm; the cytoplasm divides secondly.
Schizogony: asexual process done by an organism that is itself asexual.
Sporogony: formed by a sexual process.

13. Generalized Life Cycle of an Apicomplexan
1. Schizogony (Merogony)
Schizont or meront

14. Sexual Reproduction
Gamete: formed by sexual process (meiosis); sperm and egg.
Microgamete (sperm) and macrogamete (egg).
Gametes are made by a process called gametogenesis.

15. Sexual Reproduction
Gametocyte gametogenesis gametes

16. Generalized Life Cycle of an Apicomplexan
2. Gamogony: sexual reproduction.

17. Generalized Life Cycle of an Apicomplexan
3. Sporogony: multiple fission of a zygote.

18. Malaria
Disease has been known since antiquity - one of first reports described fevers in 1550 BC.

19. Malaria
Disease has been known since antiquity - one of first reports described fevers in 1550 BC.
Malaria was commonly found in swampy areas and was thought to be contracted by breathing in "bad air" (= mal aria) in the swamps.

20. Malaria
Disease has been known since antiquity - one of first reports described fevers in 1550 BC.
Malaria was commonly found in swampy areas and was thought to be contracted by breathing in "bad air" (= mal aria) in the swamps.
Much effort was directed towards finding a causative agent in the water or air of these swamps.
We now know that the mosquitoes that vectors the disease lived in these swamps.

21. Malaria (Plasmodium) Life Cycle
Has a two host life cycle.
Mosquitoes in the genus Anopheles are the vector hosts.

22. Anopheles quadrimaculatus

23. 200 mm

24. Mosquito Life Cycle

25. Life Cycle of Plasmodium –Human Cycle

26. Life Cycle of Plasmodium –Mosquito Cycle

27. Some Stages of Malaria in Anopheles
Feeding female Anopheles
Exflagellation showing microgametes
Sporozoites from salivary gland
Oocysts on outside of mosquito stomach

28. Some Stages of Malaria in the human
Cryptozoite in liver cell – it will burst releasing merozoites
Trophozoite – uninucleate form in rbc
Schizont – multinucleate form in rbc
Gametocyte – uninucleate form in rbc

29. Ring Stage

30. Ring Stage

31. Schizonts

32. Gametocytes

33. Blood Apicomplexans
Plasmodium-cause malaria in people; occur in birds, lizards, mammals.
Have exoerythrocytic and erythrocytic schizogony.

34. Blood Apicomplexans
Leucocytozoon: only have exoerythrocytic schizogony.
Occur in birds can cause severe economic loss in poultry (ducklings, turkeys).

35. Black Flies: Simuliidae

36. Blood Apicomplexans
Haemoproteus: only have exoerythrocytic schizogony.
Occur in birds and reptiles common in the Midwest.

37. Culicoides spp. are vectors

38. Malaria Plasmodium Tropical and sub-tropical regions
40% of the world’s population are at risk
300 million illnesses per year
1.2 million deaths per year
90% deaths in sub-Saharan Africa

39. Life Cycle of Plasmodium –Human Cycle

40. Life Cycle of Plasmodium –Mosquito Cycle

41. Period of Schizogony
Breaking of erythrocytes Paroxysm.

42. Period of Schizogony
Breaking of erythrocytes Paroxysm.
Tertian – 48 hr erythrocytes break; attacks every other day, P. vivax and P. ovale.

43. Period of Schizogony
Breaking of erythrocytes Paroxysm.
Tertian – 48 hr erythrocytes break; attacks every other day, P. vivax and P. ovale.
Quartan – 72 hr erythrocytes break; attacks three days, P. malariae.

44. Period of Schizogony
Breaking of erythrocytes Paroxysm.
Tertian – 48 hr erythrocytes break; attacks every other day, P. vivax and P. ovale.
Quartan – 72 hr erythrocytes break; attacks three days, P. malariae.
P. falciparum- attacks not as predictable hr.

45. Malaria
We usually think of malaria as a tropical disease, but it can occur in temperate zones.
There have been cases of malaria above the arctic circle.

46. Species of Plasmodium
Four species that infect humans

47. Species of Plasmodium Plasmodium vivax
Four species that infect humans
Plasmodium vivax
Widespread, temperate areas, Asia, North Africa
43%
Tertian malaria

48. Species of Plasmodium Plasmodium falciparum
Four species that infect humans
Plasmodium vivax
Widespread, temperate areas, Asia, North Africa
43%
Tertian malaria
Plasmodium falciparum
Tropics, 50% of malaria in the world
Falciparum malaria, malignant tertian malaria

49. Species of Plasmodium Plasmodium malariae
Four species that infect humans
Plasmodium vivax
Widespread, temperate areas, Asia, North Africa
43%
Tertian malaria
Plasmodium falciparum
Tropics, 50% of malaria in the world
Falciparum malaria, malignant tertian malaria
Plasmodium malariae
Rare, localized, but widespread
Quartan Malaria

50. Species of Plasmodium Plasmodium ovale
Four species that infect humans
Plasmodium vivax
Widespread, temperate areas, Asia, North Africa
43%
Tertian malaria
Plasmodium falciparum
Tropics, 50% of malaria in the world
Falciparum malaria, malignant tertian malaria
Plasmodium malariae
Rare, localized, but widespread
Quartan Malaria
Plasmodium ovale
Very rare, Africa, Philippines, India, S. America, Vietnam
Mild tertian malaria

51. What is Happening in The Human?
Parasite in RBC.
When RBC erupts
Parasite in blood stream
Pigment from parasite
Hemoglobin from RBC
Metabolic byproducts of parasite

52. What is Happening in The Human?
200 parasites per cc of blood.
So how many parasites in a person?
Cardinal symptom of malaria Paroxysm!

54. Paraxysm
1st Chill (violent) even when surrounding temperature is stable.
Chill lasts about 1 hr

55. Paraxysm Then comes the fever.
1st Chill (violent) even when surrounding temperature is stable.
Chill lasts about 1 hr
Then comes the fever.
Fever (as high as 106°F) headaches, nausea, vomiting, rapid pulse
Lasts several to 10 hr and then breaks.

56. Paraxysm Profuse sweating 2-4 hr.
1st Chill (violent) even when surrounding temperature is stable.
Chill lasts about 1 hr
Then comes the fever.
Fever (as high as 106°F) headaches, nausea, vomiting, rapid pulse
Lasts several to 10 hr and then breaks.
Profuse sweating 2-4 hr.

57. Paraxysm Person is spent but symptoms subside until next cycle.
1st Chill (violent) even when surrounding temperature is stable.
Chill lasts about 1 hr
Then comes the fever.
Fever (as high as 106°F) headaches, nausea, vomiting, rapid pulse
Lasts several to 10 hr and then breaks.
Profuse sweating 2-4 hr.
Person is spent but symptoms subside until next cycle.

58. Periodicity Synchrony of the Erythrocytic Cycle Day Temperature 3 1 45 6 7 8 2
Day
Temperature

59. Symptoms
After three weeks primary attacks stop!
Why?

60. Life Cycle of Plasmodium –Human Cycle

61. Malaria Relapse
Relapse occurs after primary attack.

62. Malaria Relapse
Relapse occurs after primary attack.
True relapse persistent exoerythrocytic schizogony produces merozoites that infect RBC’s that then produce more merozoites.

63. Malaria Relapse
Relapse occurs after primary attack.
True relapse persistent exoerythrocytic schizogony produces merozoites that infect RBC’s that then produce more merozoites.
Only occurs in P. vivax and P. ovale. Why is this important?

64. Mechanisms for Malaria Relapse
When sporozoites are inoculated, not all genetically identical.

65. Mechanisms for Malaria Relapse
When sporozoites are inoculated, not all genetically identical.
When they infect liver cells some turn into schizonts but others turn into dormant stages known as hypnozoites.

66. Mechanisms for Malaria Relapse
When sporozoites are inoculated, not all genetically identical.
When they infect liver cells some turn into schizonts but others turn into dormant stages known as hypnozoites.
Can be dormant for up to 3 years!

67. Reoccurrence of P. malariae
After primary attack there are a small number of organisms that remain in the blood stream but don’t turn into gametocytes!
Reoccurrence (Recrudescence) has been known to happen 50 yrs after the primary attack!

68. P. falciparum No relapse!
Survival of primary attack reconstitutes a cure!
There have been a few cases of reoccurrences; same mechanism as P. malariae but will not last for 50 yrs.

69. Pathology

71. Pathology
Destruction of RBC’s.

72. Pathology
Destruction of RBC’s.
Loss of Oxygen to tissues and cells

73. Pathology Accumulation of iron pigment in liver, spleen, or brain.
Destruction of RBC’s.
Loss of Oxygen to tissues and cells
Accumulation of iron pigment in liver, spleen, or brain.

74. Pathology
Destruction of RBC’s.
Loss of Oxygen to tissues and cells
Accumulation of iron pigment in liver, spleen, or brain.
When RBC’s burst they release cell debris, hemoglobin and metabolites of parasite

75. Pathology Iron pigment can disrupt functions of cells and tissues
Destruction of RBC’s.
Loss of Oxygen to tissues and cells
Accumulation of iron pigment in liver, spleen, or brain.
When RBC’s burst they release cell debris, hemoglobin and metabolites of parasite
Iron pigment can disrupt functions of cells and tissues

76. Pathology
Destruction of RBC’s.
Loss of Oxygen to tissues and cells
Accumulation of iron pigment in liver, spleen, or brain.
When RBC’s burst they release cell debris, hemoglobin and metabolites of parasite
Iron pigment can disrupt functions of cells and tissues
Sometimes iron pigment will collect under skin cause jaundice

77. Pathology Pigment can collect in kidneys, causing them to shut down
Destruction of RBC’s.
Loss of Oxygen to tissues and cells
Accumulation of iron pigment in liver, spleen, or brain.
When RBC’s burst they release cell debris, hemoglobin and metabolites of parasite
Iron pigment can disrupt functions of cells and tissues
Sometimes iron pigment will collect under skin cause jaundice
Pigment can collect in kidneys, causing them to shut down

78. Pathogenesis 2 Major aspects during the erythrocytic cycle.
Host Inflammatory response
Anemia

79. Most Severe P. falciparum
More cells infected (about 60%).
Infected cells clump more.
Cause clogging of capillaries and hemorrhaging.

80. Clinical Conditions associated with Plasmodium falciparum
Complications
Cerebral Malaria
Headache, Coma
High temp (>108 F)
Psychotic symptoms
Hypoxia

82. Clinical Conditions associated with Plasmodium falciparum
Complications
Pulmonary edema
Algid Malaria
Shock
Circulatory collapse, low blood pressure
Blackwater fever
Associated with massive RBC lysis
Hemozoin in urine
Usually occurs in patients that previously had the disease and received inadequate drug treatment

84. Drugs
Quinine found in a specific tree disrupts erythrocytic schizogony; no effect on sporozoites or exoerythrocytic schizogony.
Chloroquine drug of choice against non resistant malaria; no adverse side-effects. Acts on sporozoites and erythrocytic schizogony. Often give with Primaguine.
Primaquine acts on exoerythrocytic schizogony, not used to replace others because it is toxic.

85. Drugs
Mefloquine (Larium) widely used; used for chloroquine resistant strains of P. falciparum; acts on sporozoites; schizonts; exo-erythrocytic schizonts and gametocytes, but people don’t react to it very well lots of side effects!

86. Immunity to Plasmodium
If you recover, somewhat protected against reinfections.
Subsequent infections won’t produce as many symptoms.
Antibodies and their response (acquired immunity).

87. Side Effects of Malaria
Malnutrition
Shutting down of organs
Stunts growth of children
Affects growth of children
Ancient disease
Endemic that can turn to epidemics