P.

westermani (Paragonomiasis)
Diagnostic Methods:
1. based on the finding of characteristics
eggs in:
sputum (30-40% sensitivity)
aspirated pleural effusion fluid
feces (occasionally in children who swallow
sputum)
2. lab diagnosis
radiographs may be used as aid in diagnosis
sputum microscopy (28038% sensitivity)
concentration technique for light infection: 3%
NaOH (NaOH concentrated sputum)
intradermal sensitivity test (80-90%
sensitivity), but cross reactions might occur in
patients with other food borne trematode
infections
ELISA, serologic test (92% sensitivity),
immunoblot (99% sensitivity)
downside: detection of antibody cannot
differentiate between active & past infection
cross reaction with other trematode
infection may produce false positive results
for paragonimiasis
Ideal sputum specimen (early morning
collection)
- high concentration of eggs in oropharxynx
due to ciliary action of oropharynx overnight
Prevention and control
Early diagnosis and appropriate
treatment
program for control and prevention (DOH)
Capability building in public health and TB
labs especially in known endemic areas
model for combined control with TB
Health education and promotion
regarding sufficient cooking of crabs
control of intermediate host may not be
feasible
elimination of reservoir hosts (cats, dogs,
rodents, crustacenas and snails is NOT
possible)
Taenia spp.
Diagnosis
Taeniasis
1. specimen: stool
2. methods:
Microscopic detection of egg or proglottin
in the stool

Detection of excretory surgace antigen

(Copro-antigens/antigens found in the
stool) - methods vary in accuracy and
sophistication
Cysticercosis
1. Neurocysticercosis
- may be suspected in a patient with epileptic
seizures w/o systemic symptoms but living in
endemic area
- presumptive evidences:
subcutaneous cycsterci concominant with
neurologic systems
increased protein and mononuclear cells
decreased glucose
Done thru CAT (Computed Axial Tomography)
and MRI (Magnetic Resonance Imaging)
2. Opthalmic cysticercosis
- visualization of cysticerci thru
opthalmoscopy (may induce movement of
scolex)

Diagnosis based on type of specimen

1. specimen: blood serum, CSF (for
neurocysticercosis)
saliva, tears
method: immunoblot assay (antibody
detection test)
2. specimen: tissue
method: detection of cysticercus in muscle
tissue thru biopsy
- biopsy of lesions for detection of cysticercus
in brain tissues
Prevention and control
general sanitary measures
proper hygiene
proper cooking of food
meat inspection
hygienic livestock and vegetable-raising
practices
diagnosis and treatment of infected
people
development of more sensitive
techniques
D. latum
Diagnosis
- travel to endemic area + pernicious type of
anemia is suggestive of diphyllobothriasis
- eggs or proglottids in stool (DFS suffices)
- exam gastric juice for presence of free HCI is

useful
Epidemiology, Prevention and Control
infection dependent on prescence of
definitive hosts, suitable intermediate
hosts, dietary habits, amt of pollution of
fresh waters
prevalent in temperate zones
all freshwater fishes should be thoroughly
cooked
freezing for 24-28 hours at -18C kills all
plerocercoids
Capillaria philippinensis
Diagnosis
eggs in stool
severe infection: other stages can be
seen in feces since all the stages of the
life cycle is present in the intestine
eggs in direct smear, wet mountand stool
concentration technique
during chronic stage of infection: larvae
and adult worms in the feces
parasites recovered in duodenum
(biopsy)
Control and prevention
1. case finding and treatment
2. environmental sanitation
3. cook the fish well - larvae can be killed with
heat
4. health education and promotion
5. discouraging people to eat raw
Fasciola sp.
Diagnosis
- difficult d/t overlapping symptoms or lack of
symptoms and intermittend passing out of
eggs
- similar symptoms with: acute viral hepatitis,
schostosomiasis, visceral toxocoriasus, biliary
tract diseases, hepatic emeobiasis
- determination of phase:
clinical suspicion
history of eating raw/improperly cooked
freshwater vegetation
lving in or travel to an endemic area
selection of adequate serological (acute)
and coprological (chronic) methods
- parasitological diagnosis
identification of eggs in stool (Kato-Katz),

duodenal contents or bile, recovery of

adult worms during surgical exploration
for chronic cases: radiologic + serological
methods

Prevention and control

thorough washing or cooking of vegetable
boiling of water in endemic areas
change in eating habits
elimination of snail intermediate host
killing Parasite in intermediate host thru
chemotherapy
(animals) vaccination with defined
Fasciola antigens
remote sensing data: comprehensive
geographic information system control
program model
O. viverrini
Diagnosis
eggs are detected in the stool
eggs cannot be differentiated under an
ordinary light microscope
phosphoglycerate kinase (PGK)
enzyme-linked immunosorbent assay
(ELISA)
enzyme immunoassay (EIA)
polymerase chain reaction (PCR)
Prevention and control
eliminate human host reservoir by
treatment with praziquantel
health education for the promotion of
cookd fish consumption
proper human waste disposal to interrupt
transmission
make immediate fish host safe for
consumption by:
- freezing or storing infected freshwater
fish in heavy salt
- acetic acid pretreatment for 4 hours
F. buski
Diagnosis
- detection of parasite eggs in stool
Prevention and control
metacercariae are very sensitive to
dryness
avoid soaking of aquatic plants in water
o_O
prolong time between harvest and

consumption
washing of the plants or boil them
swamps or ponds where aquatic plants
are cultivated should be protected

Heterophyid spp.
Diagnosis
Kato-Katz smear
Prevention and control
-avoid ingestion of raw or improperly cooked
fish