人体寄生虫学 Human Parasitology 邵红霞 医学院东1号楼 343室

1. Introduction 人体寄生虫学 Human Parasitology 邵红霞 医学院东1号楼 343室 （Tel: 54237750，13917122158） http://parasitol.fudan.edu.cn

2. 教学及考试形式 • 教师主讲与学生参与讨论、演讲相结合 • （可2～3人/组,每组学生参与1-2次讨论，以组为单位进行记分 ） • 2. 课程成绩的组成： • 平时 • 理论考试 • 实验 20％ 80％

3. 实验课安排 时间：周三下午（双周） （第 2,4,6,8,10周，共5次） 第1次实验，9月16日（周三）下午 上课地点：病原生物学实验室（东1号楼3楼东） 带上实验报告纸（8张，订起来） 穿实验服 按要求入座并固定下来（不要迟到）

4. 教学辅助 • 精品课程网站：http://parasitol.fudan.edu.cn • 2. 教学大纲 • 3. 教学参考书 • 4. 其他：常用网址： • 1. http://www.dpd.cdc.gov/dpdx/Default.htm • 2. http://www.cdfound.to.it/HTML/atlas.htm

5. Human Parasitology (Medical Parasitology) Medical Parasitology is a branch of medical science dealing with parasites living in and on the body of humans and with aspects of this host-parasite relationships having medical significance.

6. Bridge course between basic medicine and clinical medicine

7. Why do we study parasites? • Medical importance Is a lion a parasite? Is a mosquito a parasite? Who is a parasite? 认识寄生虫及寄生虫病 预防寄生虫病 诊治寄生虫病

8. In this course we will concentrate on: Protozoa 原虫 Three major groups Helminths 蠕虫 Arthropods 节肢动物

9. The detriments of parasites to humans Recent estimates of prevalence of parasites in the world are: Ascaris 1.5billion Hookworms 1.3 billion Whipworms 1 billion Filarial worms 657 million Malaria 500 million 1.1568 m ( mortality) Schistosomes 270million Amebiasis 50 million Taeniad tapeworms 50 million Clonorchis 20 million Chagas’ Disease 15 million

10. DALYs (disability-adjusted life years) 失能调整生命年 The sum of years of potential life lost due to prematuremortality and the years of productive life lost due to disability. disease burden (WHO, 2000-2004) malaria 42.7386 million leishmania 2.066 million

11. Tropical Diseases Year 2000 疟疾 malaria 血吸虫病 schistosomiasis 丝虫病 filariasis 淋巴丝虫病 lymphatic filariasis 盘尾丝虫病 onchocerciasis 利什曼病 leishmaniasis 锥虫病 trypanosomiasis 非洲锥虫病 美洲锥虫病 麻风 leprosy 结核病 tuberculosis 登革热 dengue fever Year 1975 Malaria 疟疾 Schistosomiasis 血吸虫病 Filariasis 丝虫病 Leishmaniasis 利什曼病 Trypanosomiasis 锥虫病 (麻风 leprosy)

13. Neglected Tropical Diseases被忽视的热带病 -- Forgotten People, Forgotten Diseases

14. 被忽视的热带病 (Neglected Tropical Diseases) 一类盛行千年，危害严重，多见于极端贫困地 区的慢性传染性疾病 Including several diseases, which affect one in six people globally, are neglected by everybody - by the pharmaceutical industry, by mainstream global health efforts and by the media.

15. malaria 疟疾

16. schistosomiasis 日本血吸虫病

17. elephantiasis 淋巴丝虫病 (象皮肿) river blindness (盘尾丝虫病,河盲症)

18. leishmaniasis利 什 曼 病

19. Chagas disease美洲锥虫病

20. sleeping sickness (非洲锥虫病,睡眠病)

21. Current situation of parasitic diseases in China 1950’s 2000’s Malaria 3×107 3×104 Schistosomiasis 1.16×107 8.4×105 Lymphatic filariasis 3×107eliminated Leishmaniasis 5.3×105 eliminated Hookworm disease 1.94×108 (1988-92) 3.93×107 (2001~04)

22. 2004年第二次寄调 Intestinal helminths (1.29×108) Food-borne parasitosis 食物源性寄生虫病 Neoemerging Reemerging Emerging parasitic diseases Parasitic diseases importing from other countries

23. Why do we study parasites? 2. Economic importance 3. Veterinary importance 4. Biological importance

24. 思考： • 寄生虫（寄生虫病）的研究发展史。 • 人类能最终战胜寄生虫病吗？ • （寄生虫病能消灭吗？） 3. Some types of parasitic infections are increasing, please discuss in detail.

25. biology of parasites Evolution of parasitism： Free living Symbiosis（共生） commensalisms 共栖 mutualism 互利共生 parasitism 寄生

26. Commensalism Beneficial to one partner and at least not disadvantageous to the other （One partner benefits but the other is not hurt.） 鮣鱼 return

27. Mutualism beneficial to both organisms ( Both partners benefit) Sea anemones /hermit crabs Termite /flagellated protozoan return

28. Parasitism- - - a way of life A symbiotic relationship in which one animal (the host) is to some degree injured through the activities of the other animal( the parasite). In other words, One partner (the parasite) harms or lives on the expense of the other （the host） Parasites are smart!

29. Definition of parasite, host and parasitism Parasite（寄生物，寄生虫）: An organism which is dependent on another organism for its survival Host（宿主）: An organism which harbors the parasite （and is usually larger than the parasite）

30. Adaptations to Parasitism Morphological adaptations 1. Adaptation of bodily form 2. Specialized attachment organs been developed (hooks , suckers) 3. Some organs lost or reduced Some organs strengthened (reproductive system)

31. Physiological adaptations • Metabolic changes 代谢改变 • Specialized mechanisms for affecting entrance into the body or tissue (elaboration of enzymes) 侵入机制特化 • High reproductive capacity for maintaining the species • 繁殖能力增强

32. Life cycle and the classification of the host and parasite life cycle 生活史 The whole process of the growing, development and reproduction of parasite within and outside the host. (寄生虫完成一代的生长、发育与繁殖的整个过程。) Two common phases: the route a parasite follows inside the body The route a parasite follows outside of the body

33. Three common components: a mode of transmission (discuss later) an infective stage a diagnostic stage the stage of development of parasites which can invade host and continue further development within the host. ? 感染期 infective stage （感染阶段） 生活史过程中对人体具有感染能力(侵入人体并继续发育）的阶段

34. Kinds of life cycles Direct life cycle: In which the parasite is passed from host to the next through the contaminated food or water, it doesn’t need intermediate host. Ex：Enterobius vermicularis Indirect life cycle: Intermediate host is necessary in the style of life cycle Ex：Taenia solium

35. Host Definitive host: ( 终宿主definitive host：成虫或有性生殖阶段寄生的宿主。) The one in which the parasite reaches sexual maturity or undergoes sexual reproduction. ( harbours the adult or sexual reproduction stages of the parasite)

36. Intermediate host: (中间宿主intermediate host： 幼虫或无性生殖阶段寄生的宿主。) In which only larval development or asexual reproduction occurs or both

37. Reservoir host: 保虫宿主 （储蓄宿主）： 某些寄生虫既可寄生人体，也可寄生某些脊椎动物，并可传播给人, 在流行病学称这些动物为保虫宿主。 Domestic or wild animals that harbors the adult or sexual stage of certain human’s parasite. The parasite can be transmitted to humans (zoonosis) or domestic animals as additional sources of human infection

38. Paratenic host (transport host): 转续宿主 某些寄生虫的幼虫侵入非正常终宿主,不能发育为成虫,长期保持幼虫状态,只有当该幼虫有机会侵入正常终宿主体内时,才能发育为成虫,这种非正常宿主称为转续宿主。 An abnormal host (not suitable for parasite development), when a parasite enters, it do not undergo any development but continues to stay alive and be infective to a normal host （cause disease).

39. Parasite 按宿主选择性 According to characteristic of parasites: Obligatory (obligate) parasite 专性寄生虫 A parasite can live only in a association with a host or an organism, can not survive without a host facultative parasite 兼性寄生虫 A parasite can live both in or on the host as well as in a free-living form parasitic and free living generations can alternate depending on environmental conditions Accidental parasite 偶然性寄生虫

40. permanent parasites永久性寄生虫 temporary parasite 暂时性寄生虫 some animals invading the host temporary only for bloodsucking, such as mosquitoes, ticks, etc. 按寄生时间 Ectoparasite体外寄生虫 Exist on the body surface Endoparasite体内寄生虫 Parasites living within (inside) the host body 按寄生部位

41. Opportunistic parasite Some parasites, such as Toxoplasma gondii, cryptosporidium parvum, pneumocystis jiroveci, etc, only induce unapparent infection in the host with normal immune competency, but can lead to severe disease even death in the person suffered with AIDS or other immune deficiency conditions. 机会致病寄生虫：如弓形虫、隐孢子虫、肺孢子虫等，在宿主体内通常处于隐性感染状态，在宿主免疫功能降低时，出现异常增殖或致病力增强。 immunocompromised host（免疫受累宿主）

42. Nourishment and metabolism of the parasites (omit) reproduction mode of parasites Asexual reproduction无性生殖 sexual reproduction有性生殖 Alternation of generation (世代交替) A reproduction mode of some protozoon and helminthic parasites characterized by the alternation of generations with asexual and sexual reproduction in their life cycle.

43. Nomination of the parasite Parasitology historically covers a diverse collection of metazoan and unicellular organisms Kingdom 界 Phylum 门 Class 纲 Order 目 Family 科 Genus 属 Species 种

44. specific name of parasites Binominal system is applied for parasites Genus name + species name With a capital with a small Initial letter initial letter All in latinied language with italic or underlined Schistosoma japonicum Abbreviation: S.japonicum （Schistosoma japonicum Abbreviation: S. japonicum）

45. Parasite-host relationship Effects of the parasite on the host 1. Nutrition robbing 2. Mechanical injury 3. Poisoning and Immunopathology

46. Effects of the host on the parasite --Natural immunity (nonspecific immunity) • Barrier : Skin/Mucous membrance/Placenta. • Fluid(Acid): • Phagocytosis : • But not very strong! Immune evasion hypersensitivity

47. Effects of the host on the parasite --Acquired immunity (specific immunity) Sterilizing immunity 消除性免疫 Wipe out the parasites completely, meanwhile get a long-term specific resistance to re-infection. Non-sterilizing immunity 非消除性免疫(Common! ) Wipe out most of the parasites, but not completely. No parasite, no immunity! premunition 带虫免疫 concomitant immunity 伴随免疫

48. The characteristics of parasitic infections and parasitosis parasitic infections 寄生虫感染: establishment of the parasite in its host parasitic diseases (parasitosis寄生虫病): Clinical manifestation of the parasitic infection which shows the active presence and production of the parasite causing damage in the host.

49. Carrier 带虫者:a person who is infected with a certain parasite without displaying any clinical signs or symptoms but can serve as a source of parasitic infection. Suppressive infection隐性感染 without any clinical signs or symptoms can not be detected by usual methods may or may not as a source of parasitic infection chronic infection 慢性感染

50. 为什么会出现多寄生？ 多寄生后会出现什么结果？ …… Polyparasitism 多寄生现象 larva migrans 幼虫移行症 Some juveniles of animal helminths invade human if human is not their adapted host, the juveniles can not develop to adults but migrate in the body of human and cause lesions to tissues or organs.