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Parasitic worm
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<h2 id="taxonomy">Taxonomy</h2> <p>Helminths are a group of organisms which share a similar form but are not necessarily <a href="/facts/Phylogenetics/bw4rsovt">evolutionarily related</a>. The term "helminth" is an artificial term.<a class="footnote-ref" id="fnref:5" href="#fn:5"><sup>5</sup></a><a class="footnote-ref" id="fnref:6" href="#fn:6"><sup>6</sup></a> There is no real consensus on the taxonomy (or groupings) of the helminths, particularly within the <a href="/facts/Nematodes/yLMJ43Eu">nematodes</a>.<a class="footnote-ref" id="fnref:7" href="#fn:7"><sup>7</sup></a> The term "helminth" contains a number of <a href="/facts/Phylum/ELT3Jyax">phyla</a>, many of which are completely unrelated. However, for practical considerations the term is currently used to describe four phyla with superficial similarities: <a href="/facts/Annelida/PQvb7NAM">Annelida</a> (ringed or segmented worms), <a href="/facts/Platyhelminths/lvqbrb2V">Platyhelminthes</a> (<a href="/facts/Flatworm/lvqbrb2V">flatworms</a>), <a href="/facts/Nematoda/yLMJ43Eu">Nematoda</a> (roundworms), and <a href="/facts/Acanthocephala/dJqMq426">Acanthocephala</a> (thorny-headed worms).<a class="footnote-ref" id="fnref:8" href="#fn:8"><sup>8</sup></a> The phylum <a href="/facts/Platyhelminthes/lvqbrb2V">Platyhelminthes</a> includes two classes of worms of particular medical significance: the <a href="/facts/Cestodes/DP40WIv2">cestodes</a> (tapeworms) and the <a href="/facts/Trematodes/d3J87oDn">trematodes</a> (flukes and <a href="/facts/Schistosoma/aBmHzzJV">blood flukes</a>), depending on whether or not they have segmented bodies.<a class="footnote-ref" id="fnref:9" href="#fn:9"><sup>9</sup></a><a class="footnote-ref" id="fnref:10" href="#fn:10"><sup>10</sup></a> </p><p>There may be as many as 300,000 species of parasites affecting vertebrates,<a class="footnote-ref" id="fnref:11" href="#fn:11"><sup>11</sup></a> and as many as 300 affecting humans alone.<a class="footnote-ref" id="fnref:12" href="#fn:12"><sup>12</sup></a> </p><p>Helminths of importance in the <a href="/facts/Sanitation/NLGqBs2T">sanitation</a> field are the human parasites, and are classified as <a href="/facts/Nemathelminthes/yLMJ43Eu">Nemathelminthes</a> (nematodes) and <a href="/facts/Platyhelminthes/lvqbrb2V">Platyhelminthes</a>, depending on whether they possess a round or flattened body, respectively.<a class="footnote-ref" id="fnref:13" href="#fn:13"><sup>13</sup></a> </p><p><a href="/facts/Ringworm/hFyb8T6n">Ringworm</a> (dermatophytosis) is actually caused by various <a href="/facts/Fungus/BHo5DP59">fungi</a>, and not by a parasitic worm.<a class="footnote-ref" id="fnref:14" href="#fn:14"><sup>14</sup></a><a class="footnote-ref" id="fnref:15" href="#fn:15"><sup>15</sup></a> </p> <h2 id="reproduction-and-life-cycle">Reproduction and life cycle</h2> <p>The <a href="/facts/Life_expectancy/uPc8bWWW">lifetime</a> of adult worms varies tremendously from one species to another but is generally in the range of 1 to 8 years (see following table). This lifetime of several years is a result of their ability to manipulate the immune response of their hosts by secreting immunomodulatory products.<a class="footnote-ref" id="fnref:16" href="#fn:16"><sup>16</sup></a> </p><p>Helminths can be either hermaphroditic (having the sex organs of both sexes), like tapeworms and flukes (not including the blood fluke), or have their sexes differentiated, like the roundworms.<a class="footnote-ref" id="fnref:17" href="#fn:17"><sup>17</sup></a> All helminths produce eggs (also called ova) for reproduction.<a class="footnote-ref" id="fnref:18" href="#fn:18"><sup>18</sup></a> </p> <h3>Eggs</h3> <p>Generally, thousands or even hundreds of thousands of eggs are produced each time the female worm deposits its eggs - a process called <a href="/facts/Oviposition/oSgSIVHY">oviposition</a>. There is a large variation in the number of eggs produced by different species of worm at one time; it varies in the range of 3,000 to 700,000. The frequency of egg deposition from an adult helminth is generally daily, and can occur up to six times per day for some <i>Taenia</i> species. Adult trematodes lay smaller numbers of eggs compared to cestodes or nematodes. However, the egg develops into a <a href="/facts/Miracidia/dogRpgmG">miracidia</a> from which thousands of <i><a href="/facts/Cercariae/dogRpgmG">cercariae</a></i>, or swimming larvae, develop. This means that one egg may produce thousands of adult worms.<a class="footnote-ref" id="fnref:19" href="#fn:19"><sup>19</sup></a> Helminth eggs remain viable for 1–2 months in crops and for many months in soil, fresh water, and <a href="/facts/Sewage/aC5N1kls">sewage</a>, or even for several years in <a href="/facts/Human_feces/E55Ym1Cl">feces</a>, <a href="/facts/Fecal_sludge/UvbdekQA">fecal sludge</a> (historically called <a href="/facts/Night_soil/REFQrR4L">night soil</a>), and <a href="/facts/Sewage_sludge/qztXxBSD">sewage sludge</a> – a period that is much longer compared to other microorganisms.<a class="footnote-ref" id="fnref:20" href="#fn:20"><sup>20</sup></a><a class="footnote-ref" id="fnref:21" href="#fn:21"><sup>21</sup></a> </p><p> Helminth eggs are resistant to various environmental conditions due to the composition of the egg shell. Each helminth egg species has 3 to 4 layers with different physical and chemical characteristics:<a class="footnote-ref" id="fnref:22" href="#fn:22"><sup>22</sup></a></p><ol><li>the 1 to 2 outer layers are formed of <a href="/facts/Mucopolysaccharide/fo22ktAQ">mucopolysaccharides</a> and <a href="/facts/Protein/Jxmagu3E">proteins</a>,</li><li>the middle layers consist of <a href="/facts/Chitin/Fo1f8b86">chitinous</a> material and serve to give structure and mechanical resistance to the eggs, and</li><li>the inner layer is composed of <a href="/facts/Lipid/TdQR87HX">lipids</a> and proteins and is useful to protect eggs from desiccation, strong acid and bases, oxidants and reductive agents as well as detergent and proteolytic compounds.<a class="footnote-ref" id="fnref:23" href="#fn:23"><sup>23</sup></a><a class="footnote-ref" id="fnref:24" href="#fn:24"><sup>24</sup></a><a class="footnote-ref" id="fnref:25" href="#fn:25"><sup>25</sup></a><a class="footnote-ref" id="fnref:26" href="#fn:26"><sup>26</sup></a></li></ol> <h3>Larvae</h3> <p>Larvae hatch from eggs, either inside or outside the host, depending on the type of helminth. For eggs in moist soil at optimal temperature and oxygen levels, the embryo develops into an infective larva after 2 to 4 weeks, named "second-stage larva". Once ingested by a host, this larva has the ability to get out of the egg, hatch in the small intestine and migrate to different organs. These infective larvae (or "infective eggs") may remain viable in soil for two years or longer.<a class="footnote-ref" id="fnref:27" href="#fn:27"><sup>27</sup></a> </p><p>The process of larval maturation in the host can take from about two weeks up to four months, depending on the helminth species. </p><p>The following table shows the principal morphological and reproductive distinctions for three helminth groups: </p> <table><tbody><tr><th colspan="2"></th><th colspan="2">Tapeworms(Cestodes)</th><th colspan="1">Flukes(Trematodes)</th><th colspan="4">Roundworms(Nematodes)</th></tr><tr><td colspan="2">Examples</td><td colspan="2"><i><a href="/facts/Taenia_solium/JxQfjxVn">Taenia solium</a>,</i> <i><a href="/facts/Taenia_saginata/wlcUBfRI">Taenia saginata</a>,</i> <i><a href="/facts/Hymenolepis_(flatworm)/qCskIvLz">Hymenolepis</a> spp.,</i> <i><a href="/facts/Echinococcus_granulosus/hDmxUp85">Echinococcus granulosus</a>,</i> <i><a href="/facts/Echinococcus_multilocularis/51mM73WX">Echinococcus multilocularis</a></i>, <i>Multiceps multiceps</i></td><td><i><a href="/facts/Schistosoma_mansoni/c49TWF1V">Schistosoma mansoni</a></i>, <i><a href="/facts/Schistosoma_japonicum/HK4qRGM1">Schistosoma japonicum</a></i>,<p><i><a href="/facts/Fasciola_hepatica/9tmET3em">Fasciola hepatica</a></i></p></td><td colspan="4"><i><a href="/facts/Ascaris/kK1ub8Rs">Ascaris spp.</a></i>, <a href="/facts/Pinworm_(parasite)/qlWErWBr"><i>Enterobius</i></a>, <i><a href="/facts/Filarioidea/n2Nb311e">Filarioidea</a>, <a href="/facts/Onchocerca/Rnn7rkyI">Onchocerca spp.</a></i>, <i>Rhabditis spp.</i>, <i><a href="/facts/Trichuris/Uhl1UNCh">Trichuris spp.</a>,</i> <i><a href="/facts/Necator_americanus/b4Wsq9gp">Necator americanus</a></i>, <i>Ancylostoma spp.</i></td></tr><tr><td colspan="2">Pathological conditions caused in humans</td><td colspan="2"><a href="/facts/Tapeworm_infection/XQpcfzUx">Tapeworm infection</a>, <a href="/facts/Echinococcosis/0FnVxknd">echinococcosis</a>, <a href="/facts/Alveolar_hydatid_disease/QTgszK2u">alveolar echinococcosis</a></td><td><a href="/facts/Schistosomiasis/qXtvvvUo">Schistosomiasis</a>, <a href="/facts/Swimmer%2527s_itch/WSdqUkH1">swimmer's itch</a></td><td colspan="4"><a href="/facts/Ascariasis/0FWWf6fg">Ascariasis</a>, <a href="/facts/Pinworm_infection/CkqEXkKy">enterobiasis (pinworm infection, oxyuriasis)</a>, <a href="/facts/Filariasis/8AkVK5hy">filariasis</a>, <a href="/facts/Dracunculiasis/gVcneqAs">dracunculiasis</a> (guinea worm), <a href="/facts/Elephantiasis_tropica/F2xm8pYq">elephantiasis</a>, <a href="/facts/Enterobiasis/CkqEXkKy">enterobiasis (pinworm)</a>, <a href="/facts/Filariasis/8AkVK5hy">filariasis</a>, <a href="/facts/Hookworm/vSo9fQmh">hookworm</a> infection (includes <a href="/facts/Necatoriasis/6RUGXEnp">Necatoriasis</a> and <i><a href="/facts/Ancylostoma_duodenale/bz2PoPlz">Ancylostoma duodenale</a></i> infection), <a href="/facts/Onchocerciasis/ItVjR7BI">onchocerciasis</a>, <a href="/facts/Trichinosis/LfNISDQs">trichinosis</a>, <a href="/facts/Trichuriasis/DNIjp8IT">trichuriasis (whipworm)</a></td></tr><tr><td colspan="2">Shape</td><td colspan="2">Segmented plane</td><td>Unsegmented plane</td><td colspan="4">Cylindrical</td></tr><tr><td colspan="2"><a href="/facts/Body_cavity/cPMtaaeC">Body cavity</a></td><td colspan="2">None</td><td>None</td><td colspan="4">Present</td></tr><tr><td colspan="2">Body covering</td><td colspan="2"><a href="/facts/Tegument_(Helminth)/Mox3ro7a">Tegument</a></td><td>Tegument</td><td colspan="4"><a href="/facts/Cuticle/LWaIDBIG">Cuticle</a></td></tr><tr><td colspan="2">Digestive tube</td><td colspan="2">None</td><td>Ends in cecum</td><td colspan="4">Ends in anus</td></tr><tr><td colspan="2">Sex</td><td colspan="2"><a href="/facts/Hermaphroditic/C4aYIk4n">Hermaphroditic</a></td><td><a href="/facts/Hermaphroditic/C4aYIk4n">Hermaphroditic</a>, except <a href="/facts/Schistosomes/aBmHzzJV">schistosomes</a> which are <a href="/facts/Dioecious/jwMHLkuM">dioecious</a></td><td colspan="4"><a href="/facts/Dioecious/jwMHLkuM">Dioecious</a></td></tr><tr><td colspan="2">Attachment organs</td><td colspan="2"><a href="/facts/Sucker_(platyhelminth_anatomy)/XGXebc5a">Sucker</a> or <a href="/facts/Bothridia/XGXebc5a">bothridia</a>, and <a href="/facts/Rostellum_(helminth)/tIRexvld">rostellum</a> with hooks</td><td>Oral sucker and ventral sucker or <a href="/facts/Acetabulum_(morphology)/WICVzznQ">acetabulum</a></td><td colspan="4">Lips, teeth, filariform extremities, and dentary plates</td></tr><tr><td colspan="2"><p>Number of species</p></td><td colspan="2">6000<a class="footnote-ref" id="fnref:28" href="#fn:28"><sup>28</sup></a></td><td>Estimated > 15,000<a class="footnote-ref" id="fnref:29" href="#fn:29"><sup>29</sup></a> Registered > 9,000<a class="footnote-ref" id="fnref:30" href="#fn:30"><sup>30</sup></a></td><td colspan="4">Estimated > 800,000 to 1,000,000<p>Registered > 25,000<a class="footnote-ref" id="fnref:31" href="#fn:31"><sup>31</sup></a></p></td></tr><tr><td colspan="2">Number of species known to infect humans</td><td colspan="2">40<a class="footnote-ref" id="fnref:32" href="#fn:32"><sup>32</sup></a></td><td>16<a class="footnote-ref" id="fnref:33" href="#fn:33"><sup>33</sup></a></td><td colspan="4">> 12,000<a class="footnote-ref" id="fnref:34" href="#fn:34"><sup>34</sup></a></td></tr><tr><td colspan="2">Species</td><td><p><i><a href="/facts/Hymenolepis_nana/8EEC25Fx">Hymenolepis nana</a></i></p></td><td><p><i><a href="/facts/Taenia_solium/JxQfjxVn">Taenia solium</a> /<a href="/facts/Taenia_saginata/wlcUBfRI">Taenia saginata</a></i></p></td><td><p><i><a href="/facts/Fasciola_hepatica/9tmET3em">Fasciola hepatica</a></i></p></td><td><p><i><a href="/facts/Ascaris_lumbricoides/CJGz5JIm">Ascaris lumbricoides</a></i></p></td><td><p>Hookworm</p></td><td><p><i><a href="/facts/Trichuris_trichiura/AEISzWkd">Trichuris trichiura</a></i></p></td><td><i><a href="/facts/Toxocara/s7Dvs4rH">Toxocara</a> spp.</i></td></tr><tr><td rowspan="4">Timeline of lifecycle stages</td><td>Larval formation</td><td></td><td><p>Some days (eggs can survive for months)<a class="footnote-ref" id="fnref:35" href="#fn:35"><sup>35</sup></a></p></td><td><p>9–15 days<a class="footnote-ref" id="fnref:36" href="#fn:36"><sup>36</sup></a></p></td><td><p>18 days to several weeks<a class="footnote-ref" id="fnref:37" href="#fn:37"><sup>37</sup></a></p></td><td><p>1–2 days<a class="footnote-ref" id="fnref:38" href="#fn:38"><sup>38</sup></a></p></td><td><p>15–30 days<a class="footnote-ref" id="fnref:39" href="#fn:39"><sup>39</sup></a></p></td><td></td></tr><tr><td>Larval growth</td><td></td><td><p>After hatching, the larvae develop into cysticercoid, which can survive for years in an animal<a class="footnote-ref" id="fnref:40" href="#fn:40"><sup>40</sup></a></p></td><td><p>5–7 weeks as <i><a href="/facts/Cercariae/dogRpgmG">cercariae</a></i> in snails and longer periods in wet environments as encysted <i><a href="/facts/Metacercariae/dogRpgmG">metacercariae</a></i><a class="footnote-ref" id="fnref:41" href="#fn:41"><sup>41</sup></a></p></td><td><p>10–14 days<a class="footnote-ref" id="fnref:42" href="#fn:42"><sup>42</sup></a></p></td><td><p>5–10 days (after maturing can survive for weeks outside the host)<a class="footnote-ref" id="fnref:43" href="#fn:43"><sup>43</sup></a></p></td><td rowspan="2"><p>60–70 days (from hatching to mature state)<a class="footnote-ref" id="fnref:44" href="#fn:44"><sup>44</sup></a></p></td><td><p>5–6 days<a class="footnote-ref" id="fnref:45" href="#fn:45"><sup>45</sup></a></p></td></tr><tr><td>Maturation to adult</td><td></td><td><p>2 months (from cysticercoid to adult)<a class="footnote-ref" id="fnref:46" href="#fn:46"><sup>46</sup></a></p></td><td><p>3–4 months<a class="footnote-ref" id="fnref:47" href="#fn:47"><sup>47</sup></a></p></td><td><p>2–3 months<a class="footnote-ref" id="fnref:48" href="#fn:48"><sup>48</sup></a></p></td><td><p>2–8 weeks<a class="footnote-ref" id="fnref:49" href="#fn:49"><sup>49</sup></a> (can become dormant for months)</p></td><td></td></tr><tr><td>Lifespan of adult worm</td><td><p>4–6 weeks</p></td><td><p>Several years<a class="footnote-ref" id="fnref:50" href="#fn:50"><sup>50</sup></a></p></td><td><p>8–10 years<a class="footnote-ref" id="fnref:51" href="#fn:51"><sup>51</sup></a></p></td><td><p>1–2 years<a class="footnote-ref" id="fnref:52" href="#fn:52"><sup>52</sup></a></p></td><td><p>Several years<a class="footnote-ref" id="fnref:53" href="#fn:53"><sup>53</sup></a></p></td><td><p>1 year<a class="footnote-ref" id="fnref:54" href="#fn:54"><sup>54</sup></a></p></td><td></td></tr><tr><td colspan="2">Eggs laid per day</td><td colspan="2">250,000<a class="footnote-ref" id="fnref:55" href="#fn:55"><sup>55</sup></a> to 700,000<a class="footnote-ref" id="fnref:56" href="#fn:56"><sup>56</sup></a></td><td>3,000 to 25,000<a class="footnote-ref" id="fnref:57" href="#fn:57"><sup>57</sup></a></td><td colspan="4">3,000<a class="footnote-ref" id="fnref:58" href="#fn:58"><sup>58</sup></a> to 250,000<a class="footnote-ref" id="fnref:59" href="#fn:59"><sup>59</sup></a></td></tr><tr><td rowspan="2">Egg deposition</td><td>Frequency</td><td></td><td><p>up to 6 times a day<a class="footnote-ref" id="fnref:60" href="#fn:60"><sup>60</sup></a></p></td><td></td><td><p>daily<a class="footnote-ref" id="fnref:61" href="#fn:61"><sup>61</sup></a></p></td><td><p>daily<a class="footnote-ref" id="fnref:62" href="#fn:62"><sup>62</sup></a></p></td><td><p>daily<a class="footnote-ref" id="fnref:63" href="#fn:63"><sup>63</sup></a></p></td><td></td></tr><tr><td>Number of eggs per event</td><td></td><td><p>50,000-100,000<a class="footnote-ref" id="fnref:64" href="#fn:64"><sup>64</sup></a></p></td><td></td><td><p>200,000<a class="footnote-ref" id="fnref:65" href="#fn:65"><sup>65</sup></a><a class="footnote-ref" id="fnref:66" href="#fn:66"><sup>66</sup></a> to 250,000 or more<a class="footnote-ref" id="fnref:67" href="#fn:67"><sup>67</sup></a></p></td><td><p>5,000-10,000<a class="footnote-ref" id="fnref:68" href="#fn:68"><sup>68</sup></a></p></td><td><p>3,000-20,000<a class="footnote-ref" id="fnref:69" href="#fn:69"><sup>69</sup></a></p></td><td></td></tr><tr><td colspan="2">Larvae per egg</td><td>1</td><td>1</td><td>300 <i><a href="/facts/Cercariae/dogRpgmG">cercariae</a></i> (<i><a href="/facts/Schistosoma/aBmHzzJV">Schistosoma</a></i>), 250,000 <i><a href="/facts/Metacercariae/dogRpgmG">metacercariae</a></i> (<i><a href="/facts/Fasciola/qBx10mK7">Fasciola</a></i>)<a class="footnote-ref" id="fnref:70" href="#fn:70"><sup>70</sup></a></td><td>1</td><td>1</td><td>1</td><td>1</td></tr></tbody></table> <p>Draft genomes for all categories of helminth have been sequenced in recent years and are available through the ParaSite sub-portal of <a href="/facts/WormBase/vUkJdykd">WormBase</a>.<a class="footnote-ref" id="fnref:71" href="#fn:71"><sup>71</sup></a> </p> <h2 id="use-in-medicine">Use in medicine</h2> <p class="note">Main article: <a href="/facts/Helminthic_therapy/0ktBh2rE">Helminthic therapy</a></p> <p>Parasitic worms have been used as a medical treatment for various diseases, particularly those involving an overactive <a href="/facts/Immune_system/HRCTf1pb">immune response</a>.<a class="footnote-ref" id="fnref:72" href="#fn:72"><sup>72</sup></a> As <a href="/facts/Human/rlcTENsr">humans</a> have evolved with parasitic worms, proponents argue they are needed for a healthy immune system.<a class="footnote-ref" id="fnref:73" href="#fn:73"><sup>73</sup></a> Scientists are looking for a connection between the prevention and control of parasitic worms and the increase in <a href="/facts/Allergy/dYAVosh8">allergies</a> such as hay-fever in developed countries.<a class="footnote-ref" id="fnref:74" href="#fn:74"><sup>74</sup></a> Removal of parasitic worms from areas is correlated with an increase in autoimmune disorders in those areas.<a class="footnote-ref" id="fnref:75" href="#fn:75"><sup>75</sup></a> Parasitic worms may be able to damp down the immune system of their host, making it easier for them to live in the intestine without coming under attack.<a class="footnote-ref" id="fnref:76" href="#fn:76"><sup>76</sup></a> This may be one mechanism for their proposed medicinal effect. </p><p>One study suggests a link between the rising rates of <a href="/facts/Metabolic_syndrome/jI70tRBv">metabolic syndrome</a> in the developed worlds and the largely successful efforts of Westerners to eliminate intestinal parasites. The work suggests eosinophils (a type of white blood cell) in fat tissue play an important role in preventing insulin resistance by secreting interleukin 4, which in turn switches <a href="/facts/Macrophage/z7hkQu3o">macrophages</a> into "alternative activation". Alternatively-activated macrophages are important to maintaining glucose homeostasis (i.e., blood sugar regulation). Helminth infection causes an increase in eosinophils. In the study, the authors fed rodents a high-fat diet to induce metabolic syndrome, and then injected them with helminths. Helminth infestation improved the rodents' metabolism.<a class="footnote-ref" id="fnref:77" href="#fn:77"><sup>77</sup></a> The authors concluded: </p> <blockquote><p>Although sparse in blood of persons in developed countries, eosinophils are often elevated in individuals in rural developing countries where intestinal parasitism is prevalent and metabolic syndrome rare. We speculate that eosinophils may have evolved to optimize metabolic homeostasis during chronic infections by ubiquitous intestinal parasites....<a class="footnote-ref" id="fnref:78" href="#fn:78"><sup>78</sup></a></p></blockquote> <h3>Human stool samples</h3> <p>For medical purposes, the exact number of helminth eggs is less important and therefore most <a href="/facts/Diagnosis/VcsPwshd">diagnoses</a> are made simply by identifying the appearance of the <a href="/facts/Worm/FMrnWM8s">worm</a> or eggs in <a href="/facts/Feces/r9HDKB8G">feces</a>. Due to the large quantity of eggs laid, <a href="/facts/Physicians/qJ3woFvG">physicians</a> can <a href="/facts/Diagnose/VcsPwshd">diagnose</a> using as few as one or two <a href="/facts/Fecal_smear/xpJx5mgl">fecal smears</a>. The <a href="/facts/Kato_technique/FHgWADvF">Kato technique</a> (also called the Kato-Katz technique) is a laboratory method for preparing human stool samples prior to searching for parasite eggs. <a href="/facts/Eggs_per_gram/aN7RtvAy">Eggs per gram</a> is a laboratory test that determines the number of eggs per gram of feces in patients suspected of having a parasitological infection, such as schistosomiasis. </p> <h2 id="relevance-for-sanitation">Relevance for sanitation</h2> <p>Helminth eggs can reach the soil when polluted <a href="/facts/Wastewater/g6Bn8xvT">wastewater</a>, <a href="/facts/Sewage_sludge/qztXxBSD">sewage sludge</a> or <a href="/facts/Human_waste/FkBVmLgc">human waste</a> are used as <a href="/facts/Fertilizer/ysh3r6NJ">fertilizer</a>. Such soil is often characterized by moist and warm conditions. Therefore, the risk of using contaminated wastewater and sludge in agricultural fields is a real problem, especially in poor countries, where this practice is prevalent.<a class="footnote-ref" id="fnref:79" href="#fn:79"><sup>79</sup></a><a class="footnote-ref" id="fnref:80" href="#fn:80"><sup>80</sup></a> Helminth eggs are regarded as the main biological health risk when applying sewage sludge, fecal sludge or fecal matter on agricultural soils.<a class="footnote-ref" id="fnref:81" href="#fn:81"><sup>81</sup></a> The eggs are the infective stage of the helminths' life cycle for causing the disease <a href="/facts/Helminthiasis/pX5etdRm">helminthiasis</a>. </p><p>Due to this strong shell, helminth eggs or ova remain viable in soil, fresh water and sewage for many months. In feces, fecal sludge and sewage sludge they can even remain viable for several years.<a class="footnote-ref" id="fnref:82" href="#fn:82"><sup>82</sup></a><a class="footnote-ref" id="fnref:83" href="#fn:83"><sup>83</sup></a> Helminth eggs of concern in <a href="/facts/Wastewater/g6Bn8xvT">wastewater</a> used for <a href="/facts/Irrigation/RWX5PEgK">irrigation</a> have a size between 20 and 90 μm and a relative density of 1.06–1.23.<a class="footnote-ref" id="fnref:84" href="#fn:84"><sup>84</sup></a> It is very difficult to inactivate helminth eggs, unless temperature is increased above 40 °C or moisture is reduced to less than 5%.<a class="footnote-ref" id="fnref:85" href="#fn:85"><sup>85</sup></a> Eggs that are no longer viable do not produce any larvae. In the case of <i><a href="/facts/Ascaris_lumbricoides/CJGz5JIm">Ascaris lumbricoides</a></i> (giant roundworm), which has been considered the most resistant and common helminth type, fertilized eggs deposited in soil are resistant to desiccation but are, at this stage of development, very sensitive to environmental temperatures: The reproduction of a fertilized egg within the eggshell develops at an environmental soil temperature about 25 °C which is lower than the body temperature of the host (i.e., 37 °C for humans).<a class="footnote-ref" id="fnref:86" href="#fn:86"><sup>86</sup></a> However, development of the larvae in the egg stops at temperatures below 15.5 °C, and eggs cannot survive temperatures much above 38 °C. If the temperature is around 25 °C, the infectiousness occurs after nearly 10 days of incubation.<a class="footnote-ref" id="fnref:87" href="#fn:87"><sup>87</sup></a><a class="footnote-ref" id="fnref:88" href="#fn:88"><sup>88</sup></a><a class="footnote-ref" id="fnref:89" href="#fn:89"><sup>89</sup></a> </p> <h3>Removal versus inactivation</h3> <p>Processes that remove particles, such as sedimentation, filtration or <a href="/facts/Flocculation/dNLUAP4o">coagulation-flocculation</a> physically remove helminth eggs from wastewater (but do not inactivate them).<a class="footnote-ref" id="fnref:90" href="#fn:90"><sup>90</sup></a><a class="footnote-ref" id="fnref:91" href="#fn:91"><sup>91</sup></a> Therefore, <a href="/facts/Stabilization_pond/PcB1T0hd">waste stabilization ponds</a> (lagoons), storage basins, <a href="/facts/Constructed_wetlands/z1q4EWAM">constructed wetlands</a>, rapid filtration or <a href="/facts/Upflow_anaerobic_sludge_blanket/lvKRwGF8">upflow anaerobic sludge blanket</a> (UASB) reactors can be used. </p><p>Helminth ova cannot be inactivated with chlorine, UV light or ozone (in the latter case at least not with economical doses because >36 mg/L ozone are needed with 1 hour contact time). </p><p>Helminth ova can be inactivated in <a href="/facts/Sewage_sludge_treatment/MygYNh5Y">sewage sludge treatment</a> if the temperature is increased over 40 °C or moisture is reduced to less than 5%.<a class="footnote-ref" id="fnref:92" href="#fn:92"><sup>92</sup></a> Best results can be obtained when both of these conditions are met together for an extended period of time.<a class="footnote-ref" id="fnref:93" href="#fn:93"><sup>93</sup></a> Details about the contact time under these conditions and other related environmental factors are generally not well-defined for every type of helminth egg species.<a class="footnote-ref" id="fnref:94" href="#fn:94"><sup>94</sup></a> Helminth eggs are considered highly resistant biological structures.<a class="footnote-ref" id="fnref:95" href="#fn:95"><sup>95</sup></a> </p> <h3>Measurements</h3> <h4>Indicator organism</h4> <p class="note">This section is an excerpt from <a href="/facts/Indicator_organism/TNEBVqf8">Indicator organism § Indicator helminth eggs</a>.[<a href="https://en.wikipedia.org/w/index.php?title=Indicator_organism&action=edit#Indicator_helminth_eggs">edit</a>]</p> <p>The eggs from <a href="/facts/Helminth/V9wRobaA">helminths</a> (parasitic worms) are a commonly used indicator organism to assess the safety of <a href="/facts/Sanitation/NLGqBs2T">sanitation</a> and <a href="/facts/Wastewater/g6Bn8xvT">wastewater</a> reuse systems (such schemes are also called <a href="/facts/Reuse_of_human_excreta/A4FUhsdv">reuse of human excreta</a>).<a class="footnote-ref" id="fnref:96" href="#fn:96"><sup>96</sup></a>: 55 This is because they are the most resistant <a href="/facts/Pathogens/axMXtV1M">pathogens</a> of all types of pathogens (pathogens can be <a href="/facts/Viruses/mf88Bcbl">viruses</a>, <a href="/facts/Bacteria/wC8xSCsU">bacteria</a>, <a href="/facts/Protozoa/JczTf25H">protozoa</a> and helminths).<a class="footnote-ref" id="fnref:97" href="#fn:97"><sup>97</sup></a> It means they are relatively hard to destroy through conventional treatment methods. They can survive for 10–12 months in tropical climates.<a class="footnote-ref" id="fnref:98" href="#fn:98"><sup>98</sup></a> These eggs are also called <i>ova</i> in the literature.<a class="footnote-ref" id="fnref:99" href="#fn:99"><sup>99</sup></a> </p><p>Helminth eggs that are found in wastewater and sludge stem from soil-transmitted helminths (STHs) which include <i><a href="/facts/Ascaris_lumbricoides/CJGz5JIm">Ascaris lumbricoides</a></i> (Ascaris), <i><a href="/facts/Ancylostoma_duodenale/bz2PoPlz">Anclostoma duodenale</a></i>, <i><a href="/facts/Necator_americanus/b4Wsq9gp">Necator americanus</a></i> (hookworm), and <i><a href="/facts/Trichuris_trichiura/AEISzWkd">Trichuris trichiura</a></i> (whipworm).<a class="footnote-ref" id="fnref:100" href="#fn:100"><sup>100</sup></a> Ascaris and whipworm that are identified in reusable wastewater systems can cause certain diseases and complications if ingested by humans and pigs.<a class="footnote-ref" id="fnref:101" href="#fn:101"><sup>101</sup></a> Hookworms will plant and hatch their larvae into the soil where they grow until maturity. Once the hookworm eggs are fully developed, they infect organisms by crawling through the organism’s skin.<a class="footnote-ref" id="fnref:102" href="#fn:102"><sup>102</sup></a> </p><p>The presence or absence of viable helminth eggs ("viable" meaning that a larva would be able to hatch from the egg) in a sample of dried fecal matter, <a href="/facts/Compost/q6kmXGWU">compost</a> or <a href="/facts/Faecal_sludge/UvbdekQA">fecal sludge</a> is often used to assess the efficiency of diverse wastewater and sludge treatment processes in terms of pathogen removal.<a class="footnote-ref" id="fnref:103" href="#fn:103"><sup>103</sup></a>: 55 In particular, the number of viable <a href="/facts/Ascaris/kK1ub8Rs">Ascaris</a> eggs is often taken as an indicator for all helminth eggs in treatment processes as they are very common in many parts of the world and relatively easy to identify under the microscope. However, the exact inactivation characteristics may vary for different types of helminth eggs.<a class="footnote-ref" id="fnref:104" href="#fn:104"><sup>104</sup></a> </p> The technique used for testing depends on the type of sample.<a class="footnote-ref" id="fnref:105" href="#fn:105"><sup>105</sup></a> When the helminth ova are in sludge, processes such as alkaline-post stabilization, acid treatment, and <a href="/facts/Anaerobic_digestion/EUaMIVpM">anaerobic digestion</a> are used to reduce the amount of helminth ova in areas where there is a large amount. These methods make it possible for helminth ova to be within the healthy requirements of ≤1 helminth ova per liter. Dehydration is used to inactivate helminth ova in fecal sludge. This type of inactivation occurs when feces is stored between 1-2 years, a high total solids content (>50-60%) is present, items such as leaves, lime, earth, etc. are added, and at a temperature of 30°C or higher.<a class="footnote-ref" id="fnref:106" href="#fn:106"><sup>106</sup></a> <h4>Environmental samples</h4> <p>For the purpose of setting treatment standards and reuse legislation, it is important to be able to determine the amount of helminth eggs in an environmental sample with some accuracy. The detection of viable helminth eggs in samples of wastewater, sludge or fresh feces (as a diagnostic tool for the infection <a href="/facts/Helminthiasis/pX5etdRm">helminthiasis</a>) is not straight forward. In fact, many laboratories in developing countries lack the right equipment or skilled staff required to do so. An important step in the analytical methods is usually the concentration of the eggs in the sample, especially in the case of wastewater samples. A concentration step may not be required in samples of dried feces, e.g. samples collected from <a href="/facts/Urine-diverting_dry_toilet/yCt55pPw">urine-diverting dry toilets</a>. </p> <h2 id="see-also">See also</h2> <ul> <li>Biology portal</li><li>Medicine portal</li></ul> <ul><li><a href="/facts/Helminthology/0LUzbCTf">Helminthology</a> – the study of parasitic worms and their effects on their <a href="/facts/Host_(biology)/L6mop0kh">hosts</a></li> <li><a href="/facts/Anthelminthic/2p02KN0X">Anthelmintic</a></li> <li><a href="/facts/Parasitism/HWPcgky7">Parasitism</a></li> <li><a href="/facts/Schistosomiasis/qXtvvvUo">Schistosomiasis</a> – a disease caused by parasitic <a href="/facts/Flatworm/lvqbrb2V">flatworms</a> called <a href="/facts/Schistosoma/aBmHzzJV">schistosomas</a></li> <li><a href="/facts/Lymphatic_filariasis/F2xm8pYq">Lymphatic filariasis</a> caused by <a href="/facts/Filarial_worms/8AkVK5hy">filarial worms</a></li> <li><a href="/facts/Dracunculiasis/gVcneqAs">Dracunculiasis</a> caused by the <a href="/facts/Roundworm/yLMJ43Eu">roundworm</a> <i><a href="/facts/Dracunculus_medinensis/HpK9La8C">Dracunculus medinensis</a></i> (Guinea worm)</li></ul> <h2 id="further-reading">Further reading</h2> <ul><li><a href="/facts/Dickson_Despommier/UGLGbMA7">Dickson Despommier</a>, <i>People, Parasites, and Plowshares: Learning from Our Body's Most Terrifying Invaders</i>, <a href="/facts/Columbia_University_Press/5dVrKLey">Columbia University Press</a>, 2016 (<a href="/facts/ISBN_(identifier)/15AdSPa9">ISBN</a> 978-0231161954).</li></ul> <h2 id="external-links">External links</h2> Wikimedia Commons has media related to Helminths. <ul><li><a href="https://web.archive.org/web/20071017030045/http://www.niaid.nih.gov/factsheets/roundwor.htm">Parasitic Roundworm Diseases</a></li> <li><a href="https://www.who.int/intestinal_worms/en/">World Health Organisation (WHO) topic page on Intestinal worms</a></li></ul> <h2 id="references">References</h2> <ol> <li id="fn:1"><p>"CDC - Parasites - About Parasites". www.cdc.gov. 20 April 2018. <a href="https://www.cdc.gov/parasites/about.html" target="_blank">https://www.cdc.gov/parasites/about.html</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li> <li id="fn:2"><p>Hildersley, Katie A.; McNeilly, Tom N.; Gillan, Victoria; Otto, Thomas D.; Löser, Stephan; Gerbe, François; Jay, Philippe; Maizels, Rick M.; Devaney, Eileen; Britton, Collette (2021). 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(ISBN 9684630514) <a href="http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B" target="_blank">http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B</a> <a href="#fnref:36" class="footnote-back-ref">↩</a></p></li> <li id="fn:37"><p>"Centers for Disease Control and Prevention: Parasites - Ascariasis". Retrieved 13 January 2015. <a href="https://www.cdc.gov/parasites/ascariasis/biology.html" target="_blank">https://www.cdc.gov/parasites/ascariasis/biology.html</a> <a href="#fnref:37" class="footnote-back-ref">↩</a></p></li> <li id="fn:38"><p>"Centers for Disease Control and Prevention: Parasites - Hookworm". Retrieved 13 January 2015. <a href="https://www.cdc.gov/parasites/hookworm/biology.html" target="_blank">https://www.cdc.gov/parasites/hookworm/biology.html</a> <a href="#fnref:38" class="footnote-back-ref">↩</a></p></li> <li id="fn:39"><p>"Centers for Disease Control and Prevention: Parasites - Trichuriasis (also known as Whipworm Infection)". Retrieved 13 January 2015. <a href="https://www.cdc.gov/parasites/whipworm/biology.html" target="_blank">https://www.cdc.gov/parasites/whipworm/biology.html</a> <a href="#fnref:39" class="footnote-back-ref">↩</a></p></li> <li id="fn:40"><p>"Centers for Disease Control and Prevention". Parasites - Taeniasis (Biology). 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Retrieved 13 January 2015. <a href="https://www.cdc.gov/parasites/hookworm/biology.html" target="_blank">https://www.cdc.gov/parasites/hookworm/biology.html</a> <a href="#fnref:43" class="footnote-back-ref">↩</a></p></li> <li id="fn:44"><p>"Centers for Disease Control and Prevention: Parasites - Trichuriasis (also known as Whipworm Infection)". Retrieved 13 January 2015. <a href="https://www.cdc.gov/parasites/whipworm/biology.html" target="_blank">https://www.cdc.gov/parasites/whipworm/biology.html</a> <a href="#fnref:44" class="footnote-back-ref">↩</a></p></li> <li id="fn:45"><p>Lamonthe Argumedo, R., Garcia Prieto, L. (1988). Human helminthiasis in Mexico. Treatment and prophylaxis Archived 2014-12-29 at the Wayback Machine, A.G.T. Editor, S.A., 1st edition, Mexico. (ISBN 9684630514) <a href="http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B" target="_blank">http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B</a> <a href="#fnref:45" class="footnote-back-ref">↩</a></p></li> <li id="fn:46"><p>"Centers for Disease Control and Prevention". Parasites - Taeniasis (Biology). Retrieved 22 January 2015. <a href="https://www.cdc.gov/parasites/taeniasis/biology.html" target="_blank">https://www.cdc.gov/parasites/taeniasis/biology.html</a> <a href="#fnref:46" class="footnote-back-ref">↩</a></p></li> <li id="fn:47"><p>"Centers for Disease Control and Prevention: Parasites - Fascioliasis (Fasciola Infection)". Retrieved 13 January 2015. <a href="https://www.cdc.gov/parasites/fasciola/biology.html" target="_blank">https://www.cdc.gov/parasites/fasciola/biology.html</a> <a href="#fnref:47" class="footnote-back-ref">↩</a></p></li> <li id="fn:48"><p>"Centers for Disease Control and Prevention: Parasites - Ascariasis". Retrieved 13 January 2015. <a href="https://www.cdc.gov/parasites/ascariasis/biology.html" target="_blank">https://www.cdc.gov/parasites/ascariasis/biology.html</a> <a href="#fnref:48" class="footnote-back-ref">↩</a></p></li> <li id="fn:49"><p>Lamonthe Argumedo, R., Garcia Prieto, L. (1988). Human helminthiasis in Mexico. Treatment and prophylaxis Archived 2014-12-29 at the Wayback Machine, A.G.T. Editor, S.A., 1st edition, Mexico. (ISBN 9684630514) <a href="http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B" target="_blank">http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B</a> <a href="#fnref:49" class="footnote-back-ref">↩</a></p></li> <li id="fn:50"><p>"Centers for Disease Control and Prevention". Parasites - Taeniasis (Biology). Retrieved 22 January 2015. <a href="https://www.cdc.gov/parasites/taeniasis/biology.html" target="_blank">https://www.cdc.gov/parasites/taeniasis/biology.html</a> <a href="#fnref:50" class="footnote-back-ref">↩</a></p></li> <li id="fn:51"><p>Lamonthe Argumedo, R., Garcia Prieto, L. (1988). Human helminthiasis in Mexico. Treatment and prophylaxis Archived 2014-12-29 at the Wayback Machine, A.G.T. Editor, S.A., 1st edition, Mexico. (ISBN 9684630514) <a href="http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B" target="_blank">http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B</a> <a href="#fnref:51" class="footnote-back-ref">↩</a></p></li> <li id="fn:52"><p>"Centers for Disease Control and Prevention: Parasites - Ascariasis". Retrieved 13 January 2015. <a href="https://www.cdc.gov/parasites/ascariasis/biology.html" target="_blank">https://www.cdc.gov/parasites/ascariasis/biology.html</a> <a href="#fnref:52" class="footnote-back-ref">↩</a></p></li> <li id="fn:53"><p>"Centers for Disease Control and Prevention: Parasites - Hookworm". Retrieved 13 January 2015. <a href="https://www.cdc.gov/parasites/hookworm/biology.html" target="_blank">https://www.cdc.gov/parasites/hookworm/biology.html</a> <a href="#fnref:53" class="footnote-back-ref">↩</a></p></li> <li id="fn:54"><p>"Centers for Disease Control and Prevention: Parasites - Trichuriasis (also known as Whipworm Infection)". Retrieved 13 January 2015. <a href="https://www.cdc.gov/parasites/whipworm/biology.html" target="_blank">https://www.cdc.gov/parasites/whipworm/biology.html</a> <a href="#fnref:54" class="footnote-back-ref">↩</a></p></li> <li id="fn:55"><p>"CDC Centers for Disease Control and Prevention, about parasites". CDC. Retrieved 28 November 2014. <a href="https://www.cdc.gov/parasites/about.html" target="_blank">https://www.cdc.gov/parasites/about.html</a> <a href="#fnref:55" class="footnote-back-ref">↩</a></p></li> <li id="fn:56"><p>Lamonthe Argumedo, R., Garcia Prieto, L. (1988). Human helminthiasis in Mexico. Treatment and prophylaxis Archived 2014-12-29 at the Wayback Machine, A.G.T. Editor, S.A., 1st edition, Mexico. (ISBN 9684630514) <a href="http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B" target="_blank">http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B</a> <a href="#fnref:56" class="footnote-back-ref">↩</a></p></li> <li id="fn:57"><p>Pumarola, A., Rodríguez-Torres, A., García, R.J.A., Piedrola, A.G. (1987). Medical Microbiology and Parasitology (in Spanish), Ediciones Científicas y Técnicas, S. 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(ISBN 9684630514) <a href="http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B" target="_blank">http://www.cabdirect.org/abstracts/19890856899.html;jsessionid=02B0A5F1A56ABCF2168CCE818117C655;jsessionid=73E2DEA523DD5F13598E546729323C4B</a> <a href="#fnref:59" class="footnote-back-ref">↩</a></p></li> <li id="fn:60"><p>"Centers for Disease Control and Prevention". Parasites - Taeniasis (Biology). Retrieved 22 January 2015. <a href="https://www.cdc.gov/parasites/taeniasis/biology.html" target="_blank">https://www.cdc.gov/parasites/taeniasis/biology.html</a> <a href="#fnref:60" class="footnote-back-ref">↩</a></p></li> <li id="fn:61"><p>"Centers for Disease Control and Prevention: Parasites - Ascariasis". 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Bibcode:2007WSTec..56...43J. doi:10.2166/wst.2007.555. ISSN 0273-1223. PMID 17881836. <a href="https://iwaponline.com/wst/article/56/5/43/14049/Helminth-ova-control-in-wastewater-and-sludge-for" target="_blank">https://iwaponline.com/wst/article/56/5/43/14049/Helminth-ova-control-in-wastewater-and-sludge-for</a> <a href="#fnref:106" class="footnote-back-ref">↩</a></p></li> </ol>