Helminths

Helminths (/hlmns/), also commonly known as parasitic worms, are large multicellular organisms,
which when mature can generally be seen with the naked eye. They are often referred to as intestinal
worms even though not all helminths reside in the intestines; for example Schistosomes (causing the
disease schistosomiasis) are not intestinal worms, but rather a helminth which resides in blood vessels.
Helminths belong to the group of intestinal parasites (the other type of intestinal parasite are the
protozoa). An infection by a Helminth is known as helminthiasis, soil-transmitted helminthiasis, helminth
infection or intestinal worm infection. The same naming convention applies to all helminths whereby
the ending "-asis" (or in veterinary science the ending "-osis") at the end of the name of the worm is
added to signify the infection with that particular worm, e.g. Ascaris is the name of a particular
helminth, and Ascariasis is the name of the infectious disease caused by this helminth.
They are worm-like organisms living in and feeding on living hosts, receiving nourishment and protection
while disrupting their hosts' nutrient absorption, causing weakness and disease. Those that live inside
the digestive tract are called intestinal parasites. They can live inside humans and other animals. In their
adult form, helminths cannot multiply in humans.[1] Helminths are able to survive in their mammalian
hosts for many years due to their ability to manipulate the immune response by secreting
immunomodulatory products.[citation needed]
Helminthology is the study of parasitic worms and their effects on their hosts. The word helminth comes
from Greek hlmins, a kind of worm. Ringworm (dermatophytosis) is actually caused by various fungi
and not by a parasitic worm.
Immune Evasion:
Parasites have evolved sophisticated mechanisms to evade effective host immune response (see
Immune Effectors).

(1) Seclusion from Immune System:

Leishmania promastigotes activate complement and become taken up by macrophages. Normally, this
would trigger respiratory burst in macrophages; however, the promastigotes fuse with the cell's
lysosome and produce antioxidants and enzyme inhibitors to neutralize the effects of the toxins
generated by the macrophage. Moreover, the larval stage of the muscle nematode trichinella
transforms the muscle cell into a specialized nurse cell that protects it and provides nutrients. This
parasitic worm survives there for the lifetime of the host.
(2) Parasites Produce Antioxidant Enzymes:
Activation of leukocytes produce hydrogen peroxide (H2O2), superoxide ions, and hydroxy radicals (OH-)
which are toxic to parasites. Parasites have their own oxygen-scavenging enzymes to protect themselves
from host attack. These include the enzymes: superoxide dismutase, catalase, and glutathione
peroxidase. All helminth and protozoan parasites examined to date have at least on of these enzymes.
(3) Interfering with Complement:
Leishmania is completely covered with lipophosphoglycan.
This elongated LPG binds complement, assisting direct entry of the parasite into macrophages. The
parasite avoids damage by complement by the extreme length of the LPG. The lytic C5b-9 complex
forms too far away from the parasite membrane.
(4) Antigenic Variation:
Trypanosoma brucei coats itself with a dense protein that comprises of a single antigen called variant
surface glucoprotein (VSG). The amount of parasites eventually declines when the host antibodies
recognize this VSG (Figure 6). However, parasites that have replicated have new VSG, so the old immune
response is no longer effective.

Vaccination
Vaccination is the administration of antigenic material (a vaccine) to stimulate an individual's immune
system to develop adaptive immunity to a pathogen. Vaccines can prevent or ameliorate morbidity from
infection. The effectiveness of vaccination has been widely studied and verified; for example, the
influenza vaccine, the HPV vaccine, and the chicken pox vaccine. Vaccination is the most effective
method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible
for the worldwide eradication of smallpox and the restriction of diseases such as polio, measles, and
tetanus from much of the world. The World Health Organization (WHO) reports licensed vaccines are
currently available to prevent, or contribute to the prevention and control of, 25 vaccine-preventable
infections.
The active agent of a vaccine may be intact but inactivated (non-infective) or attenuated (with reduced
infectivity) forms of the causative pathogens, or purified components of the pathogen that have been
found to be highly immunogenic (e.g., outer coat proteins of a virus). Toxoids are produced for
immunization against toxin-based diseases, such as the modification of tetanospasmin toxin of tetanus
to remove its toxic effect but retain its immunogenic effect.
Smallpox was most likely the first disease people tried to prevent by inoculating themselves[7][8] and
was the first disease for which a vaccine was produced. The smallpox vaccine was designed in 1796 by
the British physician Edward Jenner, although at least six people had used the same principles years
earlier.[9] Louis Pasteur furthered the concept through his work in microbiology. The immunization was
called vaccination because it was derived from a virus affecting cows (Latin: vaccacow).[7][9] Smallpox
was a contagious and deadly disease, causing the deaths of 2060% of infected adults and over 80% of
infected children. When smallpox was finally eradicated in 1979, it had already killed an estimated 300
500 million peoplein the 20th century.
In common speech, 'vaccination' and 'immunization' have a similar meaning. This distinguishes it from
inoculation, which uses unweakened live pathogens, although in common usage either can refer to an
immunization. Vaccination efforts have been met with some controversy on scientific, ethical, political,
medical safety, and religious grounds. In rare cases, vaccinations can injure people and, in the United
States, they may receive compensation for those injuries under the National Vaccine Injury
Compensation Program. Early success and compulsion brought widespread acceptance, and mass
vaccination campaigns have greatly reduced the incidence of many diseases in numerous geographic
regions.
Immunodeficiency - HIV
HIV (human immunodeficiency virus) is a virus that attacks the immune system, the body's natural
defense system. Without a strong immune system, the body has trouble fighting off disease. Both the
virus and the infection it causes are called HIV.

White blood cells are an important part of the immune system. HIV infects and destroys certain white
blood cells called CD4+ cells. If too many CD4+ cells are destroyed, the body can no longer defend itself
against infection.
The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome). People with AIDS have a
low number of CD4+ cells and get infections or cancers that rarely occur in healthy people. These can be
deadly.
But having HIV doesn't mean you have AIDS. Even without treatment, it takes a long time for HIV to
progress to AIDSusually 10 to 12 years.
When HIV is diagnosed before it becomes AIDS, medicines can slow or stop the damage to the immune
system. If AIDS does develop, medicines can often help the immune system return to a healthier state.
With treatment, many people with HIV are able to live long and active lives.
There are two types of HIV:
HIV-1, which causes almost all the cases of AIDS worldwide
HIV-2, which causes an AIDS-like illness. HIV-2 infection is uncommon in North America.
HIV infection is caused by the human immunodeficiency virus. You can get HIV from contact with
infected blood, semen, or vaginal fluids.
Most people get the virus by having unprotected sex with someone who has HIV.
Another common way of getting it is by sharing drug needles with someone who is infected with HIV.
The virus can also be passed from a mother to her baby during pregnancy, birth, or breast-feeding.
HIV doesn't survive well outside the body. So it can't be spread by casual contact like kissing or sharing
drinking glasses with an infected person.
HIV may not cause symptoms early on. People who do have symptoms may mistake them for the flu or
mono. Common early symptoms include:
Fever.
Sore throat.
Headache.
Muscle aches and joint pain.
Swollen glands (swollen lymph nodes).
Skin rash.
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Symptoms may appear from a few days to several weeks after a person is first infected. The early
symptoms usually go away within 2 to 3 weeks.
After the early symptoms go away, an infected person may not have symptoms again for many years.
After a certain point, symptoms reappear and then remain. These symptoms usually include:
Swollen lymph nodes.
Extreme tiredness.
Weight loss.
Fever.
Night sweats.
A doctor may suspect HIV if symptoms last and no other cause can be found.
If you have been exposed to HIV, your immune system will make antibodies to try to destroy the virus.
Doctors use tests to find these antibodies in urine, saliva, or blood.
If a test on urine or saliva shows that you are infected with HIV, you will probably have a blood test to
confirm the results.
Most doctors use two blood tests, called the ELISA and the Western blot. If the ELISA is positive
(meaning that HIV antibodies are found), a Western blot or other test will be done to be sure.
It may take as long as 6 months for HIV antibodies to show up in your blood. If you think you have been
exposed to HIV but you test negative for it:
Get tested again. Tests at 6, 12, and 24 weeks can be done to be sure you are not infected.
Meanwhile, take steps to prevent the spread of the virus, in case you do have it.
You can get HIV testing in most doctors' offices, public health clinics, hospitals, and Planned Parenthood
clinics. You can also buy a home HIV test kit in a drugstore or by mail order. Make sure it's one that is
approved by the Food and Drug Administration (FDA). If a home test is positive, see a doctor to have the
result confirmed and to find out what to do next.
The standard treatment for HIV is a combination of medicines called antiretroviral therapy, or ART.
Antiretroviral medicines slow the rate at which the virus multiplies.
Taking these medicines can reduce the amount of virus in your body and help you stay healthy.
Medical experts recommend that people begin treatment for HIV as soon as they know that they are
infected.1, 2
To monitor the HIV infection and its effect on your immune system, a doctor will regularly do two tests:
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Viral load, which shows the amount of virus in your blood.

CD4+ cell count, which shows how well your immune system is working.
After you start treatment, it's important to take your medicines exactly as directed by your doctor.
When treatment doesn't work, it is often because HIV has become resistant to the medicine. This can
happen if you don't take your medicines correctly.
HIV is often spread by people who don't know they have it. So it's always important to protect yourself
and others by taking these steps:
Practice safer sex. Use a condom every time you have sex (including oral sex) until you are sure that you
and your partner aren't infected with HIV or other sexually transmitted infection (STI).
Don't have more than one sex partner at a time. The safest sex is with one partner who has sex only
with you.
Talk to your partner before you have sex the first time. Find out if he or she is at risk for HIV. Get tested
together. Getting tested again at 6, 12, and 24 weeks after the first test can be done to be sure neither
of you is infected. Use condoms in the meantime.
Don't drink a lot of alcohol or use illegal drugs before sex. You might let down your guard and not
practice safer sex.
Don't share personal items, such as toothbrushes or razors.
Never share needles or syringes with anyone.
You also can take antiretroviral medicine to help protect yourself from HIV infection. But to keep your
risk low, you still need to practice safer sex even while you are taking the medicine.
SCID Immunodeficiency
SCID, Severe Combined Immunodeficiency, is a primary immune deficiency. The defining characteristic is
usually a severe defect in both the T- & B-lymphocyte systems. This usually results in the onset of one or
more serious infections within the first few months of life. These infections are usually serious, and may
even be life threatening, they may include pneumonia, meningitis or bloodstream infections. Children
affected by SCID can also become ill from live viruses present in some vaccines. These vaccines (such as
Chickenpox, Measles, Rotavirus, oral polio and BCG, etc.) contain viruses and bacteria that are
weakened and dont harm children with a healthy immune system. In patients with SCID however, these
viruses and bacteria may cause severe, life-threatening infections.
Pediatric Emergency
This once-fatal disease should be now seen as a pediatric emergency, a condition that needs immediate
diagnosis and treatment, says Dr. Rebecca Buckley, of Dukes division of Pediatric Allergy and
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Immunology. Early diagnosis of SCID is still uncommon because not all states routinely perform a test in
newborns which could alert physicians to the possibility of a T-cell defect. The newborn screening heel
stick test could pick up children with SCID, as well as those with other serious immune deficiencies, that
would not be apparent until the child developed an infection. This simple blood test could allow us to
treat, and most likely cure SCID in an infant at a reasonable cost. If found later, less effective treatment
can run into the millions. Buckley states, What were saying is that essentially every baby with SCID
could be cured if diagnosed early enough. SCID should be considered a pediatric emergency.
Bubble Boy Disease
SCID is often called bubble boy disease. SCID became widely known during the 1970s and 80s, when
the world learned of David Vetter, a boy with X-linked SCID, who lived for 12 years in a plastic, germ-free
bubble.
There are several forms of SCID. The most common type is linked to the X-chromosome, making this
form affect only males. Other forms of SCID usually follow an autosomal recessive inheritance pattern or
are the result of spontaneous mutations. One of these other forms is linked to a deficiency of the
enzyme adenosine deaminase (ADA) while other cases of SCID are caused by a variety of other defects.