ascariasis

A B B D E F G And K L M N O U R C T Y P X C H W E I

Ascariasis - helminthiasis of nematosis group, characterized by a primary lesion of the gastrointestinal tract. Ascariasis is widespread, except for the Arctic regions.

Pathogen - Ascaris (Ascaris lumbricoides); females 25-40 cm length, male length - 15-25 cm adult roundworm live in the small intestine, where the females lay day after fertilization up to 200 000 eggs.. Dimensions eggs 0.05-0.07 mm and 0.04-0.05 mm. Eggs with the feces enter the environment, where under favorable conditions (sufficient humidity, temperature 14-35 ° C and a supply of oxygen) of these larvae are formed. Development of eggs lasts from 15 days to several months, depending on the temperature and humidity of the soil. If you get mature eggs in the gut of human larvae are released from the egg membranes and penetrate into the capillaries of the intestine wall, which fall into the portal, and then the inferior vena cava, the right heart and pulmonary circulation. Through capillary bronchioles they come in airways. Using ciliated bronchial cilia larvae reach the mouth, mixed with saliva, swallowed and re-enter the small intestine, where the parasites develop into adults. Migration lasted 14-15 days; development of Ascaris (from the moment of getting the eggs into the intestine before the eggs in the feces of the new generation) takes about 3 months; live roundworm not more than one year.

The source of the causative agents of infection is a sick man. Infection occurs as a result of importation of mature eggs from the soil in the mouth with dirty hands or by eating vegetables, fruits and berries contaminated with faeces containing helminth eggs. Of great importance in the spread of fertilizer has ascariasis of gardens uncleared faeces. Roundworm eggs can get on household items and food products with dust, as well as entered into the living quarters on the soles of shoes. Infection ascaridiasis often occurs in summer and autumn. Ascariasis occurs mostly in children; in adults it is less common due to the more rigorous compliance with the rules of hygiene, and perhaps the state of the immune system.

Larvae of Ascaris sensitized organism products of their metabolism, and decay, as well as mechanical damage the walls of blood vessels and tissue during migration. Adults roundworm have a toxic effect on the host organism, may cause mechanical damage to the intestinal wall, and the intensive invasion - obturation (occlusion) ulcers.

The clinical picture. The first symptoms appear within 4-8 weeks after infection. There are early (migration) and late (intestinal) phase of ascariasis. The early phase is associated with the migration of the larvae and is manifested by fever, pains in the joints, muscles, itchy rash on the skin, swelling of the eyelids and face, coughing with phlegm, shortness of breath, pain while breathing, enlargement of the liver and spleen, blood eosinophilia up to 40-60%, the formation of eosinophilic pulmonary infiltrates. They can also develop bronchitis and lobular pneumonia . For the late phase is characterized by malaise, headaches, loss of appetite, nausea , sometimes vomiting , abdominal pain, irritability, restless sleep. Late Complications phase - bowel obstruction, peritonitis, ruptured, and the penetration of ascarids in the liver (with the possible development of purulent cholecystitis, liver abscess, obstructive jaundice). When zapolzaniya ascarids through the esophagus into the throat and respiratory tract can occur blockage of the respiratory tract with the development of asphyxia.

The diagnosis is based on the early phase of clinical data and results of immunological reactions with an antigen from ascaris diagnosed late phase - on detection of eggs in faeces.

Treatment is carried out in the early phase mintezolom, Vermoxum. For the treatment of the late phase used in medamin, dekaris, Vermoxum, kombantrin, piperazine salt (piperazin-adipate et al.).

Prevention is based on prevention of pollution of the environment with faeces: the improvement of residential areas, their sewage, the device impermeable cesspool nekanalizovannyh latrines, regular cleaning cesspools, fertilizing orchards faeces only after disinfecting them by composting. Vegetables, berries, fruit, eaten raw should be thoroughly washed. Before eating and after excavation (for example, work in the garden) should wash their hands thoroughly. Measures relating to the sources of infection are reduced to the identification and treatment of individuals infested with ascarids. For this purpose, carried gelmintokoprologicheskoe examination of patients in the hospital, and as clinically indicated - patients who have treatment on an outpatient basis, and each year children in kindergartens, primary school pupils, children's homes, sanatorium schools, children's homes, the adult population groups , by their occupations at risk (operating treatment plants, agricultural fields, irrigation, greenhouses, conservatories, gardeners, etc.). In areas disadvantaged by ascariasis, where prevalence exceeds 10% of the population, examine the entire rural population of 1 times a year, and in areas where ascariasis affected up to 10% of the population, 20% of the population examined 1 time in 2 years. All TB patients are subjected to de-worming, and their estates carried sanitary measures. All residents of the estates subject to preventive deworming.