Ascaris
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Ascaris lumbricoides is the most common helminth infection of humans worldwide and is the largest intestinal roundworm.
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 Adult female
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Ascaris is a genus of parasitic nematode worms. One species, A. suum, typically infects pigs, while another, A. lumbricoides, affects human populations, typically in sub-tropical and tropical areas with poor sanitation. This infection is known as ascariasis.
Adult A.lumbricoides and A.suum live in the small intestine. A female A.lumbricoides can produce up to 200,000 eggs a day, though the number of eggs produced per female worm is lower when there are large number of worms present in the gut, a phenomenon called density dependent fecundity. When an egg is passed into the environment it develops into a third stage larva in about 10 days, the rate depending on the temperature and relative humidity. This typically takes place on the soil, which is why A.lumbricoides is classified with Trichuris trichiura and the hookworms Necator americanus and Ancylostoma duodenale as soil-transmitted helminths. It is estimated that some 1.2 billion people are infected with A.lumbricoides.
Infections with A.lumbricoides occur by the accidental ingestion of mature, embryonated eggs, typically in food or on fingers. The egg hatches in the intestine, penetrates the mucosa and passes via the portal blood vessels to the lungs. There the larva breaks out into the alveoli and is coughed up and swallowed. If large numbers of larvae are present this can cause verminous pneumonia. The larvae then pass though the stomach again and grow to become adult worms in the small intestine. A female A.lumbricoides can grow up to 40 cm long and weigh 9 g. An adult male worm is about half the weight of a female and up to 30 cm long. Large numbers of worms can accumulate in the intestine which can cause intestinal obstruction, or they can migrate into the bile duct or pancreatic duct and cause obstruction there.
The distribution of worms among hosts is typically high aggregated, so that the majority of people have light infections while a small proportion have moderate to heavy infections. The distribution of A.lumbicoides and many other intestinal helminths is empirically best described by the negative binomial distribution. The heaviest infections with A.lumbricoides are typically found among children of school-age (5 - 14 years).
Infections with A.lumbricoides are easily treated with a number of anthelmintic drugs:
- pyrantel pamoate given as a single dose of 10 mg/kg;
- levamisole given as a single dose of 2.5 mg/kg;
- mebendazole given as a single dose of 500 mg;
- albendazole given as a single dose of 400 mg.
See ascariasis for more information.
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