Adult worms (1) live in the lumen of the small intestine. A female may produce approximately 200,000 eggs per day, which are passed with the feces (2). Unfertilized eggs may be ingested but are not infective. Fertile eggs embryonate and become infective after 18 days to several weeks (3), depending on the environmental conditions (optimum: moist, warm, shaded soil). After infective eggs are swallowed (4), the larvae hatch (5), invade the intestinal mucosa, and are carried via the portal, then systemic circulation to the lungs . The larvae mature further in the lungs (6) (10 to 14 days), penetrate the alveolar walls, ascend the bronchial tree to the throat, and are swallowed (7). Upon reaching the small intestine, they develop into adult worms (8). Between 2 and 3 months are required from ingestion of the infective eggs to oviposition by the adult female. Adult worms can live 1 to 2 years.

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Ascariasis

Ascariasis is a debilitating human disease caused by the roundworm Ascaris lumbricoides; other species of Ascaris are parasitic in domestic animals (see Nematode). Perhaps as many as one quarter of the world's people are infected, but ascariasis is particularly prevalent in tropical regions and in areas of poor hygiene. more...

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Infection occurs through ingestion of food contaminated with fecal matter containing Ascaris eggs. The larvae hatch, burrow through the intestine, reach the lungs, and finally migrate up the respiratory tract. From there they are then reswallowed and mature in the intestine, growing up to 30 cm (12 in.) in length and anchoring themselves to the intestinal wall.

Infections are usually accompanied by inflammation, fever, and diarrhea, and serious problems may develop if the worms migrate to other parts of the body.

Prevalence

Roughly 1.5 billion individuals are infected with this worm¹. Ascariasis is endemic in the United States including Gulf Coast and Ozark Mountains; in Nigeria and in Southeast Asia. One study indicated that the prevalence of ascariasis in the United States at about 4 million (2%). In a survey of a rural Nova Scotia community, 28.1% of 431 individuals tested were positive for Ascaris, all of them being under age 20, while all 276 tested in metropolitan Halifax were negative².

Deposition of ova (eggs) in sewage hints at the degree of ascariasis incidence. A 1978 study showed about 75% of all sewage sludge samples sampled in United States urban catchments contained Ascaris ova, with rates as high as 5 to 100 eggs per liter. In Frankfort, Indiana, 87.5% of the sludge samples were positive with Ascaris, Toxocara, Trichuris, and hookworm. In Macon, Georgia, one of the 13 soil samples tested positive for Ascaris. Municipal wastewater in Riyadh, Saudi Arabia detected over 100 eggs per liter of wastewater ³ and in Czechoslovakia was as high as 240-1050 eggs per liter ⁴.

Ascariasis sources can often be measured by examining food for ova. In one field study in Marrakech, Morocco, where raw sewage is used to fertilize crop fields, Ascaris eggs were detected at the rate of 0.18 eggs/kg in potatoes, 0.27 eggs/kg in turnip, 4.63 eggs/kg in mint, 0.7 eggs/kg in carrots, and 1.64 eggs/kg in radish⁵. A similar study in the same area showed that 73% of children working on these farms were infected with helminths, particularly Ascaris, probably as a result of exposure to the raw sewage.

Life cycle

First appearance of eggs in stools is 60-70 days. In larval ascariasis, symptoms occur 4-16 days after infection. The final symptoms are gastrointestinal discomfort, colic and vomiting, fever; observation of live worms in stools. Some patients may have pulmonary symptoms or neurological disorders during migration of the larvae. However there are generally few or no symptoms. A bolus of worms may obstruct the intestine; migrating larvae may cause pneumonitis and eosinophilia.

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Aloantibodies ABO in patients with ascariasis
From Revista do Instituto de Medicina Tropical de Sao Paulo, 9/1/00 by de Leon, Patricia Ponce

Immunization in the ABO system may be produced by heteroimmunization (through substances of animal origin or from bacterial origin), or by aloimmunization (pregnancy or transfusions).

Immuneantibodies have many properties, among which we may mention the following: 1) They are generally IgG; 2) They are haemolytic; 3) Their highest degree of activity is reached at 37 'C; 4) They may disappear a few weeks or months after immunization.

With respect to probable associations between blood groups and the presence of parasites, information is contradictory12'4,7. HUNTLEY et al.5 have associated the presence of immune antibodies in the ABO system in children with infection caused by helminths in their mother. We would like to comment on our experience in detecting the presence of immune antibodies of ABO system in children who were infected by Ascaris lumbricoides. Since immune antibodies tend to disappear as the antigenic stimulus decreases, the quantitative determination of this kind of antibodies would allow the evaluation of the treatment efficacy.

Four patients with ABO haemolytic antibodies were selected. Their sera were used within 12 hours after extraction. Sera were titrated at different temperatures (37 'C, 20 deg C and V Q, following the conventional methodology'.

SP is a useful value to compare quantitatively the capability of two or more techniques to detect differences between agglutinations.

Results of the experience are shown on Table 1:

Apparently our results support the association Ascaris lumbricoides infection with the ABO hemolytic disease. The proposed technique is easy to carry out and may be useful in the prognosis and-ontrol of this illness.

REFERENCES

1. AYRES, M.; SALZANO, F.M.; HELENA, M.; FRANCO, LP. & DE SOUZA BARROS, R.M. - The association of blood groups ABH secretion, haptoglobins and hemoglobins with filariasis. Hum. Hered., 26:105-109, 1976.

2. CARME, B.; MAMBOUENI, LP; COPIN, N. & NOIREAU, F. - Clinical and biological study of Loa loa filariasis in Congolese. Amer. J. trop. Med. Hyg., 41: 331-337, 1989. 3. GOUDEMAND, M. & MARSALET, LD. - Elements d'immuno-hematologie. Paris, Flammarion, 1967.

4. GYORKOS, T.W.; SUKUL, N.C. & DASDAL, A. - Filariasis and ABO blood group status: a critical appraisal. Trees, roy. Soc. trop. Med. Hyg., 77: 564-565, 1983.

5. HUNTLEY, C.C.; LYERLY, A.D.; LITTLEJOHN, M.P.; RODRIGUEZ TRIAS, H. & BOWERS JR., G.W. - ABO hemolytic disease in Puerto Rico and North Carolina. Pediatrics, 57: 875883, 1976.

6. MARCEL.LI, A.; FIN LM.; HOMBE, JLC. & RIBAT, L -en Im-totem. P degis, Flammarion, 1991.

7. MORALES, G.A.; PINO, L.A. & CHOURIO LOZANO. G. - FxoepWetWolofs de Ascaris honbos en mm zone endia y su mladin con Im gnqm gangufiwm Act&gi-oA deuL vemz, 45-287-291.1994.

8. VALVERDE DE RASK LPL & RASM J. - Soludnts de baja ftm i6nica en las Im de Coombs pam la detocci6n de andcuopos anti-Rh. Act& bloq. dhL InL-immer, 16. 295-305, 19v

Received: 26 Abril 2000

Accepted: 21 July 2000

Bioq. Patricia PONCE DE LEON

Dra. Juana VALVERDE

Dra. Marfa ZDERO

Departamento de Microbiologia

Facultad de Cs. Bioq. y Farm.

Suipacha 531

2000 Rosario - Argentina.

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