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Roundworms (ascaris lumbricoides)
Ascaris lumbricoides is one of the largest and most common parasites found in humans. The adult females of this species can measure up to 18 inches long (males are generally shorter), and it is estimated that 25% of the world's population is infected with this nematode. The adult worms live in the small intestine and eggs are passed in the faeces.
A single female can produce up to 200,000 eggs each day!
About two weeks after passage in the faeces the eggs contain an infective larval or juvenile stage, and humans are infected when they ingest such infective eggs. The eggs hatch in the small intestine, the juvenile penetrates the small intestine and enters the circulatory system, and eventually the juvenile worm enters the lungs.
In the lungs the juvenile worm leaves the circulatory system and enters the air passages of the lungs. The juvenile worm then migrates up the air passages into the pharynx where it is swallowed, and once in the small intestine the juvenile grows into an adult worm.
Why Ascaris undergoes such a migration through the body to only end up where it started is unknown. Such a migration is not unique to Ascaris, as its close relatives undergo a similar migration in the bodies of their hosts.
Adult Female Ascaris Lumbricoides
Ascaris infections in humans can cause significant pathology. The migration of the larvae through the lungs causes the blood vessels of the lungs to haemorrhage, and there is an inflammatory response accompanied by edema.
The resulting accumulation of fluids in the lungs results in "ascaris pneumonia," and this can be fatal. The large size of the adult worms also presents problems, especially if the worms physically block the gastrointestinal tract.
Ascaris is notorious for its reputation to migrate within the small intestine, and when a large worm begins to migrate there is not much that can stop it. Instances have been reported in which Ascaris have migrated into and blocked the bile or pancreatic duct or in which the worms have penetrated the small intestine resulting in acute (and fatal) peritonitis.
Ascaris seems to be especially sensitive to anaesthetics, and numerous cases have been documented where patients in surgical recovery rooms have had worms migrate from the small intestine, through the stomach, and out the patient's nose or mouth.
Infections of Ascaris are diagnosed by finding characteristic eggs in the faeces of the infected host.
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