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Sixth Edition Parasitic Diseases Despommier Griffin Gwadz Hotez Knirsch Parasites Without Borders, Inc. NY Dickson D. Despommier, Daniel O. Griffin, Robert W. Gwadz, Peter J. Hotez, Charles A. Knirsch Life Cycles by Photographs by John Karapelou Dickson D. Despommier and Daniel Griffin Parasitic Diseases Sixth Edition With over 400 illustrations in full color >3,000 references Parasites Without Borders, Inc. NY Dickson D. Despommier, Ph.D. Professor Emeritus of Public Health (Parasitology) and Microbiology, The Joseph L. Mailman School of Public Health, Columbia University in the City of New York 10032 Daniel O. Griffin, M.D., Ph.D. CTropMed® ISTM CTH© Clinical Instructor of Medicine, Department of Medicine- Division of Infectious Diseases, Associate Research Scientist, Department of Biochemistry and Molecular Biophysics, Columbia University Medical Center New York, New York, NY 10032, ProHealth, Plainview, NY 11803. Robert W. Gwadz, Ph.D. Captain USPHS (ret), Visiting Professor, Collegium Medicum, The Jagiellonian University, Krakow, Poland, Fellow of the Hebrew University of Jerusalem, Fellow of the Ain Shams University, Cairo, Egypt, Chevalier of the Nation, Republic of Mali Peter J. Hotez, M.D., Ph.D., FASTMH, FAAP Dean, National School of Tropical Medicine, Professor, Pediatrics and Molecular Virology & Microbiology, Head, Section of Pediatric Tropical Medicine, Baylor College of Medicine, Texas Children’s Hospital Endowed Chair of Tropical Pediatrics, Director, Sabin Vaccine Institute Texas Children’s Hospi- tal Center for Vaccine Development, President, Sabin Vaccine Institute, Baker Institute Fellow in Disease and Pov- erty, Rice University, University Professor, Baylor University, Co-Editor-in-Chief, PLoS Neglected Tropical Diseases, Chair, Technical Advisory Board, END Fund, United States Science Envoy Charles A. Knirsch, M.D., M.P.H. Assistant Clinical Professor, Division of Infectious Diseases, Department of Medicine, College of Physicians and Surgeons, Columbia University in the City of New York, New York, NY 10032; Vice President, Pfizer Vaccines Clinical Research and Development, Pearl River, NY, 10965 A number of the drawings utilized herein are printed with the permission of Karapalou Medical Art, with all rights reserved. 3739 Pendlestone Drive, Columbus, Ohio. 43230. Cover Design: Dickson Despommier and Daniel O. Griffin Toxoplasma( gondii infected cell) Page layout and design: Dickson Despommier and Daniel O. Griffin Library of Congress Cataloguing-in-Publication Data Parasitic Diseases / Dickson D. Despommier, Robert W. Gwadz, Daniel O. Griffin, Peter J. Hotez, Charles A. Knirsch: - 6th edition p. cm. Includes bibliographical references and index. ISBN :978-0-9978400-0-1 (Hardcover) ISBN: 978-0-9978400-1-8 (PDF version) ISBN :978-0-9978400-2-5 (Kindle version) ISBN: 978-0-9978400-3-2 (iBook version) 1. Parasitic diseases Dickson D. Despommier, Robert W. Gwadz, Daniel O. Griffin, Peter J. Hotez, Charles A. Knirsch. IV. Title. Parasitic Diseases . © Printed on paper made of pulp from trees harvested in managed forests. © 2017 Parasites Without Borders; 2005, 2000 Apple Tree Productions; 1995, 1989, 1982, Springer-Verlag, New York, Inc. All rights reserved. This work may not be translated or copied in whole or in part without the written permission of Parasites Without Borders (www.parasiteswithoutborders.com) except for small portions quoted in reviews or aca- demic works. Any other use (electronic information storage, retrieval, or adaptation, computer software, or by similar or dissimilar methodology) is strictly prohibited. Our use of names, trade names, or trade marks in Parasitic Diseases 6th ed., even if they are not identified as such, must not be interpreted to mean that such names, as defined by the Trade Marks and Merchandise Marks Act, may therefore be used by anyone else. Neither the authors nor the publisher accept legal responsibility for any errors or omissions that may be made. The publisher makes no warranty regarding the mate- rial contained herein. Printing by Sentinel Printing, 250 North Highway 10, St. Cloud, MN 65302 We dedicate our 6th edition to President Jimmy Carter and William Campbell. We want to recognize President Carter’s leadership and support for the eradica- tion and elimination of neglected tropical diseases as central to alleviating suffer- ing and improving life for the world’s most disadvantaged populations. We want to recognize William Cambell as one of the people responsible for the miracle drug, ivermectin. For his excellent work, he was awarded the Nobel Prize in Physiology or Medicine in 2015. President Jimmy Carter William Campbell iv Acknowledgements: We acknowledge the contribution of John Karapelou for his elegant life cycle drawings. Thanks to David Scharf for granting us use of his stunning scanning electron micrographs of the very things that attract legions of new medical students to the field of tropical medicine. Thanks to all the course directors of parasitic diseases and parasitology who choose our book as the one to help guide their students through the complexities of life cycles, clinical presen- tations, and biology. We hope that the 6th edition proves even more useful for you and your students in the coming years. Thanks to all the infectious disease experts (Justin Aaron, Sapha Barkati, Craig Boutlis, Mary Burgess, Matthew Cheng, Lucy Cheng, Elise O’Connell, Priya Kodiyanplakkal, Atul Kothari, Michael Libman, Tim McDonald, Juan Carlos Rico, Jordan Rupp, Keyur Vyas, and- Johnnie Yates) who have volunteered their time and expertise to review this textbook prior to its publication. Appreciation to our entomology experts Jonathan Larson and Amy Murillo for many corrections and suggestions in the Arthropod sections. Thank you to all the donors who are making it possible for us to get this book into the hands of those who need it the most. v Preface Remarkable achievements in parasitic disease research, both basic and translational, have occurred over the last ten years, and we have incorporated these into the 6th edition of Parasitic Diseases. We have added over 1,000 new references to document these advances. Innovative work in the laboratory has provided the clinician/research scientist with a much clearer under- standing of the mechanisms of pathogenesis. The number of recently discovered interleukins and their cellular networks has completely re-ordered our comprehension of how parasites and our defense system works to produce protection against infection/reinfection, or in some cases, how it becomes subverted by the offending pathogen to enable it to endure inside us for long periods of time. A plethora of molecular-based diagnostic tests have found their way into the routine of the parasitology diagnostic laboratory, improving the ease at which the offend- ing pathogen can be rapidly identified. Newer drugs, many with less harmful side-effects than the ones they replaced, have come on the market that make controlling parasite populations at the community level possible without the risk of harming the very ones we wish to help. The Human Genome Project was completed in 2003. Now the genomes of a significant number of pathogens have also been determined, and many of the eukaryotic variety are fea- tured in Parasitic Diseases, 6th edition. Furthermore, the genomes of some important arthropod vectors have also been published. Results from these efforts hold great promise for the devel- opment of effective new vaccines, drugs, and control programs based on identifying unique molecular pathways essential to each pathogen in question. These on-going projects serve as a living testament to the perseverance of a small, dedicated band of talented parasitologist/ parasitic disease researchers, whose wish is to help stem the tide regarding the spread of these life-threatening entities. Political will and strong social support have combined to severely limit the spread of some parasites without the use of vaccines or drugs. For example, dracunculosis has been brought under control in all but a few regions of Africa, and the southern cone initiative of South America has resulted in fewer and fewer cases of Chagas Disease. The use of ivermectin has greatly reduced the burden of River Blindness in many countries in West Africa. While there are no new classes of drugs for treating resistant malaria, artemesinin derivatives continue to be effective in reducing the mortality of the world’s most devastating infectious disease wher- ever that chemotherapeutic agent is available. As encouraging and inspiring as these research efforts are, they are rare bright spots on an ever increasingly depressing picture of world health, revealing the lack of control of many species of eukaryotic parasites that significantly detract from our ability to carry out a decent day’s work. For example, worm infections continue to exact their toll on the normal develop- ment of the world’s children, who are forced, simply by where they live, to co-exist with these intestinal helminths. In addition, diarrheal diseases caused by a variety of infectious agents, including Entamoeba histolytica, Giardia lamblia, Cryptosporidium parvum and Cyclospora cayatenensis, round out the list of miseries to be dealt with by all those living in poverty in the less developed world. The seemingly simple employment of basic sanitation, safely sequester- ing feces and urine away from our drinking water and food supply, remains high on the list of things to do in those countries in which these two human
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