University of Louisville ThinkIR: The University of Louisville's Institutional Repository Electronic Theses and Dissertations 5-2012 Parasitic nematodes in humans : exploring the host-parasite dynamic through historical, biological, and public health evaluations of infection. Erin Christine Welsh 1987- University of Louisville Follow this and additional works at: https://ir.library.louisville.edu/etd Recommended Citation Welsh, Erin Christine 1987-, "Parasitic nematodes in humans : exploring the host-parasite dynamic through historical, biological, and public health evaluations of infection." (2012). Electronic Theses and Dissertations. Paper 1546. https://doi.org/10.18297/etd/1546 This Master's Thesis is brought to you for free and open access by ThinkIR: The University of Louisville's Institutional Repository. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of ThinkIR: The University of Louisville's Institutional Repository. This title appears here courtesy of the author, who has retained all other copyrights. For more information, please contact [email protected]. PARASITIC NEMATODES IN HUMANS: EXPLORING THE HOST-PARASITE DYNAMIC THROUGH HISTORICAL, BIOLOGICAL, AND PUBLIC HEALTH EVALUATIONS OF INFECTION By Erin Christine Welsh B.S. University of Kentucky, 2009 A Thesis Submitted to the Faculty of the School of Public Health and Information Sciences of the University of Louisville in Partial Fulfillment of the Requirements for the Degree of Master of Science Department of Epidemiology and Population Health University of Louisville Louisville, KY May 2012 Copyright 2012 by Erin Christine Welsh All rights reserved PARASITIC NEMATODES IN HUMANS: EXPLORING THE HOST-PARASITE DYNAMIC THROUGH HISTORICAL, BIOLOGICAL, AND PUBLIC HEALTH EVALUATIONS OF INFECTION By Erin Christine Welsh B.S. University of Kentucky, 2009 A Thesis Approved on May 1, 2012 by the following Thesis Committee: Elizabeth O’Brien, Thesis Director Paul Ewald Rose Anderson ii ABSTRACT PARASITIC NEMATODES IN HUMANS: EXPLORING THE HOST-PARASITE DYNAMIC THROUGH HISTORICAL, BIOLOGICAL, AND PUBLIC HEALTH EVALUATIONS OF INFECTION Erin Christine Welsh May 1,2012 This thesis investigated infection dynamics of parasitic nematodes at both the population and individual levels by exploring evolutionary and historical aspects of infection as well as how host-parasite interactions influence virulence. In particular, this thesis sought to answer questions of how host populations have influenced the spread of infection and how transmission determines infection virulence, with a final goal of understanding how eradication programs for parasites can be developed or improved with this knowledge. The host-parasite dynamic was explored throughout history, with particular focus on the ways host populations have shaped infection distribution in present, historic, and pre- historic times. Then, data for each nematode was systemically collected and presented for a comprehensive analysis of virulence and transmission mode. It was discovered that microparasitic principles of virulence can be applied limitedly to predict virulence of macroparasitic nematodes, and the relative virulence of each nematode can be explained partially by transmission mode. III TABLE OF CONTENTS PAGE ABSTRACT ....................................................................................................................... iii INTRODUCTION ............................................................................................................... 1 HISTORY OF NEMATODE INFECTIONS ...................................................................... 6 Evidence for Prehistoric & Historic Infection ......................................................... 6 Human Influence on Transmission of Nematodes ................................................. 29 Impact of Nematodes on Human Evolution .......................................................... .39 FACTORS AFFECTING VIRULENCE .......................................................................... .43 Mode of Transmission .......................................................................................... .43 Soil-Borne and Direct-Contact Nematodes .......................................................... .48 Nematodes Transmitted Through Consumption of Contaminated Meat ............... 69 Vector-Borne Nematodes ....................................................................................... 73 Water-Borne Nematodes ........................................................................................ 87 The Role of Transmission in Nematode Virulence: Conc1usions .......................... 91 Within-Host Dynamics of Infection ....................................................................... 97 Implications for Public Health ............................................................................. 10 1 Future Research ................................................................................................... l 06 CONCLUSION ................................................................................................................ 109 REFERENCES ................................................................................................................ 112 IV APPENDEX OF TABLES AND LIFE CYCLE FIGURES ............................................ 130 CURRICULUM VITAE .................................................................................................. 145 v CHAPTER I INTRODUCTION In 1624, John Donne penned the words "No man is an island entire of itself; every man is a piece of the continent, a part of the main." (I). Donne's intent was to express the importance of human relationships; however unintended by the author, the phrase also has meaning for those who study the intricate interactions between man and the many single- and multi-cellular organisms to which he is host. It is estimated that in the human intestinal tract alone there are 10 to 100 trillion resident microbes (2). The presence of these microbes, along with countless others that inhabit the organs, surfaces, and orifices of the human body, may serve to aid their host in digestion or prevent the colonization of the body by pathogenic organisms (2). In return, microbes are provided with a home and energy resources which they use to survive and reproduce. The mutualistic relationship between microbes and their human hosts describes one type on a spectrum of inter­ relationships between two organisms. Ranging from mutualism, in which both organisms benefit from an association, to parasitism, in which one \benefits while the other experiences a reduction in overall health and survival, this spectrum allows for a wide variety of ecological relationships. Close consideration of variation over this spectrum of inter-relationships also has powerful implications for the joint evolution of organisms by means of natural selection and adaptation, and for the dynamic fitness effects that come to bear both on the individual organisms and on the differential qualities shared between them. Eukaryotic cellular life, as an example, is believed to have originated through a series of symbioses in which prokaryotic cells with particular functions were engulfed, acting as organelles as they evolved complete interdependence with the host cell (3). As parasitic associations evolve, parasites acquire adaptations that allow them to effectively exploit their hosts (4). A parasitic relationship will evolve only if the parasite is able to use host resources to survive and reproduce (in or out of the host) without being eliminated by the host's defenses (4). Both prehistoric humans and their ancestors harbored a wide variety of both single- and multi-cellular parasites (5). The presence of these parasites had and continues to have a profound impact on the evolution of man, although the degree and outcome of these effects is variable among parasites and their hosts. Microparasites include VIruses, bacteria, and protozoa while macroparasites include multicellular organisms such as parasitic worms. In addition to differences in size, microparasites and macroparasites tend to produce characteristically different infections. Infections caused by microparasites are often acute in nature, and recovery is usually accompanied by protective immunity in the host, although exceptions to both of these characteristics are common (6). Macroparasites are generally associated with chronic infections that sometimes resolve in partial immunity, though reinfection is frequent (6). The selective pressures exerted upon hosts by these two types of parasites also differ. Although mortality directly due to macroparasites is less common than what is known for the more acute infections of microparasites, macroparasites can still have a significant effect on overall host health and thus, on the evolutionary fitness of their hosts 2 (6). If the burden of macroparasitic infection is high enough to cause disease, host fitness may be reduced directly or indirectly. In humans, such effects can include decreased productivity, lowered intelligence, temporary or permanent disability, poor nutrition, and anemia (7-17). Host fitness can be reduced through morbidity, with effects on host mating success, reproduction, general health, and mortality. The influence that a parasite has on host health is dependent upon a number of variables relating to the host, the parasite, and the environment. Virulence, defined as harmfulness to the host,