Ascaris lumbricoides

Ascaris lumbricoides is a large parasitic worm that causes ascariasis in humans. A roundworm of genus Ascaris, it is the most common parasitic worm in humans. An estimated one-sixth of the human population is at some point infected by a roundworm such as A. lumbricoides; people living in tropical and subtropical countries are at greater risk of infection. It has been proposed that Ascaris lumbricoides and Ascaris suum (pig roundworm) are the same species. Ascaris lumbricoides, a roundworm, infects humans via the fecal-oral route. Eggs released by adult females are shed in feces. Unfertilized eggs are often observed in fecal samples but never become infective. Fertilized eggs embryonate and become infectious after 18 days to several weeks in soil, depending on the environmental conditions (optimum: moist, warm, shaded soil). Infection occurs when a human swallows water or food contaminated with embryonated eggs. In the duodenum, a single rhabditiform larva hatches from each of the ingested eggs. The larvae then penetrate the mucosa and submucosa and enter the venules or lymphatic vessels. From there, the larvae then pass through the heart to enter the pulmonary circulation. The larvae then break through the walls of the pulmonary capillaries to enter the alveoli. The juvenile worms then migrate from the alveoli, through the bronchioles and bronchi, and into the trachea. An acute inflammatory reaction can occur if some of the worms get lost during this migration process and accumulate in other organs of the body. Once in the trachea, the worms are coughed up into the pharynx and then swallowed again, after which they pass through the stomach and into the small intestine, where they mature into adult worms. The adult worms begin producing fertilized eggs within 60–65 days of being swallowed; females produce as many as 200,000 eggs per day for 12–18 months. These fertilized eggs become infectious after two weeks in soil; they can persist in soil for 10 years or more. It might seem odd that the worms end up in the same place where they began.