African Trypanosomiasis CATT
Human african trypanosomiasis, known as “sleeping sickness”, is caused by the parasite Trypanosoma brucei. It is acquired through the feces of an infected tsetse fly and passes into the bloodstream to reach other blood fluids. T.b.gambiense is found in large areas of West and Central Africa. T.b.rhodesiense, on the other hand, causes East African sleeping sickness. The test procedure is an agglutination assay (CATT = Card Agglutination Test for Trypanosomiasis) that detects circulating antibodies against several surface antigens of T. b. gambiense of the infected host by direct agglutination.
American trypanosoma ELISA & Immunoblot
Chagas disease, or American trypanosomiasis, is acquired through contact with the feces of an infected triatomine bug (or “kissing bug”). Infection can also occur from mother-to-baby (congenital), contaminated blood products (transfusions) or an organ transplanted from an infected donor. Chagas disease is endemic throughout Mexico, Central America, and South America where an estimated 8 to 11 million people are infected. Blood smears are limited to the acute phase of infection, however, parasites are barely seen circulating in blood when there is low parasitemia. In the chronic phase, parasites are not found in circulating blood and the diagnosis of chronic Chagas disease in patients without immunosuppression should be performed with serology. The test procedure is an in-house indirect enzyme-linked immunosorbent (ELISA) assay for the detection of antibodies to Trypanosoma cruzi. An immunoblot assay is also available upon request for confirmatory testing.
Amoebiasis is acquired by ingesting cysts of Entamoeba histolytica in contaminated food, drinking water, or soiled hands. It is found throughout the world but is more prevalent in developing countries which lack sanitary facilities. Human infection results in several types of clinical conditions: a) asymptomatic carriers passing cysts whose infections are confined to the lumen of the intestine; b) patients with gastrointestinal symptoms with amoebic invasion of the intestinal mucosa; c) patients with extra-intestinal infection, usually liver abscess. Parasitological diagnosis of infection by stool examination should be performed, and is useful for detecting intestinal infections, but not extra-intestinal infection. Immunodiagnostic methods can provide serologic evidence of amoebic infection. The test procedure is a commercial indirect enzyme-linked immunosorbent assay (ELISA) kit for the detection of antibodies to E. histolytica.
Babesiosis in North America is caused by the protozoan Babesia microti. It is transmited by the bite of infected ticks. Babesiosis can be co-transmitted with Anaplasma phagocytophila and/or Borrelia burgdorferi. Historically, diagnosis is made by the demonstration of characteristic intra-erythrocytic inclusions in thin smear preparations of peripheral blood. The IFA (immunofluorescence assay) test utilizes Babesia microti-infected erythrocytes as a source of characteristics inclusions for specific antibody detection.
Baylis ascaris Immunoblot
Baylis ascaris infection is caused by a roundworm found in raccoons. This roundworm can infect people as well as a variety of other animals, including dogs. Human infections are rare, but can be severe if the parasites invade the eye (ocular larva migrans), organs (visceral larva migrans) or the brain (neural larva migrans). The test procedure is an in-house Immunoblot assay for the detection of antibodies to Baylis ascaris.
Cysticercosis, caused by the larval parasites of Taenia solium, is acquired by ingesting eggs from human feces or cysts from raw or poorly cooked infected pork. It is endemic in Mexico, Central and South America, Africa, India, and China. Patients with neurocysticercosis (when the larvae invades the central nervous system), often have seizures, increased intracranial pressure, and mental disorders. Brain scans (CT and MRI) can be very useful in demonstrating typical patterns of cysticerci but are not definitive diagnostic for single lesions. Parasitological diagnosis of infection requires biopsy of the cyst, often at great risk to the patient. Detection of cysticercosis-specific antibodies can provide useful evidence of infection. The test procedure is an immunoblot assay for the detection of antibodies to cysticercosis.
Echinococcosis (hydatidosis) is the infection caused by cestodes of the genus Echinococcus and is acquired by ingesting eggs passed in the feces of an infected animal. Hydatid cysts often develop in the liver, lung, spleen, and brain. The infection caused by Echinococcus granulosus is referred to as cystic hydatid disease (CHD). It is endemic worldwide and more frequently in rural, grazing areas where dogs ingest organs from infected animals. E. multilocularis is referred to as alveolar hydatid disease (AHD) and occurs in the northern hemisphere, including central Europe and the northern parts of Europe, Asia, and North America. Parasitological diagnosis of infection requires needle biopsy or excision of the cyst to demonstrate scoleces in the hydatid fluid of the cyst. The patient, however, is at great risk of experiencing an anaphylactic reaction when the cyst is breached. Immunodiagnostic methods can provide serologic evidence of echinococcal infection without disturbing the cyst. The test procedure is a commercial indirect enzyme-linked immunosorbent assay (ELISA) kit for the detection of antibodies to Echinococcus species.
Fascioliasis, caused by Fasciola hepatica, is also commonly known as “the common liver fluke” or “the sheep liver fluke”. Fascioliasis is found in regions where sheep or cattle are reared. People usually become infected by eating raw watercress or other water plants contaminated with immature parasite larvae. Parasitological diagnosis involves stool examination under a microscope. However, infected people don’t start passing eggs during the acute phase of the infection. Even during the chronic phase of infection, it can be difficult to find eggs in stool specimen from people who have light infections. Serologic technique includes the detection of Fasciola hepatica-specific antibodies. The test procedure is an in-house indirect enzyme-linked immunosorbent assay for the detection of antibodies to Fasciola hepatica.
Lymphatic filariasis, caused by microscopic, thread-like worms, affects over 120 million people in 80 countries throughout the tropics and sub-tropics of Asia, Africa, the Western Pacific, and parts of the Caribbean and South America. Damages to the lymph system, lymphedema, elephantiasis, or hydrocele may result from infection. Parasitological diagnosis of infection is made by the identification of microfilariae in a blood smear by microscopic examination. Serologic technique include the detection of Filaria-specific antibodies. Patients with active filarial infection have elevated levels of anti-filarial antibodies. The test procedure is an in-house indirect enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies to Brugia malayi. This assay could be used to investigate cutaneous findings (pruritis, nodules), eosinophilia, genitourinary findings (epididymitis, orchitis, hydrocele, chyluria), lumphangitis/lymphadema, and pulmonary infiltrates with eosinophilia syndrome.
There are three different filarial species that can cause lymphatic filariasis in humans. Most of the infections worldwide are caused by Wuchereria bancrofti. Lymphatic filariasis affects over 120 million people in worldwide throughout the tropics and sub-tropics of Asia, Africa, the Western Pacific, and parts of the Caribbean and South America. The infection spreads from person to person by mosquito bites. The adult worm lives in the human lymph vessels, mates, and produces millions of microfilariae in the blood. They grow into adult worms, a process that takes 6 months or more. People with microfilariae can serve as a source of infection to others. This test is a rapid immunochromatographic test (ICT) for the qualitative detection of Wuchereria bancrofti antigen in whole blood, serum or plasma.
Gnathostomiasis is caused by a group of parasitic worms of the genus Gnathostoma. It is predominantly present in Southeast Asia, particularly in Thailand. However, infection in other parts of the world such as Central and South America, and Africa is increasing. Gnathostomiasis is acquired by eating undercooked and raw infected freshwater fish. Three to four weeks after ingestion of the parasite, when the parasite moves under the skin, people may experience swellings under the skin that may be painful, red, or itchy as well as high levels of eosinophils in the blood. The swelling can occur up to around 10 years after infection. The test procedure is an immunoblot assay for the detection of antibodies to Gnathostoma. Test is performed in a laboratory outside of Canada.
Leishmaniasis includes two major diseases, cutaneous leishmaniasis and visceral leishmaniasis, caused by more than 20 different leishmanial species. It is transmitted by the bite of the sandfly. Visceral leishmaniasis, caused by Leishmania donovani or L. infantum, is a severe systemic disease that is usually fatal without treatment. The distribution is worldwide, but 90% of cases occur in India, Bangladesh, Nepal, Sudan, Ethiopia and Brazil. This test is a direct agglutination test (DAT) that detects circulating antibodies against antigens of L. donovani or L. Infantum. Even before the onset of clinical symptoms, the direct agglutination assay is able to detect antibodies present in the blood or serum of the infected host.
Malaria is a parasitic disease caused by pathogenic agents of the genus Plasmodium. According to the World Health Organisation there are over 300 million malaria cases every year. The pathogen is found in many tropical and subtropical regions and can be transported by travellers to regions where it does not normally occur. The disease is mainly caused by P. falciparum, P. vivax, P. ovale, and P. malariae. Plasmodium falciparum, which survives in the blood, can be responsible for life-threatening relapses up to 2 years after the initial illness. The diagnosis of acute malaria is based on clinical symptoms and detection of the parasite in blood. Microscopic identification is the method of choice to demonstrate an active infection. The test procedure is a commercial indirect immunofluorescence assay for the detection of antibodies to Plasmodium falciparum.
Paragonimiasis is caused by a trematode of the genus Paragonimus. The most common specie infecting humans is P. westermani, the oriental lung fluke, which occurs mainly in Asia. P. kellicotti is found in the midwestern and southern United States. The infection is transmitted by eating infected crab or crawfish that is raw, partially cooked, pickled or salted. Paragonimus infection can be serious if the fluke travels to the central nervous system, where it can cause symptoms of meningitis. The infection is usually diagnosed by identification of Paragonimus eggs in sputum but can only be detected 2-3 months after infection. Antibody tests also help differentiate between paragonimiasis and tuberculosis. The test procedure is an immunoblot assay for the detection of antibodies to P. westermani antigen.
Schistosomiasis, caused by parasites of the genus Schistosoma is estimated to infect over 200 million people in Africa, the Middle East, the Far East, and South America. Hepatosplenomegaly, liver disease, or bladder disease may result from Schistosoma infection. Parasitological diagnosis of infection is made by observation of eggs in stool, urine, or biopsy material. Detection of circulating antibodies in serum can also be useful for diagnostic. The test procedure is an in-house indirect enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies to Schistosoma mansoni and S. haematobium.
Strongyloides ELISA & Immunoblot
Symptoms of strongyloidiasis, caused by the parasite Strongyloides stercoralis, may include eosinophilia and diarrhea. Diagnosis and treatment of strongyloidiasis in the chronic intestinal phase are critical for preventing dissemination of the infection, which may prove lethal in immunosuppressed patients. Parasitological diagnosis of infection generally can be made by demonstration of larvae in stool, duodenal fluid, pleural fluid, or sputum. However, parasites may be difficult to find in some patients; detection of Strongyloides stercoralis-specific antibodies in serum may be a useful tool to indicate infection in such individuals. The test procedure is an in-house indirect enzyme-linked immunosorbent (ELISA) assay for the detection of antibodies to Strongyloides stercoralis. An immunoblot assay is also available upon request for confirmatory testing..
Toxocariasis (larva migrans), is caused by the roundworm parasite Toxocara canis, and is acquired by ingestion of soil contaminated with embryonated eggs. Infection does not occur by contact with fresh feces; it takes 2-4 weeks for eggs to become infectious. Children with pica habits, as well as children in a household with a young pup, are at high risk for the disease. Symptoms of infection may include elevated eosinophil counts, fever, myalgias, hepatomegaly, rash, and ocular problems. Parasitological diagnosis of infection by demonstration of larvae in muscle tissue is very difficult so detection of Toxocara-specific antibodies in serum is the acceptable means of confirmation of infection. The test procedure is a commercial indirect enzyme immunoassay (ELISA) kit for the detection of antibodies to Toxocara larvae.
Toxoplasmosis is caused by the parasite Toxoplasma gondii. The main source of infection is from Toxoplasma oocysts that are shed through an infected cat’s feces. Humans become infected by accidentally ingesting anything that has come into contact with Toxoplasma oocysts e.g. while cleaning a cat’s litter box. Toxoplasma can also be transmitted mother-to-child (congenital), whereby a newly infected woman may not show symptoms but there can be severe consequences for the unborn child, such as diseases of the nervous system and eyes. Organ transplant recipients can become infected by receiving an organ from a Toxoplasma-positive donor. The test procedure is an enzyme-linked immunofluorescent assay (ELFA) to detect antibodies against Toxoplasma gondii. It is offered as a CONFIRMATORY TEST ONLY for institutions outside of the province of Quebec. Previous serology results are required..
Trichinosis, caused by the parasite Trichinella spiralis, is acquired by ingestion of undercooked infected meat such as pork, wild game, and sea mammals. Symptoms of infection may include fever, myalgias, periorbital edema, conjunctivitis, vomiting or diarrhea, and elevated eosinophil counts. Parasitological diagnosis of infection by demonstration of larvae in muscle tissue is very difficult so detection of Trichinella-specific antibodies in serum is the acceptable means of confirmation of infection. The test procedure is a commercial indirect enzyme immunoassay (ELISA) kit for the detection of antibodies to Trichinella larvae.
Polymerase Chain Reaction (PCR)
African Trypanosoma PCR
Human african trypanosomiasis, known as “sleeping sickness”, is caused by the parasite Trypanosoma brucei. It is acquired through the feces of an infected tsetse fly and passes into the bloodstream to reach other blood fluids. T.b.gambiense is found in large areas of West and Central Africa. T.b.rhodesiense, on the other hand, causes East African sleeping sickness. Infection occurs in 3 stages. A trypanosomal chancre can develop on the site of inoculation. This is followed by a hemolymphatic stage with symptoms that include fever, lymphadenopathy, and pruritus. In the meningoencephalitic stage, invasion of the central nervous system can cause headaches, somnolence, abnormal behaviour, and loss of consciousness and coma. Parasitological diagnosis of infection requires microscopic examination of chancre fluid, lymph node aspirates, blood, bone marrow, or, in the late stages of infection, cerebrospinal fluid. Polymerase chain reaction (PCR) is used to amplify DNA from T. brucei parasites present in circulating blood or CSF.
American trypanosoma PCR
Chagas disease, or American trypanosomiasis, is acquired through contact with the feces of an infected triatomine bug (or “kissing bug”). Infection can also occur from mother-to-baby (congenital), contaminated blood products (transfusions) or an organ transplanted from an infected donor. Chagas disease is endemic throughout Mexico, Central America, and South America where an estimated 8 to 11 million people are infected. The most common diagnosis of Chagas disease is microscopic examination of blood smears. However, blood smears are limited to the acute phase of infection when parasites are seen circulating in blood. In the chronic phase, parasites are not found in the circulating blood and serologic testing is recommended. Polymerase chain reaction (PCR) is used to amplify T. cruzi-specific DNA in the acute phase of the infection or in re-activation of chronic Chagas disease due to immunosuppression. PCR can also be useful for early detection of T. cruzi in transplant-transmitted recipients of organs from donors with chronic Chagas disease.
Amoebiasis, an infection affecting over 50 million people worldwide is transmitted by ingestion of contaminated water and food. Although amebic infection is caused worldwide, it is highly prevalent in Central and South America, Africa and in the Indian subcontinent. The pathogenic parasite causing this disease, Entamoeba histolytica is hard to distinguish from the non-pathogenic parasite Entamoeba dispar due to their morphological similarity. Thus, diagnosis requires highly sensitive molecular and enzymatic assays than microscopic examination. Polymerase chain reaction (PCR) allows the differentiation between these two species.
Babesiosis is caused by the parasite Babesia microti that infect red blood cells. Babesia microti is spread by the bite of an infected Ixodes scapularis ticks (also called blacklegged ticks or deer ticks). Tickborne transmission is most common in parts of the Northeast and upper Midwest of the United States especially in New England, New York state, New Jersey, Wisconsin, and Minnesota during warm months. Babesia infection can range in severity from asymptomatic to life threatening. Babesiosis can cause a hemolytic anemia, which can lead to jaundice and dark urine. The infection is both treatable and preventable. In symptomatic people, babesiosis is diagnosed by microscopy of red blood cells. It is also diagnosed by polymerase chain reaction (PCR), which has high sensitivity and specificity. Polymerase chain reaction (PCR) is used to amplify DNA from Babesia microti parasites present in blood.
Neurocysticercosis (NC), caused by the cestode parasite Taenia solium, is one of the most common parasitic diseases of the central nervous system (CNS). This disease is a major public health problem in Latin America, Africa, and Asia and has been diagnosed with increasing frequency in the United States. Most NC cases are asymptomatic. However, due to the high prevalence of CNS infection, symptomatic NC is also frequent. Symptomatic NC can range from a clinically mild to a severe, disabling disease, which includes seizures, intracranial hypertension, neurological deficits, and mental changes. Diagnosis is based on CT and magnetic resonance imaging (MRI). PCR, used to amplify DNA from Taenia solium parasites, is useful for the diagnosis of NC cases when imagery techniques are not available or have failed.
Cystic echinococcosis (CE) and alveolar echinococcosis (AE), caused by metacestode stages of Echinococcus granulosus and Echinococcus multilocularis, respectively, belong to the most serious helminth zoonotic diseases of humans. The diagnostic procedure for CE as well as for AE includes clinical, radiological and serological examinations carried out before (surgical) treatment. The definitive diagnosis is usually based on pathological–histological analysis of particularly periodic acid Schiff (PAS-) stained specimen of surgically resected tissues. However, Echinococcus cysts may be parasitologically sterile and contain neither protoscoleces nor rostellar hooklets, so that sometimes the pathologist is not able to differentiate between the two species E. granulosus and E. multilocularis. These strain differentiation is not possible using histological analysis and is only feasible by molecular methods such as PCR.
Leishmaniasis includes two major diseases, cutaneous leishmaniasis and visceral leishmaniasis, caused by more than 20 different leishmanial species. It is transmitted by the bite of sand flies. Cutaneous leishmaniasis, the most common form of the disease, causes skin ulcers. Mucocutaneous leishmaniasis is a rare but severe form affecting the nasal and oral mucosa. Visceral leishmaniasis causes a severe systemic disease that is usually fatal without treatment. The distribution is world-wide, but 90% of visceral leishmaniasis cases occur in India, Bangladesh, Nepal, Sudan, Ethiopia and Brazil, while 90% of cutaneous leishmaniasis cases occur in Afghanistan, Algeria, Iran, Saudi Arabia and Syria (Old World leishmaniasis) as well as Brazil, Colombia, Peru and Bolivia (New World leishmaniasis). Leishmania Pan PCR assay uses polymerase chain reaction to amplify DNA from all species of Leishmania i.e. genus detection. Two additional PCR assays are offered for species differentiation between Old World and New World leishmaniasis.
Malaria is transmitted among humans by the mosquito of the genus Anopheles. It is widespread in tropical and subtropical regions, including parts of the Americas, Asia and Africa. The disease is triggered by various species of the parasite Plasmodium. P. falciparum, P. vivax, P. ovale and P. malariae are of the greatest clinical significance. The most economic and common diagnosis of malaria is microscopic examination of blood smears. However, microscopic diagnosis can often be difficult, in particular with mixed infections, because early trophozoites (“ring form”) of all four species look identical. Polymerase chain reaction (PCR) is accurate in distinguishing between the species.
Toxoplasmosis is a disease caused by the parasite Toxoplasma gondii, the definitive host for which is the felidae (domestic cats and their relatives) family. The disease is usually transmitted through ingestion of food contaminated with cat faeces, undercooked meat, transfusion from mother to fetus or rarely by organ transplantation and blood transfusions. The disease causes mild flu-like symtoms or no symptoms at all in healthy adults. However, it can cause serious illness in immunocompromised patients and pregnant women. Diagnosis commonly involves serological assays, molecular methods like polymerase chain reaction (PCR) and to a lesser extent direct microscopic examination. Polymerase chain reaction (PCR) is used to amplify DNA from T. gondii parasites present in body fluid.
Cryptosporidium Lateral Flow
Cryptosporidiosis is one of the most common waterborne diseases. The main symptom in immunocompetent individuals is a self-limiting short term watery diarrhea with symptoms lasting an average one week. The very young, old and the immunocompromised patients may develop more severe cryptosporidiosis. Infection occurs by the fecal-oral route via water, soil or food that has been contaminated with feces of an infected individual or animal. The test is a single use rapid immunoassay for the qualitative detection of Cryptosporidium parvum antigens in human stool specimens. It is intended for use with patients with gastrointestinal symptoms as an aid in the diagnosis of suspected Cryptosporidium gastrointestinal infections. Results should be considered in conjunction with the clinical evaluation and medical history.
Giardia Lateral Flow
G. lamblia cysts are excreted through the human colon into the environment. They are relatively resistant to chlorination and ozonolysis explaining why it is the most common cause of outbreaks of diarrheal illness due to drinking water. Giardiasis is also one of the leading causes of food and waterborne diarrhea throughout the world. Individuals contract Giardiasis by consuming contaminated food and water containing the Giardia cyst. Some symptoms associated with Giardiasis include but are not limited to diarrhea, malaise, flatulence, foul-smelling greasy stool, and abdominal cramps. Infections can last from several days or several weeks if left untreated. This test is a single use rapid immunoassay for the qualitative detection of Giardia lamblia antigens in human stool specimens. It is intended for use with patients with gastrointestinal symptoms as an aid in the diagnosis of suspected Giardia gastrointestinal infections. Results should be considered in conjunction with the clinical evaluation and medical history.
Leishmaniasis includes two major diseases, cutaneous leishmaniasis and visceral leishmaniasis, caused by more than 20 different leishmanial species. It is transmitted by the bite of sand flies. Cutaneous leishmaniasis, the most common form of the disease, causes skin ulcers. Mucocutaneous leishmaniasis is a rare but severe form affecting the nasal and oral mucosa. In this test, biopsies/lesion scrapings/aspirates are cultured in an in-house growth medium and monitored over the course of 2 weeks for signs of Leishmania parasites. Specimen must be sampled, kept and sent at room temperature.
© 2016 National Reference Centre for Parasitology, All Rights Reserved.
© 2016 National Reference Centre for Parasitology, All Rights Reserved.