PHYLUM ASCHELMINTHES
Transcription
PHYLUM ASCHELMINTHES
Animal Diversity: (Non-Chordates) Phylum: Aschelhelminthes Dr. Promila Madan Associate Professor, Department of Zoology, Maitreyi College, Bapudham Complex, Chankyapuri, New Delhi-110021. 24th September 2007 Contents ASCARIS LUMBRICOIDES Morphology Body wall Digestive System Respiration Excretory System Nervous System Sense Organs Reproductive System Life History Pathogenicity Parasitic Adaptations Phylum Nematoda Classification I. The Class I. Aphasmida: Orders 1. Enoplida, 2. Isolaimida, 3. Monochida, 4. Dorylaimida, 5. Trichocephlida, 6. Mermithida, 7. Muspiceida, 8. Chromadorida and 9. Araeolaimida. II. The class II Scernentea or Phasmida Orders a. Rhabditida, b. c. d. e. f. g. Strongylida, Ascaridida, Spirurida, Camallanida, Diplogasterida, Tylenchida, and h. Aphelenchida. Ancylostoma (hook worm) Wuchereria bancrofti Enterobius vermicularis ASCARIS LUMBRICOIDES Ascaris is a common roundworm found in the small intestine of various vertebrates like chicken, pig, cattle, horse and man. Among the roundworms the genus Ascaris is of the larger size. There can be roughly one thousand to four thousand adult Ascaris in a single man. Ascaris is more common in the children. Morphology Ascaris lumbricoides is an elongated, cylindrical, endoparastic and bisexual worm. It exhibit marked sexual dimorphism. The female measures 20-41 cms and the male 15-31cms (Fig 1). The tail of the female is straight while that of the male is curved like a hook. (Fig 2). They are generally white or yellow in colour. The body is covered by tough and elastic cuticle. The mouth lies at the anterior end of the body surrounded by three lips. (Fig 3). One is drosal in position and the other two are ventro-lateral, so the mouth is triradiate. Ventrally, little behind the mouth is the excretory pore. Ventrally, little before the hind end is anus in female and the cloacal aperture in male. The female has a separate gonopore placed ventrally nearly one-third length from the anterior side. Body wall The body wall is covered by thick tough non-chitinous cuticle resistant to the host’s digestive enzymes but it is permeable to the salts and water. The cuticle is continuous with the cuticular lining of the pharynx foregot and rectum hindgut. The cuticle is not smooth, it has wrinkles or transverse striations. The cuticle is shed four times during the lifetime and is secreted by the, the underlying epidermis secretes cuticle. (Fig 4).Below the cuticle is syncytial epidermis meaning that the epidermis is having many nuclei but no cell membrane i.e. the cells limits are not marked. The epidermis is thickened internally into ridges at four regions, commonly called cords or ridges. The lateral cords are more conspicuous and contain the longitudinal excretory canals along with lateral new card. The dorsal and the ventral thickenings contain the dorsal and the ventral nerve cords respectively. The longitudinal muscles lie in four groups, which is separated by four thickenings of the epidermis. There are no circular muscles present. Each cord has nearly 150 muscles cells.The muscle cell has two distinct portions. An outer and towards the epidermis is the fibrillar portion, which is contractile, and the inner cytoplasmic portion, which has noncontractile supporting fibrils. The cytoplasmic zone is extended into a long narrow process, the muscle tail. The muscle tails of the dorsal side extend dorsally to get inserted into the dorsal epidermal cord. The muscle tails of the ventral side gets inserted into the ventral epidermal cord. Body cavity is the space between the gut and the body wall. As it is not lined by mesodermal epithelium,so it is not a coelom but a pseudocoelom. The body cavity has pesudocoelomic fluid, which distributes the digested food and collects the waste material in it. The pesudocoel has five giant cells the pseudocoelocytes. Their position is fixed in the epidermal cords. (Fig 5). The pesudocoelocytes on the pharynx extend as membrane having delicate fibrous strands covering the internal structures and organ of the pseudocoel. Digestive System The alimentary canal is complete divided into three parts foregut or pharynx, mid gut or the intestine and hindgut or the rectum. (Fig6). The pharynx and the rectum are lined by the cuticle and are ectodermal in origin. The mouth is tri-radiate in shape. In nematodes six lips or labia surround the mouth. However in two Ascaris the mouth is surrounded by only three lips because of the fusion of lips each, one is mid dorsal, the other two are latero ventral in position. The lips have sensory structures on them (to be described later). The pharynx or oesophagus is short, thick walled, having tri-radiate lumen, which is lined by cuticle continuous with the body wall. (Fig7). The wall of the pharynx has radial muscles. Posteriorly pharynx opens into the intestine, which is dorso-ventrally flattened and thin walled as it is made up of a single layer of columnar epithelial cells. The free margin of the cells is produced into microvilli to increase the surface area for absorption. The intestine opens into the rectum, which is flattened dorsally and is lined by cuticle.(Fig8).The hindgut wall has tall columnar cells, and few muscle fibers. In female the rectum opens into a transverse slit the anus but in male it opens out by cloaca aperture because the male reproductive duct also joins the rectum. The food of the Ascaris contains blood and partly or fully digested food of the host. The muscular pharynx sucks the food. Digestion in the intestine is mainly extra cellular, facilitated by proteases, amylase and lipase. Some intracellular digestion also takes place. The digested food is absorbed by the intestinal cells from there it diffuses into the pseudocoelomic fluid, and distributed to the entire body cells. Respiration There are no respiratory structures. The oxygen concentration of the host’s intestine is very low so anaerobic respiration takes place. Ascaris obtains energy by breaking down glycogen into carbon dioxide and fatty acids. Whenever sufficient oxygen is present it goes for aerobic respiration. Excretory System There is no protonephridia. The excretory system consists of two long longitudinal canals, which are connected to each other by the transverse canalicular network below the pharynx. A short terminal duct arises from the transverse canal and opens out as a minute excretory pore on ventral side just behind the lips. The anterior canals are quite short and the posterior longitudinal excretory canals run the entire length and are closed at both the ends. Fig 9 It was earlier thought that the entire excretory system is formed by the cytoplasm of a single giant cell whose nucleus lies on the left side of the transverse canaliculi. A firm membrane lines the entire system; there being no cilia or flagella. With the discovery of two more nuclei in the excretory system it is now believed that the entire excretory system is made up of more than one cell. The entire longitudinal excretory canals are intracellular excavations. The excretory waste material is ammonia and urea and it is pushed forward towards the excretory pore probably by the muscular undulations of the body of the Ascaris. Nervous System Nervous System is very well developed and quite complicated. The nerve cells are fixed in number and position. Around the pharynx is circumpharnygeal nerve ring from which arise the nerves. (Fig10) Associated with the nerve rings are: 1. 2. 3. 4. A Median dorsal ganglion A pair of sub-dorsal ganglia A pair of lateral ganglia each divided into six smaller ganglia A large ventral ganglion Anteriorly the nerve ring gives off eight nerves 1. Six papillary nerves, which innervate sensory papillae of the lips. Two of these nerves are dorso-lateral, two laterals, and two ventro-lateral in position. Each papillary nerve forms small papillary ganglia very near to its origin. 2. The two-amphidial nerves of each side arise from one of the six lateral ganglia and innervate the sensory structure the amphids. Posteriorly the nerve ring gives eight nerve or cords 1. 2. 3. 4. 5. A dorsal nerve cord lying in the dorsal line. Ventral ganglionated nerve cord lying in the ventral line, it is the main nerve cord. A pair of lateral nerve cards A pair of dorsolateral nerve cards A pair of ventrolateral nerve cards Various Transerverse connectives and commissures connect the eight nerves. Sense Organs The sense organs are very simple because Ascaris is an endoparasite. The sensory structures are Papillae, Amphids and the Phasmids. The papillae are of three kinds labial,cervical and genital. The papillae are projections of the cuticle. It is an elongated structure having fine sensory fibers with some expansion below the cuticle, surrounded by supporting cells. The dorsal lip has two double sensory structure the papilla, one on either end. Only one double sensory structure is present on one side of the ventro lateral lip. On the other side of the lip there is a single papilla and an amphid. Each double sensory structure has a labial papilla & a cephalic papilla. First narrow and then widens and ends below the surface of the cuticle. Genital papillae are present only in males. There are fifty pairs of preanal and five pairs of post anal genital papillae (Fig 11). They help during copulation. The papillae are tango receptors. Amphids: Each ventro-lateral lip has small pit just above the labial papillae containing sensory cells. These are called amphids. They are chemoreceptors. Phasmids are a pair of unicellular glands, which open out as a small pit one on each side of the tail behind the anus they are chemoreceptors. (Fig 12) Reproductive System The gonads are thin, long and their walls are made up of single layer of cuboidal cells. It has a central rachis, which is surrounded by large number of amoeboid cells. These are developing gametes. The gonads are telogenic i.e. gametogonia are shed from the proximal part of the gonad from a terminal cell. Sexes are separate and sexual dimorphism is quite evident. The male has a curved tail and female’s tail is straight. Female has a separate anus and a genital opening whereas male has a cloaca and papillae around the cloaca. Male Reproductive System: It consists of testis, vas deferens, seminal vesicle, ejaculatory duct and penial setae confined to the posterior part of the body. The male reproductive system occurs in single set i.e. monorchis. The single testis is long thread like convoluted having central rachis. The posterior part of testis continues as vas deferens, which is thick, short and twisted, (Fig 13) The vas deferens does not have the central rachis. The vas deferens opens into more thicker,straight and muscular seminal vesicle, (Fig14) The seminal vesicle opens into a narrow, short and muscular ejaculatory duct, which opens into posterior part of the rectum to form the cloaca. The wall of the ejaculatory duct has a number of prostate glands whose secretions help in copulation. The cloaca opens out ventrally by a transverse cloacal apertune, little in front of the hind end. Penial Setae: The cloaca evaginates on the dorsal side to form a pair of muscular penial sacs or spicule pouches. The two spicule pouches join together and open into the cloaca. Each penial sac secretes a cuticular spicule having a cytoplasmic core. The spicules sacs have protractor and retractor muscles to protreude and withdraw the spicules from and into the cloacal aperture respectively . The spicules serve to open the female genital pore during copulation to deposit the sperms. Female Reproductive System: Ascaris has a pair of long twisted ovaries lying in the posterior two third of the pseudocoel. Each ovary continues posteriorly into a thicker and twisted oviduct having a lumen. Each oviduct opens into a thicker and muscular uterus. The uterus is, lined by cuticle. The first part of the uterus is called seminal receptacle, which store the sperms after copulation, (Fig 15) It is here that fertilization of eggs takes place. The distal part of the uterus store fertilized eggs. The wall of the uterus has gland cells, which secretes yolk and material for eggshell. The two uteri join together to form the vagina in the anterior third of the body. The vagina is short and a highly muscular tube, which is entirely lined by the cuticle (Fig 16). The vagina opens out mid ventrally as a female genital pore or vulva. Vulva is a transverse slit with lips and is present near about one third of the body length from the anterior side. Life History Mature male and female worms copulate in the small intestine of the host, during copulation the penial setae open the vulva and the motile amoeboid sperms move into the vagina and then to seminal receptacle of the female Ascaris by amoeboid movement . Fertilization takes place in the seminal receptacle where oocytes are also present. The unfertilized egg contains fat and glycogen globules. After fertilization glycogen forms a fertilization membrane around the fertilized egg, which hardens into a chitinous shell, (Fig 17). The fat globules accumulate below the shell and form a lipoid layer. The distal part of the uterus forms thick, heavy protein membrane on the shell. This wavy protein membrane is characteristic of Ascaris eggs. The fertilized eggs are elliptical in shape measuring 60-70u by 40-50u. The uteri of a single female may contain as many as 2,70,00,000 eggs. A female may lay as many as 15,000 to 2,00,000 unsegmented eggs in a day. In the moist soil the eggs can remain alive for several months but dry conditions can kill the eggs. The eggs require a period of incubation before entering the human body. For further development they require a temperature lower than human body. Favorable temperature is 85 degree F (about 30˚c) oxygen and moisture. The cleavage starts in the soil. The cleavage is spiral and determinate. The sixteen-cell stage is like a hollow ball. This is the blastula stage and the inner cavity the blastocoel. Blastula by invagination forms a gastrula. A juvenile develops in 10-14 days. The juvenile has an alimentary canal, a lateral excretory system and a nerve ring. This stage is called rhabditiform larva or rhabditoid (because of its resemblance to a soil nematode called Rhabditis). The larva grows for a week and then moults within the shell to become the second stage juvenile. This is the infectious stage of Ascaris and further development requires high temperature which therefore can occur in the host’s intestine only. Egg containing second stage juvenile enters the body of the host along with contaminated food and water. The egg membranes are dissolved in the intestine and the juveniles are free within few hours. The 0.02 - 0.03mm juvenile bores the intestinal wall and enters the blood vessels (branches of hepatic portal). It moves along with the blood in the body for nearly ten days and vein finally is large enough to damage the pulmonary capillary and reach the alveolar spaces. Here it moults for the second time, and after growing for few days moults for the third time. The fourth stage juvenile takes an upward journey passing through bronchus, trachea and then the pharynx. It remains in the pharynx till it is coughed out through the nostrils or mouth or moves down to enter the oesophagus. It then moves downward and reaches the intestine and measures 2-3 mm long. In the intestine the juvenile moults for the fourth and final time, becomes the adult, and attains sexual maturity. The total period taken for the whole journey in host is about 25 days. Generally it lives in the intestine for 9 –12 months. Pathogenicity: The disease caused by Ascaris is called Ascariasis. Degree of pathogenesis depends upon the number of worms present in the intestine. It causes more harm to the children than adult. Pathogenesis caused by adult Ascaris; 1. Abdominal discomforts like vomiting and colic pains, interferes in protein digestion 2. Absorb host’s digested food resulting in malnutrition and hence shunted growth. 3. Irritation of mucous membrane results in involuntary muscular contractions. Acute infection can cause coma and death 4. Can cause appendicitis and hepatitis. Larva: It may prove to be more harmful than the adult by causing hemorrhages. The circulating juveniles can cause, serious damage to any vital organ like kidney, brain, eye, particularly to lungs, which can result in pneumonia leading to death. Treatment: Use of anti-helminth drugs like mixture of tetrachlorethylene and the oil of chenopoduim is very effective; other drugs are hetrazan, pierazine hydrate dilhiazanine, tetraezole etc. Prevention: An effective sanitary system to dispose off the faeces. Vegetables should be thoroughly washed or boiled before consuming them. Nails should be cut so that no dirt and eggs collect below them. Always wash the hands with soap before eating. Parasitic Adaptations 1. Long and elongated body of the allows to accommodate many Ascaris in the small intestine of the host. 2. The cuticle protects the inner organs, and the antienzymes, counter act the digestive enzymes and toxins of the host. 3. Muscular pharynx helps in the ingestion of the food. 4. The pseudocoelomic fluid helps in the distribution of food to various parts of the body and transfer of waste substances to the excretory canal. 5. Anaerobic respiration enables the worm to service in oxygen free intestinal medium. 6. Production of large number of small sized eggs to continue the race. 7. The capsule protects the juvenile from all unfavorable environmental conditions. 8. Direct infection by the juvenile has higher chances of dispersal. 9. No intermediate host. Mature male and female in the lumen of Man's intestine Copulation Fertilized Eggs Leaves the body of the host Egg Shell covered by albuminous coat Fourth MOULT Young Ascaris Egg Shell with embroyo in open environment Coughing Developme nt of the larva 10-14 days Alimentary canal First stage Rhabditiform larva Upward journey Pharynx First moult within egg shell Non Infective stage Third MOULT after four days Fourth stage larva Through contaminate d food and water Infective stage Second MOULT Third stage larva Second stage Rhabditiform larva Egg Shell in the lumen of the alimentary canal Second stage Rhabditiform larva in the Lumen of Duodenum Pierces the wall of duodenum Lungs larva liberated from the egg shell by the enzymes of the intestine remains for few days, increase in size and bores the wall of the capillary Alveoli of Lung Heart Liver Hepatic portal vein Life Cycle of Ascaris Phylum Nematoda 1. Nematoda is derived from a Greek word nematos meaning thread and eidos meaning form. They are commonly called round worms or thread worms. 2. The body is tapering at both the ends and covered with thick cuticle, which is secreted by the epidermis. The cuticle moults for growth. 3. The epidermis mostly cellular but synctial in some. The epidermis largely disappears as a separate cellular layer. 4. A characteristic feature of the epidermis is enlargement of the cytoplasm into pseudocoel along the mid-dorsal, mid-ventral and lateral lines as longitudinal cords. 5. Nematode inhabits all kinds of habitats that can support life. 6. They are mostly free living but they are economically very important as plants, human and animal parasites. 7. The alimentary canal is complete with mouth and anus. 8. They have cavity between the body wall and the alimentary canal, which is not a coelom but a pseudocoel. 9. They are smooth rounded or flattened pseudocoelomate 10. Triploblastic, bilaterally symmetrical and has an elongated body. 11. Only longitudinal muscles present, circular muscles absent. 12. The number of cells is fixed in the adult. 13. The nervous system consists of a nerve ring having ganglia. From the nerve ring the nerves extend anteriorly and posteriorly. 14. The important sense organs are papillae, amphids and phasmids. 15. The sexes are mostly separate with district sexual dimorphism and males generally smaller than females. Life history usually complicated. Classification The phylum Nematoda is divided into two classes and has many orders. III. The Class I. Aphasmida: (a) Both free living and parasites. (b) They have variable shaped amphids (without pores) behind the lips (c) The free-living worm includes terrestrial, fresh water and almost all marine forms. There are 9 orders belonging to this class. These are 10. Enoplida, 11. Isolaimida, 12. Monochida, 13. Dorylaimida, 14. Trichocephlida, 15. Mermithida, 16. Muspiceida, 17. Chromadorida and 18. Araeolaimida. IV. The class II Scernentea or Phasmida contains nematodes that usually posses pore like amphids in the lateral lips. Mostly parasitic forms and free-living members inhabiting soil. The 8 Orders are 1. 2. 3. 4. 5. 6. 7. 8. Rhabditida, Strongylida, Ascaridida, Spirurida, Camallanida, Diplogasterida, Tylenchida, and Aphelenchida. Some Nematode parasites: Ancylostoma, Wuchereria, Enterobius Ancylostoma (hook worm) Most dangerous endoparasite in man. It is more common in rural areas where people move barefooted. The adult male worm measures 8-11mm and female measures 11-13 mms. The anterior ends of both the sexes are curved dorsally. The posterior end of the female is tapering but that of male is expanded like umbrella called copulatory bursa .The mouth opens into a large buccal cavity lined by the cuticle and is provided with six cutting plates or teeth. The animal holds to the wall of the intestine of the host by the anterior capsule and the chitinous teeth cut holes in the intestinal wall. The worms secrete an anti-coagulant and suck the blood. Even when the worm has shifted to another location the blood keeps on oozing out because of the effect of anti-coagulant. This causes anemia in the host. The life span of the adult worm in the intestine of the man is three to five years. Mode of infection: The infective stage is third stage juvenile or filariform larva present in the soil or contaminated food or water. It penetrates the skin of the host and then enters the lymphatics or small venules. It is then carried to the right side of the heart and circulates along with the blood .The larva on reaching the lung breaks the wall of the alveoli. From the alveolar spaces it ascends to reach the pharynx and during coughing it gets swallowed into the oesophagus and finally reaches the intestine and gets attached to the mucous lining, cut holes and suck the blood. They moult twice to become adult. Pathogenicity: Penetration of the skin by larvae causes tiny irritating sores and inflammation of the skin. Damage is done to the vital organs for example brain, heart, kidney, particularly lungs by the circulating larva. The maximum damage is done by the adult by forming wounds in the walls of the intestine from where the blood keeps on flowing, causing blood stools, severe anemia, lower immunity and the host becomes lethargic. The toxins secreted by the worm causes stomach disorders, pain, diarrhea or constipation. Wuchereria bancrofti Wuchereria bancrofti is also called filarial worm. It is widely spread but mainly found in tropics and sub tropics especially along the seacoast and near big rivers. Generally absent from Europe and North America and Africa. Wuchereria bancrofti is a digenetic parasite completing its life cycle in human beings, the primary host and a blood-sucking mosquito of the genus Culex or Ades, as a secondary host. The worm lives in the blood or lymph vessels or lymph glands where they block the flow of lymph. The adult worms are long and filiform and both ends are tapering. The sexes are separate. The female measures 8 – 10 cm in length and the male measures 2.5– 4 cm in length. Posterior end of the male is curved ventrally and contains two spicules of unequal length. The tail end of the female is narrow, straight and pointed. Copulation takes place when both male and female are present in the same lymph gland. The females are ovo-viviparous i.e. laying eggs with well-developed embryos. The females are much more numerous than males. The juveniles or microfilarae are very small and immature measuring about 0.2 to 0.3 mm long. A delicate cuticular covering covers the microfilariae. The embryos leave the lymph node and enter the main lymphatic channel from there it reaches the blood stream. A transparent sheath covers the microfilariae, which is longer than the larval body. During the day the microflariae are present in the superficial blood vessels, so that they can be sucked along with the blood by their intermediate host e.g. Ades or Culex. They die in the blood if not sucked by the appropriate mosquito within seventy days. Development in mosquito: In the stomach of the mosquito the microfilaria looses its sheath and penetrates the stomach wall. Within a short time it reaches the thoracic muscles. It is here that the parasite undergoes metamorphosis and grows. First it changes into a thick sausage shaped organism, the first stage larva and then to an elongated form, the second stage larva. At last it changes into a long (1.5mm) thin juvenile after two months, which is the infective stage of the microfilariae. It moults twice in ten days to become infective juvenile. By fourteen days several infective larva are coiled up in the probosis sheath of the mosquito to infect man when the mosquito is sucking the blood. The infective juveniles enter the primary host through the skin opening from where the mosquito had sucked the blood. From the blood it reaches the lymph vessels and glands where they develop into adult and mate and then the female realeases microfilariae and the whole cycle is repeated. Pathogenesis: The pathogenic effect caused by the adult Wuchereria is called Wuchereriasis, more commonly filariasis. The incubation period can last for nearly one to one and a half years during which the third stage larva becomes sexually mature. The pathologic effects are due to the adult live worm, as well as the dead worm. The microfilariae present in the blood do not cause any pathological effect. The adult worm and the third stage developing larva can obstruct the lymph vessels preventing the flow of lymph resulting in a inflammatory reaction of the lymphatic system lymphangitis because of which affected body parts swells to enormous size because of oedema called elephantiasis. Periodic attacks of fever are very common because of lymphangitis, small blood vessels may rupture in the dilated lymphatics. Treatment: The treatment has to focus on the three stages of the Wuchereria. 1. Adult worm 2. Microfilariae 3. Infective larvas Arsenal preparations are good for adult stage. Diethylcarbamazine for microfilariae. Paramelamenyl phenyl stibonate (MSb) for infective larva and immature adult worms. Prophylaxis 1. Use mosquito repellant creams on the exposed parts to avoid mosquito bites. 2. Use of mosquito nets 3. Destruction of those habitat where the mosquitoes breed 4. Destruction of mosquitoes 5. To identify the carriers and then treat them using hetrazan. Enterobius vermicularis Commonly known as pinworm. It is one of the most common worm of the man particularly children in all parts of the world. It is a thread like white or cream in color. Sexual dimorphism is very distinct in the pinworm. The female measures 8-13mm in length and the male measures 2-5mm long. The adult lives in the small intestine of man, whereas the gravid females live in the large intestine. The characteristic feature of the pinworm is a pair of cuticular expansion just below the mouth called the cephalic alae. The tail of female is long and pointed, while that of the male is curved. Generally at night the gravid female migrate to the peri-anal region and lays the egg on the skin of the peri-anal region. The movement of the worm causes intense itching. When the infected person scratches the peri-anal region the eggs get attached to the fingers and under the nails. From here the eggs are transferred to the mouth, clothing, bed linen etc. The eggs when reach the mouth enter the alimentary canal and in the duodenum they hatch out as a larva. The larva moults twice and becomes adult, they mate in small intestine and the gravid female again migrates to the peri-anal region. Sometimes the larva hatch out in the peri-anal region and through anus enters the rectum. This is called reintroduction. The life span of the adult worm is 15 –30 days. If no re-infection takes place the infection dies itself within a month. Pathogenicity: The pathogenic effects are collectively called enterobiasis. The movement of the female around the peri-anal region causes intense itching. Scratching may damage the skin around the peri-anal region, which can lead to eczematous condition. The frequency of passing urine (micturition) also increases. Inflammation of the appendix though not very common, can take place. Treatment: Anthelmintics drugs effective for enterobiasis are used to kill the worms for example piperazene salts, thiabendazole and mebendazole. Control: 1. If the infection is heavy a course of specific anthelmintics drug is necessary. 2. To avoid re-infection hands should always be washed properly before eating, nails must be short. 3. In case of heavy infection linen should be washed and changed regularly 4. Treatment of all the people in case of heavy infection.