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Department of Parasitology

Faculty of Medicine

Chulalongkorn University

Bangkok 10330, Thailand.

Tel. 022564387

about us

 Department of Parasitology

         Faculty of Medicine, Chulalongkorn University

 History

                Parasitology was originally a unit of the Department of Pathology until 1967 when the National Education Council recognized its entity and upgraded the unit to “Department of Parasitology” in January 10th, 1967, with Professor Dr. Anond Pradatsuntarasarn as Head of Department.

Head of Department

1967-1980            Prof. Dr. Anond Pradatsundarasar

1981-1984            Assoc. Prof. Dr. Kampol Pechranond

1985-1992            Assoc. Prof. Dr. Phisai Kraivichian

1993-1996            Assoc. Prof. Dr. Medhi Kulkumthorn

1997-2000            Assoc. Prof. Dr. Somchai Jongwutiwes

2001-2004            Assoc. Prof. Surang Nuchprayoon

2005-2008            Prof. Dr. Somchai Jongwutiwes

2009-2012            Assoc. Prof. Dr. Padet Siriyasatien

2013-                     Prof. Dr. Surang Nuchprayoon

Location

                The office of the department moved from Pathology building to Forensic Science building. when “Anandamahidol” building was opened in 1983, the department of Parasitology was located in the sixth floor. The department of Parasitology moved again to the current office on the 18th floor of “Aor Por Ror” building in 2001.

Academic activities

                The Department of Parasitology focused on teaching medical students, graduate students, and medical personnel in important and re-emerging parasitic diseases in the era of globalization. Moreover, the Department provide diagnostic services specialized treatment for patients at the King Chulalongkorn Memorial Hospital as well as consultation to physicians. We serve around 30,000 patients annually. In additional, the department provide community care in association with King Chulalongkorn Memorial Hospital.

                With advancement in immunology, molecular biology, and related sciences, parasitology integrates these technology into its discipline. The department promotes state-of-the art teaching, research, and diagnostic service environment for the faculty of medicine, Chulalongkorn university, and the KCMH hospital.

Courses, Curriculum, and teaching activities

                The department has provided and keep improving courses for the curriculums that the department have the responsibilities in. Historically, the department was solely responsible for “Medical Parasitology” course for Chulalongkorn University medical curriculum from 1971 to 1995. When the medical curriculum has moved toward integration in 1996, the department of parasitology was responsible for organizing a course for “Infection II”. In the revised Chulalongkorn medical curriculum since 2005, the departments parasitology participated in several core courses, including:

                Principle of Medical Microbiology and Parasitology

Clinical Hematology and Systemic Infections

Cardiovascular System II

Respiratory System II

Connective Tissue, Integumentary and Musculoskeletal System

Alimentary System II

Clinical Immunology and Infections in Immunocompromised Hosts

Additionally, the department offers elective courses in M.D. program and some integration courses with other departments. The department was involved mainly with the 3rd year medical students , which varies from 180 to 316 students annually. It also administers a graduate curriculum for Master of Science (M.Sc. in Medical Parasitology) since 1997.

                The department provided elective education in tropical diseases for overseas medical students including USA, UK, Sweden, Japan, Germany, Austria and other countries. Also, Special lectures are constantly provided to medical and pediatric resident and fellow in infectious diseases.

Services

                The Department of Parasitology offers diagnostic laboratory test for parasitic infections for the King Chulalongkorn Memorial Hospital. The quality of laboratory services is accepted as reference laboratory by department of medical sciences. It also provide a out-patient clinic specialized in treatment of parasitic and tropical disease for the KCMH.

Parasitology subspecialty

                The Department has designated sub-specialized units for helminthology, protozoology, entomology, immunology, outpatient services, and laboratory services. Furthermore, two research units was recognized by the Chulalongkorn University; the Filariasis Research Unit , led by Professor Dr. Surang Nuchprayoon and the Molecular Biology of Malaria and Opportunistic Infections research unit, led by Professor Dr. Somchai Jongwutiwes.

Research and Published Articles

                The department conducts research to gain new knowledge related to parasitology including case reports in sporadic and endemic infection, epidemiological studies both with microscopic and molecular level, and advance in diagnostic tests. These discoveries is published in leading journals both domestic and international level. During 2008-2012 the number of published articles is 70 compared to 55 in 2002-2007 and 40 between 1996-2001. The department’s current area of research includes:

- identification of filarial species in humans, mosquitoes, and other reservoirs using molecular methods.

-Applying advanced molecular biology to identify the species in Thai and foreign laborers to contain and control the disease.

-Advance in the treatment of filariasis that increase effectiveness and decrease adverse effects.

-Treatment of Gnathostomiasis.

- Laboratory test of hookworm and Trichuris trichiura.

-Amoeba culture (both free-living and parasitic)

-Molecular diagnosis of Malaria

-Development of diagnosis of Pneumocystis jiroveci from sputum

Many research are considered new discoveries in the national or even worldwide level such as

-First case report of visceral leishmaniasis in Thailand.

-First epidemic of Trichinella psuedospiralis in the World.

-First case of Plasmodium knowlesi patient in Thailand.

-First case of corneal infection from Trachipleistophora anthropopthera in the World.

                The faculty member of the department receive many distinguished awards such as
                                -Assoc. Prof. Dr. Jaturong Putaporntip (Vivax Malaria Research 2005 and Beyond)

                                -Prof. Dr. Somchai Jongwutiwes for Distinctive research unit in medical science

 

Scabies

General Knowledge

Scabies

Chulalongkorn University

“Scabies” is an infectious skin disease which is common among children in urban communities. In some countries, scabies is significant health problem that its prevalence may be up to 300 million worldwide. Its manifestation is recorded as old as 2,500 years ago. In 1687 it is discovered that scabies is caused by a species of insect by Gio van Cosimo Bonomo, and Italian Physician.

 

What cause scabies?

                Scabies is a species of insect which is in the same group as mites scientifically named “Sarcoptes Scabiei”. It’s a human parasite. It is brown and has 4 pairs of legs and very small in size which makes it unseen by naked eye. It lifecycle starts with after being inoculated with an adult female scabies which holds eggs, the insect will find an appropriate habitat and dig the skin to form a burrow then lay eggs there 2-3 eggs a day. This female scabies will continue digging at the rate of 2-3 mm a day to create a serpentine burrow. This digging only involves the epidermis. The eggs laying period lasts around 1-2 months. Eggs are around 0.1-0.15 mm in size and take 3-4 days to develop into adults which are sized 0.25-0.35 mm for a male and 0.30-0.45 mm for a female. The male adult will climb of its hole into the female’s to mate. After mating, the male adult dies and the female will get out of the hole to find another appropriate place to dig the burrow and lay eggs again.

 

                                    

Is it contagious?

 

                Scabies can spread from human to other human by direct contact. Unlike the fleas, scabies can’t jump. If the insect is without its host, it can only live for another 2-3 days unless the environmental temperature is less than 20 degrees Celcius, which makes it lives longer. In normal affected individual, 5-15 unit of scabies are found. However, the immunocompromised may host up to millions of these insects.

And It’s Symptoms?

 

                The infected may present with maculopapular rash, purulent lesions, or lichenification which is caused by scratching. Lesions are shown as curved elevated lesions with lengths of 5-15 mm which is caused by burrow digging which is specific to scabies. The involved areas are usually the warmer ones such as skinny area bridging the fingers and the toes, the folded side of elbows and knees, around and below the nipples, waist, palm of hand, sole of foot, groin, and genital skins which larger and more severe lesion(and took slower to heal) occurs. In children, the affected areas can also be face, head and both palm of hand and sole of feet. More importantly, the itching will be more severe especially during the night. The itching is caused by hypersensitivity to the female scabies, its eggs and its feces. Among some infected patients such as the immunocompromised, neurologically disabled, nutritional deficits or cancer patients, the lesion may appear in the whole body and become crusted known as “Norwegian scabies” which is different to normal scabies.

           

Picture of a scabies patient with distince lesion around the wrist(Courtesy of Kenneth E. Greer, MD.)

              

The lesion appears to be elevated curved like a short string which is specific to scabies             

             

Rash at the back found in children. Consulting a physician for differential diagnosis is needed.  (Courtesy of Kenneth E. Greer, MD.)

            

      “Norwegian scabies” The lesion is found all over the body in some group of patients. (Courtesy of Kenneth E. Greer, MD.)

What to do if you suspect scabies?

 

If you found above symptoms, consulting a physician is advised for correct diagnosis and treatment. There, the physician will take the history, check at the symptoms and the lesion. In some cases, laboratory examination is needed in order to differential diagnosis with other skin disease such as dermatitis, urticaria and lice infection. When the diagnosis of scabies is confirmed, treatment will be administered. As scabies is an ectoparasite, the treatment with local application of drugs are effective. However, the application of drugs must be done at the whole body with head and face sparing, not only at the lesion. For children age under 3, the facial and neck administration is also needed. However, the drug may be irritable and the sulfur in the drug’s odor is quite strong so facial application in adults should not be done. Oral drugs may be administered in some severe patients such as the elderly, the immunocompromised or the one with thick lesion which the local drugs may not fully function or patients with contraindication to local drugs. However, as the itching is caused by host’s own immune system, the itching may continue to occur 2-4 weeks after the treatment. Patients should follow physicians’ instructions properly for not only their own sake but in order to prevent scabies from infecting others.

How to protect yourself from scabies?

1.       If you’re infected, you have to bring your close ones to the physician’s for treatment at the same time

2.       Eliminate remaining scabies in your environment that can directly contact your skin such as clothes, bed mats, towels by 3 days before treatment. You can do this by washing and filling it with water temperature at least 60 degree Celcius for 20-30 minutes. For objects that can’t be washed, you have to cover it with tightly closed plastic bag for at least 72 hours for the scabies to die. For large objects, vacuums can be used.

 

3.       Avoid direct contact with patients. If needed, use gloves to contact with itchy patients with scabies or unknown cause.

Conclusion

 

Scabies is still a health problem in Thailand. It is an easily contagious disease but easily preventable and treatable as well. Clinically, some patient has delayed diagnosis and treatment because lack of knowledge and understanding of the disease. To prevent this, spreading knowledge to communities is an important solution in decreasing contagibility and disease control.

References

Burkhart, CG. Recent immunologic considerations regarding the itch and treatment of scabies. Dermatology Online Journal; 12(7): 7. 13 Feb. 2009 < http://dermatology.cdlib.org/127/commentary/scabies/burkhart.html>.

Karthikeyan K. Scabies in children. Arch Dis Child Educ Pract 2007; 92: 65-9.

Arlian, L. Biology, Host Relations and Epidemiology of Sarcoptes Scabiei. Ann. Rev. Entomol 1989; 34:139-61. 5 Feb. 2009 <http://arjournals.annualreviews.org/doi/pdf/10.1146/annurev.en.34.010189.001035?cookieSet=1>

Strong M, Johnstone PW. Interventions for treating scabies. Cochrane Database of Syst Rev. 2007; 3: CD000320.

http://emedicine.medscape.com/article/1109204

Photo:     http://www.inderm.go.th/inderm_sai/skin/skin41.html

Courtesy of Kenneth E. Greer, MD.:http://en.wikipedia.org/wiki/Sarcoptes_scabiei

Department of parasite : Faculty of medicine Chulalongkorn memorial hospital.

Capillariasis

Chulalongkorn University

Knowledge Articles

Capillariasis

 

                Capillariasis is a disease caused by Capillaria philippinensis which is a small roundworm which lives in small intestines. It can cause severe chronic diarrhea which may be fatal if not treated in time. The parasite be found in central and northeastern part of Thailand.

                                                                         

                                                     Adult                                                                                         Larva

How it is contagious?

 

                It is infective through consumption of raw freshwater fish. As the larvae enter the human body, they march towards the small intestine and become adults. After that, they lay eggs passed into the feces. If the eggs reach the water and the freshwater fish took it, it hatches and the larva can infect human when eaten.

 

                                                                                          Capillaria philippinensis’ lifecycle

How could you know if you’re infected?

 

                The diagnosis can be done by symptom observation and stool examination which adults, larvae and eggs will be found.

 

Eggs in feces

 

Symptoms

 

                Adults will embodied themselves in the small intestines, causing to lose absorbing functions, results in diarrhea, noisy stomach and abdominal pain. In some patients, these symptoms may occurs 5-10 times a day for a month. The stomach will distend with tenderness, nausea and vomit. Anorexia may occur, causing nutritional deficiency, weakness, compromised immunity and may be fatal.

 

Cachexic patient

 

How to prevent the disease?

 

                Eat well-cooked fish, and pass feces in the place with good sanitation to prevent spreading of parasite’s egg.