Intestinal helminths of man: the interpretation of egg counts

Of the 39 most common helminth parasites of man listed by Peters & Gilles (1977), 30 may be detected and often diagnosed by finding their eggs or larvae in the faeces of infected people. The preferred habitat of many of these helminths is the alimentary tract itself and the continual flow of material through the food tube provides a simple, passive and reliable means of transport and eventual exit from the host for the reproductive stages of a worm. Helminth eggs are generally less than 150 μm in diameter and although individually comprise a small material investment by the adult worm in the propagation of the species, the chances of infecting a host are so slim (though this may be a teleological inference) that adult worms are often highly fecund: a female Ascaris lumbricoides is estimated to release daily into the intestine approximately 200,000 eggs (WHO, 1967). Yet numbers should not always be equated with great substance or bulk – an equally important determinant of the chances of finding an egg in faeces: assuming a spherical diameter of 60 μm and a specific gravity of 1·2 (Sawitz, 1942) then a female Ascaris is estimated to produce only about 25 mg of eggs each day, which is 0·01% of a moderate daily output of 250 g of faeces.