Ichthyophthirius multifiliis

The ich protozoan goes through these life stages:

This life cycle is highly dependent on water temperature, and the entire life cycle takes from approximately 7 days at 25 °C (77 °F) to 8 weeks at 6 °C (43 °F).

Marine ich is a similar disease caused by a different ciliate, Cryptocaryon irritans.

Predisposing factors

There is no dormant stage in the lifecycle. However, any factor that reduces immunity, such as changes in water temperature and quality, accelerate an outbreak of Ich in a subclinically infected fish. Ammonia, nitrite or high levels of nitrate in water do not in themselves cause clinical cases of Ich. However, poor water quality stresses fish, which allows an outbreak to spread rapidly and increases mortality rates.

Other abiotic factors can increase both fish and tadpole susceptibility to ich. These factors include decreased temperature, predatory cues (crowding, fighting) and increased levels of UV-B radiation.

Diagnosis

The diagnosis of "ich" can easily be confirmed by microscopic examination of skin and gills. Remove several "white spots" from an infected fish, then mount them on a microscope slide with a few drops of water and cover with glass. The mature parasite is large and dark (due to thick cilia covering the entire cell). It has a horseshoe-shaped nucleus, which is sometimes visible under 100x magnification. The adult parasite moves slowly by tumbling. The immature forms [tomites] are smaller, translucent, and move quickly.

Typical behaviours of clinically infected fish include:

A subclinically infected fish will not show any of these signs. For example, a healthy fish with a newly attached trophozoite will not yet have clinical disease. The trophozoite is not visible to the naked eye until it has fed on the fish and grown to one or two millimetres. A trophozoite attached to the gills is hard to see. A subclinically infected fish may initially only have a single trophozoite.

Skin

Visible ich lesions are usually seen as one or several characteristic white spots on the body or fins of the fish. The white spots are single cells called trophozoites or trophonts, which feed on the tissues of the host and may grow to 1 mm in diameter. A smear should show ciliates if white spot is present.

Eyes

The eye becomes cloudy almost to the point of whiteness and the fish lose vision. The causes behind this disease can vary. An increase in parasites in the aquarium is the most common cause but severe stress, old age, or malnutrition can all lead to this condition. Treating this condition requires an investigation of water quality. When the water quality is suitable, the fish will usually recover by themselves within one to two weeks. Thus, it is advisable to wait for that time to elapse before administering antibiotics.

Gills

Gill infection may cause breathing at the surface and fast respiration. Gill examination may reveal numbers of white spots or wet mount of a gill from a biopsy may reveal the trophozoites. The fishes' breathing can slow, causing them to rest on the sand or gravel.

Treatment

Unfortunately, an efficient prevention of the disease by vaccination is not possible, although several studies identified potential vaccine candidate proteins, i.e. i-antigens, of the parasite. The most effective prevention is quarantining new fish for two weeks and plants for four days in a separate tank. Fish that survive an ich infection may develop at least a partial immunity, which paralyzes trophonts that attempt to infect it.

Any treatment method must take into account the species of fish (some will not tolerate certain medications), how many of the fish are affected, and the size and kind of environment. Temperature affects how quickly the parasites multiply, so increasing the temperature can force them through their life cycle more quickly, allowing treatments to target Ichthyophthirius in its tomont stage. Also, higher temperatures around 86 °F (30 °C) can prevent tomont replication.

If ich is detected before it becomes too serious, a number of different treatments can be applied. The first line of treatment for severe outbreak is usually formalin or malachite green, or a combination of the two. Copper, methylene blue, and baths of potassium permanganate, quinine hydrochloride, and sodium chloride have also been used but do not appear to offer an advantage over the more readily available formalin and malachite green products.

Treatment techniques

Several different aquarium treatments are commercially available to treat ich and similar ailments.

Total fish removal

Tomites, the motile and fish-infecting stage of the ich life cycle, exit from the trophonts that burst from affected fish and fall to the bottom of the tank. Without fish to re-attach to, however, tomites will die within 48 hours of exiting their trophonts. Thus, an effective way to clear a tank from ich is to remove all of the fish for a certain amount of time. At 80 degrees Fahrenheit, ich tomites will die at 2 days in the absence of fish, and just to be absolutely sure, some recommend keeping the tank empty of fish and at 80 degrees for 4 days (96 hours). This solution may be helpful when there are either very few fish in the tank or when tank capacity is too large to easily treat the volume of water.

Heat treatment

Heat treatment can be highly effective, and it can be combined with other treatments. However, it can only be used on fish that can tolerate high water temperatures, and is unsuitable for cold water fish like koi and goldfish, but even in those cases, a higher water temperature will accelerate the life-cycle of the parasite, allowing other treatments to take effect sooner.

Chlorine

For treating koi and goldfish, chlorine, in the form of tapwater, is very effective in removing not only the threadlike parasites, but eventually the persistent cysts. Thread like infestations on fish will disappear overnight, cysts will take a couple of weeks and possibly a couple of water changes to eliminate. Aquarium lighting is used to detect the presence of parasites, as the filament like threads fluoresce at these light frequencies.

Salt

One method of treatment for ich consists of adding aquarium salt until a specific density of 1.002 g/cm³ is achieved, as the parasites are less tolerant of salt than fish. This is not practical in ponds because even a light salt solution of 0.01% (100 mg/L), would require large quantities of salt. Fish can be dipped in a 0.3% (3 g/L) solution for thirty seconds to several minutes, or they can be treated in a prolonged bath at a lower concentration (0.05% = 500 mg/L).

Chemical treatments

Chemical treatments include formalin, malachite green, methylene blue, chelated copper, copper sulfate, potassium permanganate and quinine. There are also a large number of proprietary treatments available for the treatment of white spot, and the related Oodinium (velvet disease). Chemical treatment is only effective against free-swimming juvenile parasites [tomites]. All treatments target the free-living theronts and tomonts, which only survive about two to three days in the absence of a host fish.

Prognosis

When ich is diagnosed early, effective treatment is used, and stresses are minimised, mortality rates can be low. However, if the infection is at an advanced stage, treatment protocols are not followed, and the fish are stressed, higher death rates will occur. When a fish has had ich eradicated, it may develop partial resistance to reinfection.

Partially treated fish may initially harbour low numbers of unseen trophozoites, often in the gills. This subclinical carrier will cause another outbreak weeks later, most likely when stresses occur or uninfected fish are introduced to the aquarium.