What is taeniasis? Taeniasis is a tapeworm infection. Two parasites
commonly cause taeniasis are Taenia saginata and Taenia solium.
They require more than one vertebrate host species to complete
their developmental cycles.
What are the causes? Tapeworm infection is acquired by eating raw or
undercooked meat of infected animals. Beef generally carries
Taenia saginata while pork carries Taenia solium. Certain
freshwater fish and salmon may also carry a tapeworm called
Diphyllobothrium latum. The larvae from the infected meat develop
in the human intestine into the adult tapeworm which grows and can
attain lengths greater than 12 feet.
Adults and children with tapeworm (T. solium, pork tapeworm only)
can, if appropriate hygiene is lacking, become self-infected by
ingesting eggs from their tapeworm which were picked up on their
hands while wiping or scratching the anus.
Additionally, these individuals can expose other individuals to T.
solium eggs, usually via food handling. Ingested eggs hatch in the
intestinal tract and the larvae migrate through the tissues, where
they encyst. If the larvae migrate to the brain, they can cause
convulsions or fits and other neurological problems. This
condition is called cysticercosis.
Tapeworms are segmented, and each segment or proglottid is capable
of producing eggs. Eggs are dispersed by individual or groups of
proglottids detaching and passing out with the stool. The groups
of proglottids from the beef tapeworm are capable of movement and
actively crawl out through the anus.
What is the life cycle? Taenia saginata and Taenia solium pass their life
cycles in two hosts. In man, the adult lives in the small
intestines. Humans are the only definitive hosts for Taenia
saginata and Taenia solium. Eggs or gravid proglottids are passed
with faeces, the eggs can survive for days to months in the
environment. Cattle (T. saginata) and pigs (T. solium) become
infected by ingesting vegetation contaminated with eggs or gravid
proglottids. In the animal's intestine, they hatch, invade the
intestinal wall, and migrate to the muscles, where they develop
into cysticerci. A cysticercus can survive for several years in
the animal. Humans become infected by ingesting raw or undercooked
infected meat. In the human intestine, the cysticercus develops
over 2 months into an adult tapeworm, which can survive for years.
The adult tapeworms attach to the small intestine by their scolex
and reside in the small intestine. Length of the adult worms is
usually 5 metres or less for T. saginata (however it may reach up
to 25 metres) and 2 to 7 metres for T. solium. The adults produce
proglottids which mature, become gravid, detach from the tapeworm,
and migrate to the anus or are passed in the stool (approximately
6 per day). T. saginata adults usually have 1,000 to 2,000
proglottids, while T. solium adults have an average of 1,000
proglottids. The eggs contained in the gravid proglottids are
released after the proglottids are passed with the faeces. T.
saginata may produce up to 100,000 and T. solium may produce
50,000 eggs per proglottid respectively.
The adult stages of T.saginata and T.solium may persist for
several years in infected humans. Mixed infections of both the
parasites can occur. Although the lifespan of T. solium is not
known it is suspected to be some years.
What is the incubation period? For the adult tapeworm, it is from 8 to 14 weeks.
What are the symptoms?Tapeworm infestation does not
usually cause any symptoms. Infection is generally recognised when
the infected person passes segments of proglottids in the stool,
especially if the segment is moving. Taenia saginata taeniasis
produces only mild abdominal symptoms. Occasionally, appendicitis
or cholangitis can result from migrating proglottids. Taenia
solium taeniasis is less frequently symptomatic than Taenia
saginata taeniasis. The main symptom is often the passage
(passive) of proglottids. The most important feature of Taenia
solium taeniasis is the risk of development of cysticercosis.
How is the diagnosis made?Microscopic identification of
eggs and proglottids in faeces is diagnostic for taeniasis, but is
not possible during the first 3 months following infection, prior
to development of adult tapeworms. Repeated examination and
concentration techniques will increase the likelihood of detecting
light infections. Nevertheless, speciation of Taenia is impossible
if solely based on microscopic examination of eggs, because all
Taenia species produce eggs that are morphologically identical.
Eggs of Taenia sp. are also indistinguishable from those produced
by cestodes of the genus Echinococcus (tapeworms of dogs and other
canid hosts). Microscopic identification of gravid proglottid
allows species determination.
What is the treatment? Treatment is simple and very effective. Tapeworms are
treated with oral medications, usually in a single dose. The drug
of choice for tapeworm infections is niclosamide. Praziquantel and
albendazole can also be used.
What is the prognosis? Complete eradication of the tapeworm occurs following
treatment.
What are the complications? Self-infection with tapeworm eggs – cysticercosis (T.
solium only), which may cause seizures
Rarely, worms may cause obstruction of the intestine
What is the prevention? The usual methods employed for control are:
Treatment of infected persons
Meat inspection
Health education
Adequate sewage treatment and disposal
Early detection and early treatment of T. solium is essential to
prevent human cysticercosis. Effective drugs are available for
treatment. Adequate cooking of meat destroys the tapeworm larvae
and will prevent infection by tapeworm. Good hygiene and hand
washing after using the toilet will prevent self-infection in a
person already infected with tapeworms. Improvement of living
conditions, especially safe treatment of sewage used for farming
should be aimed at.
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