Definitions
- Taeniasis: porcine or bovine tapeworm infection.
- Cysticercosis: development of pork tapeworm larvae in the human body.
- Fin or cysticerci: larval form of tapeworms.
Symptoms
- Often asymptomatic
- Gastrointestinal symptoms, e.g., loss of appetite, nausea, vomiting, weight loss, rooting sensation around the navel, alternating constipation and diarrhea, abdominal cramps
- Itching in the anal area
- Fatigue and weakness
- Headache
- Dizziness
History
- Incubation period: 4-10 weeks
- After 2-3 months of development, the larvae are infectious
Causes
- Porcine tapeworm (Taenia solium)
Transmission
- Peroral ingestion of worm eggs through contaminated feces (smear infection) contaminated food (eg, consumption of raw or non-frozen pork) or drinking water.
- Problem: uncontrolled spread of human feces, e.g., along trunk roads, railroad embankments, etc.; inadequate sewage treatment (flooding spreads worm eggs or larvae to meadows and pastures).
Contact with infected humans or animals: 1. Development of eggs into larvae in the intestine of the intermediate host (pig) 2. Perforation of the intestinal wall and transmission into the muscles (mainly well perfused muscles) 3. Transmission of the fins through the consumption of contaminated meat to humans (final host) 4. Development of larvae in the human intestine to tapeworm 5. Excretion of tapeworm eggs in feces 6. Ingestion of worm eggs from pigs through contaminated vegetables However, humans can also become directly infected with worm eggs, i.e., they serve as intermediate rather than final hosts. The worm eggs subsequently develop into larvae in humans and are deposited in organs (cysticercosis).
Epidemiology
- Swine tapeworm infections are much less common than those with bovine tapeworm in many countries
- Porcine tapeworm is most common in Central and South America
Complications
- Appendicitis
- Ileus (intestinal obstruction)
- Inflammation of the gall bladder
- Inflammation of the pancreas
- In hematogenous infection: blockage of blood vessels by the parasite embolism.
- In case of deposition of larvae in the organs (cysticercosis): CNS disorders, epilepsy, infestation of the eye (visual disturbances), skin, heart or skeletal muscles (muscle pain).
Deposits in the brain can lead to a life-threatening situation meningoencephalitis
Risk factors
- Consumption of raw meat and vegetables
- Poor hygienic conditions
Diagnosis
Diagnosis is made by detecting proglottids (can move) or eggs in the stool. In the case of cysticercosis, antibody detection is also possible. Differentiation between infection by porcine or bovine tapeworm is made morphologically by microscopic examination The intrinsic motility of proglottids often leads to misdiagnosis, as they are mistakenly regarded as independent worms.
Differential diagnosis
Gastric, intestinal, and biliary tract diseases
Nonpharmacologic therapy
For cysticercosis: surgical removal of cysts.
Drug therapy
Antihelminthics:
- Albendazole (Zentel)
- Mebendazole (Vermox)
- Paromomycin (Humatin)
Prevention
- Pay attention to hygiene
- Cooperation between doctor, veterinarian and farmer
- After gardening or contact with soil wash hands well
- Cook meat well or freeze
- Examine the slaughtered animals for fins
- Worm eggs are resistant to alcohol and other disinfectants and can remain infectious for a very long time.
