I remembered as a child, my mum would de-worm me regularly. I always wondered why she did that. I didn't see any reason for her to give me worm medicine as we call it here. She made sure I was always dewormed, and even if I didn't know about Tapeworms, I would still be taking my deworm medicine because it has become a part of me. That said, let's look at Tapeworms and its infections, signs and symptoms, and Treatment.
Flatworms are worms that are flat as the name implies with no body cavity except their gut. They are of the phylum Platyhelminthes, and they exist in both freeliving and parasitic form. Flatworms include flukes and tapeworms. In this post, we are looking at Tapeworms.
Tapeworms are of the parasitic flatworms that look like a tape, they are hermaphroditic worms of the class Cestoda which infect both humans and animals. Humans get infected by tapeworm through eating undercooked or uncooked meat or from the injestion of contaminated flea from cat or dog. Tapeworms have varying species which such as Hymenolepis nana which is common in the United States, Taenia saginata is common in europe, africa, asia, and south america, other species include Taenia solium (pork tapeworm), Taenia saginata (Beef tapeworm), Diphyllobothrium latum (Fish Tapeworm), Hymenolepis nana (person to person), and Dipylidium caninum* (Flea injestion). Tapeworms are important causes of nutrient deficiencies in human.
A tapeworm is made up of a head which is known as a Scolex, where the tapeworm suckers are attached to, as well as a hook which is attached to the head (scolex),then it has a neck, a segmented body known as Proglottids. The Tapeworm has no gastrointestinal system to help them digest their food, so they require nutrient from their host to live. Patients get infected with cysticeri via ingestion which then develop into a tapeworm, that attaches to the internal lining of the gastrointestinal mucosa where they absorb nutrient through their flat body since they do not have any gastrointestinal system. When the epiglottids are matured, they break off with matured eggs into the stool of the host in other to be injested by another host.
Patients infected with tapeworm might be asymptomatic as they do not show signs and symptoms and this is common in adults, but in children signs and symptoms are evident. Patients who have tapeworm infection experience vague gastrointestinal symptoms. These symptoms includes the passage of proglottids with stool, abdominal pain (colicky or crampy), Nausea, vomiting, Diarrhea, Increase in apetite, weight loss, anal irritation and pruritus, headache, fever, malaise, weakness, irritability, rash (dipylidiasis), and Vitamin B12 deficiency (Diphyllobothrium latum).
Taenia solium or Taenia saginata starts with its eggs and proglottis passed through feaces in the environment, then it is consumed by Pigs or Cattle (T.saginata), in the intermidiate hosts, the Oncosphere hatches, then penetrates the intestinal wall of the pig or the cattle, then they develop into cysticerci in the muscle of the primary host. Human get infected when they ingest uncooked or undercooked pork or beef. When humans ingest Taenia solium which mature in 5 to 12 weeks and then causes Taeniasis, or Cystocercosis (a condition where human digest the egg directly without an intermidiery) and it could become neurocystocercosis.
Diphyllobothrium latum has a different mode of transmission and life cycle from Taenia Specie. It has multiple intermidiate hosts. Eggs through the feaces are disposed into water bodies, and the environment. The Eggs hatches to become Coracidia and are ingested by crustaceans. In the body cavity of the Crustacean, the coracidia become a procercoid larvae. The infected crustacean is ingested by small freshwater fish. The Procercoid Larva becomes the plarocercoid larva in freshwater fish, after which bigger fishes consume the small fishes with the larva. Humans consume uncooked, or undercooked fishes, and the larva grows to become a tapeworm in the small intestine of the human where human suffer from Diphyllobothriasis. It sometimes causes Vitamin B12 deficiency when the tapeworm is long or when it has been for a very long tim as they can stay in humans for over 20 years.
Hymenolepsis nana is another specie of tapeworm that infect human. Humans release embryonated eggs in the feaces which is then injested by insect which then develops to become cysticercoid and then it can be consumed by humans or rodents. They can also ingest their feaces without any intermidiary. Humans with Hymenolepsis nana suffer Hymenolepiasis.
Dipylidium caninum is gotten from dogs or cats as intermidiate hosts, where it is carried with flea larva is carried from the feaces of the pets, and they mature to become an adult flea and sometimes humans can ingest the flea which then becomes an adult tapeworm causing Dipylidiasis.
Diagnosis, Treatment, and Prevention
Clinicians can diagnose tapeworm through stool test for ova and parasites of the tapeworm. Taking different stool samples on different days would help identify tapeworm. Using Cellophane tape swab is another way to diagnose for tapeworm. Looking for the genetics of the tapeworm using Copro-PCR, Copro-AG ELISA will help identify tapewworm, Using MRI, ansd CT scan (Neurocysticercosis).
Treatment for tapeworm would be Antihelminth (Niclosamide, Praziquantel), Albendazole, Antiepileptics (invasive infection). Using Vitamin B12 supplementation for patients who have vitamin B12 deficiency.
Prevention of tapeworm infection would include;
- Hand Hygiene
- Washing of fruits and vegetables before use
- Improved Environmental sanitation and Sewage treatment
- properly cooking of meat
- Flea control in pets
- Flash freezing of fish not consumed immediately.