TAENIASIS

Introduction
Taeniasis is an infection with the adult tapeworm
parasite found in beef or pork
Tapeworm infection is caused by eating the raw or
undercooked meat of infected animals
Cattle usually carry Taenia saginata (T. saginata).
Pigs carry Taenia solium (T. solium).
In the human intestine, the young form of the
tapeworm from the infected meat (larva) develops
into the adult tapeworm
 Taenia saginata:
Morphology
The adult is 4-10 m long and has 1000-4000
proglottides. Scoles is pyriform, 1-2 mm in
diameter and has 4 prominent hemispherical
suckers.
They have no rostellum or hooks.
Mature proglottides, about 12 mm broad and
shorter, have irregular alternate lateral genital
pores and
Differ from those of Taenia solium by having twice
as many testes and bilobed ovary.
 Morphology contd.
The gravid proglottides, 16-20 x 5-7 mm are
differentiated from tose of T. solium by the more
numerous lateral branches (15-30) on each side of
the uterus.
The gravid uterus which has no uterine pore
contains 100,000 eggs.
The yellow brown eggs cannot be distinguished
from those of T. solium.
The radially striated embyophore, 30-40 x 20-30
m, surrounds a hexacanth embryo.
 Scolex and Neck

1.5- 2 mm in diameter
Without rostellum and
hooks
Four suckers
( unarmed tapeworm)
 Mature segment (ovary with 2 lobes)

Note : Bilobed ovary

(Carmine stained)
 Gravid segment

India ink technique

Note : More than 15 lateral
uterine branches (one side).
 Cysticercius bovis

Show invaginated scolex

(left) show evaginated
sscolex (right)
The scolex is similar to
that of adult worm in
morphology

Cysticercius bovis
 Cysticercus bovis

Cysticercus bovis
Showing the bladder
and
the scolex
(measly beef)
 Taenia eggs

The eggs of
Taenia saginata
and T. solium
are indistinguishable
morphologically .
Taenia egg

spherical
31 to 43 m
a thick embryophore
an oncosphere inside
an egg shell outside
(usually break away from
the eggs in the feces)
 Gravid segment
( the primary lateral branches of the uterus)
Taenia solium Taenia saginata
The uterus The uterus
has 7 to 13 has 15 to 30
lateral branches lateral branches
on each side on each side
 Habitat
The adult lives in the upper part of the jejunum
Life span is about 25 years.
The proglottides, usually detached singly may force
their way through the anus or be carried out in
stool, and when first passed, are quite active and
assume various shapes.
The proglottid disintegrates releasing the eggs.
Eggs are infective when evacuated, are ingested
from the ground or vegetation by the intermediate
hosts (cattle).
 Life cycle
The egg hatches in the jejunum and penetrates
through the intestinal wall in 10-40 minutes into the
lymphatics or blood vessels
Is carried to the intramuscular connective tissues
where it develops into a mature bladder worm
(cysticercus bovis) in 12-15 weeks
The masseter, hind limbs, and hump of the cow are
the sites of predilection, but the cysticerci may be
found in other muscles and viscera.
 Life cycle
The mature cyst is 5-9 mm, has an opaque
invaginated neck and scolex with four suckers.
It undergoes degeneration and calcification in a
year.
When the living cysticercus is ingested by man, the
scolex evaginates and attaches itself to the mucosa
of the jejunum, and a mature worm develops in 8-
10 weeks.
Usually a single worm is present at a time.
Life cycle
 Epidemiology
Cosmopolitan in beef-eating countries
Man acquires infection by eating raw or
undercooked infected beef.
Cattle are infected from grazing land contaminated
by human faeces, through fertilization with night
soil or through sewage-laden water.
Flooded pastures along rivers are important sources
of bovine cysticercosis
In these pastures, the eggs may remain viable for 8
or more weeks.
 Symptomatology
Adult worm may be asymptomatic
Epigastric pain, abdominal discomfort, nervousness,
vertigo, nausea, vomiting, diarrhoea, or increased
or loss of appetite
Moderate eosinophilia
Appendicitis
Intestinal obstruction due to an entangled mass of
worm
Anal irritation from migrating gravid proglottides.
 Diagnosis
Recovery of gravid proglottides or typical taenid
eggs from faeces or perianal regions
Proglottid has 15-30 lateral uterine branches on
each side of the uterus.
Scolex with four suckers but no rostellum or
hooks.
 Treatment
Praziquantel
Niclosamide (Yomesan
 Control
Removal of sources of infection by treating infected
individuals
Avoid contamination of soil with human faeces:
sanitary disposal of faeces
Inspection of beef for cysticercus bovis
Refrigeration of beef.
Thorough cooking of beef to kill cysticerci
Pickling of beef in 25% salt for 4 days will kill
cysticerci
Health education.
Taenia solium
 Introduction
Commonly known as the pork tapeworm
Man is the only known definitive host for the pork
tapeworm, T. solium with pigs serving as
intermediate host.
The chief significance of this parasite is that humans
are readily infected by the larval cysticerci as well as
the adult worm, giving rise to human cysticercosis
 Morphology:
Smaller than T. Saginata
Scolex with two rows of curved hooklets
Gravid proglottid less motile and has few lateral
uterine branches.
Morphology rostellum
Scolex: 1mm in diameter,
a rostellum sucker

armed with two circles

of hooks.
( armed tapeworm)
four suckers
Neck:
The region for proliferation
Immature segment

note that the

reproductive organs
are just beginning to
differentiate.
(Carmine stained)
Developing reproductive organs
 Mature segments (proglottids)

Hermaphroditic testes,
sperm duct
ovary, uterus, genital
pore, vitellaria (yolk
gland)
excretory canal
Mature segment
 Mature segment ( Ovary with 3 lobes)

a small central lobe

Note: Trilobed ovary

( Carmine stained )
 Gravid segment

Note : Less than 14 lateral

uterine branches (one side)

India ink stained

 Cysticercus cellulosae

Scolex
cyst

The cyst is filled with fluid

 Cysticercus cellulosae

It is soybean-like
in shape,
has a small scolex
invaginated into
the translucent cyst.
(left)

The scolex evaginated

from the cyst (right) Cysticercius cellulosae
Cystcercus cellulosae in muscles of pigs
(measly pork)
 Clinical features
Majority of carriers are unaware of their infection
and it is detected only by screening
Minor abdominal symptoms may occur, as with T.
saginata.
However, carriers carry a substantial risk of
acquiring cysticercosis by faecooral autoinfection
and members of their household are also at
increased risk
 Life cycle

The life cycle of Taenia solium is similar to that of

Taenia saginata, but the intermediate host is pig.
The cysticercus bovis (the beef bladder worm ) nearly
does not parasitize human body
Humans serve as the final hosts only (beef worm
infection)
 Life cycle
The larvae (Cysticercus cellulosea, pork
bladder worm ) localize and develop in pigs
(intermediate host)
The cysticercus cellulosae may also infect
humans causing cystcercosis (humans as
intermediate hosts)
 Diagnosis and treatment
The detection and speciation of Taenia infections
has been discussed above under T. saginata
Treatment is also similar for the two infections, with
praziquantel 10 mg/kg being the drug of choice.
Cysticercosis
 Introduction
Cysticercosis is an infection of humans with the
larval stages of Taenia solium
This infection is caused by ingestion of eggs of a
human tapeworm carrier
Pigs and humans become infected by ingesting
eggs or gravid proglottids
Humans are infected either by ingestion of food
contaminated with feces, or by autoinfection.
 Introduction
In autoinfection, a human infected with adult T.
solium can ingest eggs either through fecal
contamination or, possibly, from proglottids
carried into the stomach by reverse peristalsis
 Life cycle and transmission
Normally man is the DH for T.solium (harbour the
adult worm) and Pork the IH (harbour Cysticercus
cellulosae). Man may accidentally become I.H for
T.solium in:
Auto-infection External, in which eggs in faeces
are directly swallowed by the same person (poor
hygiene) or Internal, when retroperistalisis occur
and gravid segments burst - thousands of eggs in SI.
Heteroinfection - person-to-person infn: ingestion
of eggs in water, vegetables or food (normal
contaminative way).
Life Cycle
 Cysticercosis contd..
The eggs hatch in SI - Cysticercus cellulosae,
penetrate mucosa - blood system - muscles & sub-
cutaneous tissues, & CNS.
Common sites tongue, thoracic cage, eye, brain &
skin forming granulomas (except the eye).
In brain - serious pathology, get S & S of intracranial
space occupying lesion fits, loss of consciousness,
paralysis etc.
 Disease States
Cysticercosis = T. solium larvae in human tissues (eg,
muscle)
Usually asymptomatic
Painless subcutaneous nodules in arms and chest
Neurocysticercosis (NCC) = cysts in the central
nervous system
Most severe manifestation
Cysticercosis
 Cysticercosis:
Disease

Cerebral cysticercosis
 Cysticercosis:
Disease

Cardiac cysticercosis
Ocular cysticercosis
 Pathogenesis of Cysticerci
larva (cysticercal cysts) survive up to 5 years
living larva produce little inflammation
death of larva leads to inflammation and edema
resulting in symptoms
cellular reaction eventually destroys parasite and
leaves a calcified nodule
 Clinical Manifestations
presentation is varieddepends on stage, number,
size and location of cysts
seizures/convulsions most common symptoms
blocked circulation of CSF can lead to intracranial
hypertension or hydrocephalus
occasionally large cysts can mimic tumors
can also cause a variety of mental and motor
changes
 Diagnosis
onset of epileptic seizures
person from endemic area
CT scans and MRI are most
useful
1-2 cm cystic lesions
with or without edema and
inflammation
some serological tests
available
problems with sensitivity and
specificity
Diagnosis
 Treatment
symptomatic treatment (eg, antiepileptic drugs)
spontaneous cures noted especially in children
praziquantel and albendazole kill the cysts faster
limited clinical benefit
administer with corticosteroids (anti-inflammatory)
surgical excision of cysts was previous treatment
 Prevention and Control

Enhanced personal hygiene

Thorough cooking/ freezing of pork to kill
cysticerci
Enhanced environmental sanitation
proper disposal of human feces
Agricultural inspection of pork
Vaccination of pigs?