TAENIASIS

INTRODUCTION
 Taeniasis is a form of tapeworm infection which
is caused by tapeworms of the genus Taenia.
 The worm remains in the intestine until it
reaches a length of a metre or so.
 The two most important human pathogens in the
genus are Taenia solium (the pork tapeworm)
and Taenia saginata (the beef tapeworm).These
are classified as “cyclozoonoses” because they
require more than one vertebrate host species to
complete their developmental cycles.
 Infection is acquired by eating undercooked
contaminated meat and infected pork.
 However, the number of infections resulting
from consumption of food products
contaminated with larvae of these helminthes,
such as vegetables, is also significant.
 Tapeworms have many segments.Each
segments is able to produce eggs.Eggs are
spread individually or in groups and can
passout with stool or anus.
 Adults and children with pork tapeworm can
infeect themselves if they have poor hygiene.
 They can ingest eggs by wiping their hands or
while scretching their anus or surrounding skin.
 Taenia solium tapeworm infections can lead to
cysticercosis, which is a disease that can cause
seizures, so it is important to seek treatment.

 Cysticercosis is a serious disease. Symptoms

may appear from 15 days to many years after
infection. Humans may harbor from one to
several hundred cysticerci, located in various
tissues and organs.
 Adult T.Saginata measures about 5-12m and
may be up to 24m.
 Adult T.Solium measures 2-6m
Epidemiology
WHO estimated that 50 million persons,
predominantly from developing countries, are
infected with taeniasis, and 50,000 people die
of the disease each year.
 The tapeworm that causes taeniasis

(T.saginata ,T.solium,T.asiatica)are found

worldwide.
 Eating raw or undercooked beef or pork is the
primary risk factor for acquiring taeniasis.
Persons who don’t eat raw or undercooked beef
or pork are not likely to get taeniasis.
 Infections with T.saginata occur wherever
contaminated raw beef is eaten ,particularly in
Eastern Europe,Russia,Eastern Africa and
Latin America.
 Taeniasis due to T. saginata is rare in the united
states,except in places where cattle and people
are concentrated and sanitation is poor.
 Tapeworm infections due to T. solium are more
prevalent in under–developed communuties
with poor sanitation and where people eat raw
or undercooked pork.
 Higher rates of illness have been seen in people
in Latin America ,Eastern Europe ,sub-Saharan
Africa , India and Asia.
 Taenia asiatica is limited to Asia and is seen
mostly in the Republic of Korea, China,
Taiwan, Indonesia and Thailand
Distribution in nepal
 The zoonotic pork tapeworm,Taenia solium,is becoming an
increasing problem in Nepal with high prevalences of porcine
cysticercosis and human taeniasis/cysticercosis detected in
epidemiological studies undertaken in different parts of the
country.
 Pig farming and marketing have increased dramatically in the
country in recent years due to increased consumer demand for
pork as the country’s caste system has become relaxed.
 Postmortem surveys of pigs at slaughter establishments in
Kathmandu and Dharan municipality showed 14% (34/250) of
pigs positive for cysticercosis.
 Antemortem detection of T. solium infection of pigs in a Syangja
District community indicated 32% (136/419) of pigs positive by
lingual examination while 24% (48/201) was serologically positive
by Enzyme-linked Immunoelectro Transfer Blot (EITB).
 A human helminthological survey in Syangja District in central
Nepal indicated a very high prevalence of taeniasis, with 43%
positive (77/180), while in Tanahun District 18% were positive
(28/152).
 Taeniasis infection appears directly related to the ethnic groups
surveyed and their food habits, literacy rates, and hygiene and
sanitation.
 The prevalence of taeniasis among the ethnic groups surveyed, ie
Magars,Sarkies,Darai, and Bote, was found to be 50, 28, 10, and
30%, respectively.
 Magar people are known for rearing pigs and eating much more
pork than other ethnic groups, while the Sarkies are the poorest of
the ethnic groups and are known to consume rotting cattle
carcasses.
 In Dharan, the majority of the population belong to Rai, Limbu,
and Magar ethnic groups, and due to their socio-economic and
cultural conditions, consumption of pork is very high.
 Human cysticercosis cases were reviewed on the basis of hospital-
based data. During the past five years, records from Patan
Hospital, Bir Hospital, and Kanti Children’s Hospital reported 62,
4, and 11 cysticercosis cases in Kathmandu, respectively.
 These hospitals had different standards with regard to diagnostic
capacity, reporting, and recording systems.
 Neurocysticercosis cases from Nepal are also being diagnosed and
treated at hospitals and clinics in India.
 This preliminary evidence suggests that taeniasis/cysticercosis is a
serious and growing problem in Nepal, requiring urgent attention.
Prevalaence of human teaniasis in
Tindobate VDC,Syangja District
PLACES NAME TOTAL STOOL NO. OF POSITIVE
SAMPLES SAMPLES(%)
EXAMINED
DANSINGH 59 40(68)
BAJAKOT 63 21(33)
KUSUNDE 58 16(28)
TOTAL 180 77(43)
Prevalence of Taeniasis in Vyash
Municipality,Tanahun District
PLACES NAME TOTAL STOOL NO. OF POSITIVE
SAMPLES SAMPLES(%)
EXAMINED
BAIRENI 27 6(22)
BOTE-TAR 35 13(37)
ATREULI 43 6(14)
DUMSI 47 3(6)
TOTAL 152 28(18)
Taeniasis infection among different ethnic
groups

ETHNIC GROUPS TOTAL SAMPLES NO. OF POSITIVE

EXAMINED SAMPLES(%)
MAGARS 122 61(50)
SARKIES 58 16(28)
DARAI 90 9(10)
BOTE 62 19(31)
Prevalence of porcine cysticercosis in
Kathmandu Metropolitan City and Dharan
Municipality

PLACES NAME TOTAL MEAT NO. OF POSITIVE

SAMPLES TESTED SAMPLES(%)
KATHMANDU DISTRICT
KHICHAPOKHARI 148 22(15)
KOTESHWOR 48 6(12)
SUNSARI DISTRICT
DHARAN 54 6(11)
TOTAL 250 34(14)
Life cycle
 Humans are the only definitive hosts for these
three species.  Eggs are passed with feces.
1) The eggs can survive for days to months in the
environment.Cattle (T. saginata) and pigs (T. solium and T.
asiatica) become infected by ingesting vegetation contaminated
with eggs or gravid proglottids.
2) In the animal's intestine, the oncospheres hatch.
3) After hatching,they invade the intestinal wall and migrate to the
striated 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.
4)  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
5) It then reside in the small intestine.
 The adults produce proglottids which mature, become gravid,
detach from the tapeworm, and migrate to the anus or are passed
in the stool(approx. 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 feces.T. saginata may
produce up to 100,000 and T. solium may produce 50,000 eggs
per proglottid respectively.
Incubation period
 It takes about 5 to 12 weeks for the worm to get
mature into adulthood in the human intestine.

 Usually a single worm present at a

time.However ,multiple worms have been
known to inhabit the human body.They may
survive upto 25 years or more.
Risk factor
 Low socio economic group
 Low education level
 Use of human feces as pig fed and use of sludge
as fertilizer in vegetable crop field
 Unhealthy food habits and preparation of fast
food
 Open field defecation
Symptoms
 The presence of worms in human intestines usually
does not cause major problem.Following symptoms
may appear:
 Anorexia and chronic indigestion
 Diarrhea,constipation,flatulence,weight loss and other
mild stomach symptoms
 Appendicitis also may occur.
 Proglottid may also crawl out of the anus and cause
some discomfort or embarrasment.
 Also patient may have high IgE level in their serum
and a low grade eosinophilia(mostly under 15%).
Complication
 Rarely, worms can cause a blockage in the
intestine.
 If pork tapeworm larvae move out of the
intestine, they can cause local growths and
damage tissues such as the brain, eye, or heart.
This condition is called cysticercosis.
Cysticercosis
 Incubation period is from months to years.
 It does not occur with the taenia saginata in
humans.
 Cysticerci have been recovered from all over the body:

 Neurocysticercosis is the development of T. solium

cysts in the brain.When the larvae are in the
brain,symptoms can result from the actual larval
invasion or the death of the organism.
In either case tissue surrounding the larvae become
stimulated and can cause seizures,behavioural
distrbances ,obstructive hydrocephalus and a host
reaction to dying cysts that is like the symptoms of the
meningitis.Neurocysticercosis is the most frequent
cause of adult onset epilepsy in the world.
 Cysts in the spinal cord can cause gait
disturbances,pain,and myelitis.

 Subcutaneous cysts can produce visible

palpable nodules and calcified cysts.

 Skeletal muscle encystments is usually

asymptomatic but can lead to heavy parasitic
burden with muscular pseudohypertrophy.
 Occular involvement can cause visual
impairment and even blindness.

 Cardiac cysts may cause abnormal

conduction of heart nerves.
Control measures
 For a number of reason flatworms are a matter of great public
health concern.
 The methods usually employed for control are:
a) Cook pork or beef products adequately.(to >140 degrees F for 5
min).
b) Freezing meats to -4 degrees F for 24 hours also kills tapeworm
eggs.
c) Patient with worm infection should be treated immediately and
fecal matter should be disposed cautiously. Chances of
indigestion or autoinfection of egg must be limited.
d) Meat inspection and proper housing and feedings of
pigs.
e) Educate the public to prevent pollution of soil, water
and food with human feces, and washing hands before
and after eating and after defecation.
f) Wash and peel all raw vegetables and fruits before
eating.
g) Adequate sewage treatment and disposal.
Treatment
 Praziquantel and niclosamide are most common
drugs used.
 Praziquantel is given in a single dose of 10mg/kg body
wt.
 Niclosamide is given in a single dose of 4 tablets (2
gms).This drug is given in the morning in the empty
stomach.The tablets must be chewed thoroughly and
swallowed with water.Eating may be resumed after 2
hrs.
 For cystecercosis:

 Albendazole 10-15 mg/kg/day in 2 divided

doses for 7-14 days(longer course may be upto
28 days)
 praziquantel 50 mg/kg/day in three divided
doses for 15 days)
References
 K.Park’s “Textbook Of Preventive And
Social Medicine” 21st edition. Page no.
276-277.

 www.wikipedia/taeniasis.com
Thank you