PARASITOLOGY LECTURE 7 – Taenia + Echinococcus - Dr. Ng - half as many testes as T.

saginata
Notes from Lecture - Genital pores on consecutive
USTMED ’07 Sec C – AsM segments
TAENIA SOLIUM (pork tapeworm)

• the pork tapeworm producing taeniasis solium or pork

tapeworm infection

DISTRIBUTION

• Cosmopolitan distribution
o Countries:
 Mexico
 Pakistan
 Latin America
 India
 North China
 USA (rare)
 Manchuria iii. Gravid proglottid
o Associated with eating raw or insufficient - longer than broader
cooked pork - consists:
o common genital pore
DISEASES with muscular sphincter
o gravid uterus with 5 to
• Taeniasis solium - refers to infection of humans with 13 lateral uterine
adult pork tapeworm branches arranged in a
• Human cysticercosis - refers to infection of humans with Dendritic or finger like
larval stage of parasites fashion
• Diseases produced by infection with larval taenia solium
is not uncommon in regions where Taenia solium adult 2. Egg
infection exist • Shape – spherical
• In human cysticercosis: Man becomes the intermediate • Color – pale buff to walnut brown
host. • Measurement – 5 to 10 um in
diameter
MORPHOLOGY
• 2 radially-striated shells
a. Outer shell – thin and
1. Adult worm
rarely seen
b. Inner shell
• Measurement – 2-3 meters
– brown, thick and striated
(exceptionally 8 meters in
length) – embryo or oncosphere with six hooklets
• Composition • Eggs escape from the uterus through the ruptured wall
o Head at the anterior end after the ripe proglottids become
free

3. Larval stage or bladder worm

• also called Cysticercus
cellulosae
• measurement – 5 to 10 mm in
length and 5 mm in diameter
• Consists – dense milky white spot at one where the
invaginated scolex with hooks and suckers are located
Head or scolex
LIFE CYCLE: TAENIA SOLIUM
 globular in shaped with 4 cup-
shaped suckers
 provided with conspicuous, rounded
rostellum armed with double rows of
large and small hooks numbering 22
to 36 and measuring 140 to 200 um
and 100 to 150 um in length.

o Neck (cervical region)

 short measuring 5 to 10 mm in
length (only about one-half as thick
as scolex)

o Proglottids
 Numbers : 800 to 1,000 proglottids
 Composed

i. Immature proglottid - broader than

long
ii. Mature proglottid
- nearly square
- containing full set of functioning
male and female reproductive
organs
- 150 to 200 follicles distributed
throughout the dorsal plane
- uterus – rises from the anterior
face of ootype
- trilobed ovary – situated in the
posterior of the proglottid with
the presence of accessory ovarian
lobe
 - serious, because it may lodge in vital organs like
brain, spinal cord, heart, liver and the eyes
- Symptoms:
a. cellular reactions
b. blood cell infiltration
c. fibrosis
d. necrosis
- cysticercosis in the brain may cause:
a. epilepsy
b. behavioral changes
c. intermittent obstructive hydrocephalus
d. disequilibrium
e. meningoencephalitis
f. failing vision

Cross section of
Cysticercosis Single cysticercus of T. solium
Cysticercus cyst in of Brain (left cerebral cortex)
Human muscle

Life Cycle of Human Cysticercosis

Section of eye with a single Cysticercus of Taenia solium

DIAGNOSIS

1. Demonstration of eggs in stool

a. Direct fecal smear
Human Being Harbor Cysticercus Cellulosae: b. Scotch tape swab
1. Hetero Infection – eggs liberated from disintegrating
gravid proglottides passed by one individual get into the • Taenia spp. Differentiation is not possible through eggs
mouth of another and are swallowed examination
2. External autoinfection – eggs maybe transferred from
anus to mouth or unclean fingertips of an individual who 2. Demonstration of gravid proglottids in the stool
has an intestinal infection with Taeniasis solium 3. Recovery of scolex after antihelminthic therapy
3. Internal autoinfections – gravid proglottids in an
individual harboring the adult Taenia solium may SPECIES DIFFERENTIATION
become detached from the main strobila or regurgitated
into the stomach and then return to duodenal canal T. solium and T. saginata can be made possible thru:
where they disintegrate and liberate ripened eggs
1. scolex:
PATHOLOGY AND CLINICAL MANIFESTATIONS • T. solium – has rostellum armed with spines or hooklets
• T. saginata – no well defined rostellum nor spine
1. Pathology brought about by adult taenia solium in lumen
of the small intestines maybe negligible 2. Segment differentiation
a. Mild transitory intestinal obstruction a. Segments:
b. Vague abdominal pain similar to hunger pain o T. solium – 800-1000 segments
which is due to heavy cysticercosis resulting o T. saginata – 1000-2000 segments
to regurgitation of gravid segments in to the
stomach of patients suffering from taeniasis b. Lateral branches:
solium o T. solium have less than 13 lateral uterine
2. pathology brought about by larval stage (cysticercus branches
cellulosae) o T. saginata have more than 15 lateral uterine
 branches

EPIDEMIOLOGY

1. T. solium infection
- prevalence of infection is directly related to eating
habit of people (raw or insufficient cooked pork)
- Man is the only known definitive host and the pig
appears to be the only intermediate host
Head or Scolex
a. Man become the intermediate host
b. Can be caused by:
o Neck
o ingestion of eggs from contaminated food or
o Proglottids
water
o contamination from dirty fingers  Usual numbers between 1,000 to
2,000 proglottids
o by internal autoinfection when the eggs are
 Extending the small intestine,
carried by reverse peristalsis back to the
sometimes reaching the jejunum
duodenum or stomach
TREATMENT, PREVENTION AND CONTROL  Composed:

1. Treatment i. Immature proglottids

a. Praziquantel
- Dosage: 10 to 20 mg per kg single dose ii. Mature proglottids
- Effect: expel worm in toto - broader than longer
- contain both male and female
b. Niclosamide reproductive organ
c. Paramomycin Disadvantage – causes the proglottids - genital organs same with T. solium
to rupture and releases innumerable - contains twice as many testes as
eggs into the bowel lumen and
increase risk of cysticercosis
T. solium
- Bilobed ovary with absence of an
2. Prevention and control accessory ovarian lobe
o Taeniasis solium
- avoid eating raw or insufficiently cooked
pork
- proper excreta disposal
o Human cysticercosis
- good personal hygiene
- avoidance of drugs which causes
disintegration of gravid segments

TAENIA SAGINATA (Adult Beef Tapeworm)

• infection of man with the adult beef tapeworm

• Mode of transmission: eating raw or insufficiently
cooked beef containing the cysticercus]
• Longest human parasite capable of growing to 7.5 m iii. Gravid or Ripe proglottids
therefore most individuals harbor only one adult worm - narrower and longer
- uterus containing more than 15 to
20 mm arranged in lateral uterine
branches arranged in a tree-like
or dichotomose pattern

• cosmopolitan in distribution 2. Eggs

o Africa • are indistinguishable between species of T. solium and T.
o Mexico saginata
o Argentina • Shape: rount to slightly oval
o Middle Europe • Measurement: 31 to 43 um
o USA • Have thick, striated shell and contain the six-hooked
o Asian-Pacific region embryo (oncosphere)
 Korea • Can remain viable in soil for days to weeks
 Indonesia • Eggs of T. saginata by man do not result in infection
 Philippines
 Thailand 3. Larva (cysticercus bovis)
• man serve only as definitive host and never as • Hexacant (six-hooked) larva hatched from egg, actively
intermediate host therefore cysticercosis due to Taenia penetrates the small intestine and migrates by
saginata does not occur hematogenous route to all organ system
• It thrives in the upper half of the small intestine • Mostly they lodge in the skeletal muscles, where they
encyst in the fascial tissues and develop into
MORPHOLOGY
cysticercus, the stage infective to man
1. Adult worm

• Color: Whitish opaque in color

• Measurement: 5 to 10 meters but may extend up to 25
meters or more
• Composition
o Scolex
 Similar to T. solium except that the
rostellum is not well defined and has
no spines or hooklets
 Serve as an organ of attachment in
the mucosa of small intestines
LIFE CYCLE: TAENIA SAGINATA
SPECIES DIFFERENTIATION

• Each proglottid may contain about 80,000 eggs

• More segments in T. saginata than T. solium (1000 to
2000 segments in T. saginata)
• More lateral uterine branches (15 or more) in T. saginata

DIAGNOSIS

1. demonstration or identification of the proglottids passed

by patients
a. Method: fixing in 10% formaldehyde solution
and the uterine branches injected with India
ink
b. Twelve or more uterine branches are
characteristic of gravid proglottid of Taenia
saginata

2. Demonstration of Eggs in the Perianal skin

o Scotch tape swab
 eggs in the stool can be identified
only as Taenia species because the
eggs of all tapeworms look alike

PATHOGENESIS

• It would appear that it is more dangerous to be infected

with Taenia solium than Taenia saginata because there
seems to be no cysticercosis in man due to T. Saginata
• Is mainly due to its large size which is frequently
responsible for the disturbances in the normal function
of digestive tract
• Absorbed by-product of the worm may also cause
systemic intoxication
• Does not cause obstruction although the large tapeworm
occupies a substantial proportion of the lumen of the
small intestine flexibility and relatively fragile
• There are no host responses against the worm and
therefore no tissue reaction
• Proglottids usually pass from the patient during the
period of sleep and are found in the bedding or clothing,
the following morning
• Patient may pass a large segment of the worm either
during defecation or spontaneously

TREATMENT, PREVENTION AND CONTROL

A. Treatment
• Drug of Choice – Niclosamide
• action: damage to the point of dissolution

B. Prevention and Control

1. protection of cattle from coming in contact with
human excreta
2. Thorough cooking of beef

SUMMARY: COMPARATIVE ANALYSIS OF T. SOLIUM AND T. SAGINATA

ECHINOCOCCUS GRANULOSUS

• Parasite of dog
• Smallest tapeworm (5 mm in length)
• Only the larval form of infection is found in the human
host and causes space occupying lesions known as
hydatid cysts
• Infection is considered serious and might result to
fatalities
• World wide distribution
• Man becomes an accidental intermediate host

DISEASE

• Hydatid disease
• Unilocular echinococcosis
• Echinococcus disease

MORPHOLOGY

1. Adult Tapeworm
• smallest tapeworm parasitizing man
• measurement: 2.5 mm to 9 mm in length
• consisting:
o scolex
 has prominent rostellum with a
double row of 20 to 40 large and
small hooklets and “cup-like”
suckers

o neck
o 3 segments
i. one immature proglottid
ii. one elongated mature proglottid
 narrowest
 consists
• genital pore
• ootype
• ovary
• uterus
• seminal receptacle
• testes
• vagina
• vas deferens
 • vitellaria
• vitelline duct
iii. one long gravid proglottid (terminal)
 broades and longest
 consists of hundreds of infective
eggs
 breaks off and disintegrates in the
large bowel releasing hundreds of
infective eggs that pass out with the
feces

2. Eggs
• has brown radially striated
oncosphere or embryosphere
• cannot be differentiated from
Taenia spp.

3. Larval Stage (oncoshpere)

• Measurement: 20 cm in diameter
• Consisting of an enveloping
membrane with 2 layers
a. Outer laminated milky
opaque non-nucleated
layer
b. Inner nucleated germinal
layer which will give rise
to protoscolex or
protoscoleces
• from this inner membrane arises buds or broad capsule
which
i. may remain attached to the inner
membrane by stalks
ii. may be set free into the fluid of the cystic
cavity
• the free broad capsules or free scolices are referred to
as “hydatid sand”

LIFE CYCLE: ECHINOCOCCUS GRANULOSUS

PATHOGENESIS AND CLINCIAL MANIFESTATIONS

• The pathology produced by the hydatid cyst in the

human body is both mechanical and toxic

A. Mechanical
1. Growing hydatid cyst lodged in the vital organs like
liver, lungs, brain, heart interferes with the
functions of the organs
2. Infection may become fatal due to growing cyst
which can cause obstruction to the organ
o A unilocular cyst located in the bone cells is
called osseous hydatid cyst
B. Toxic
1. Rupture of the cyst may produce allergic or
anaphylactic shock

DIAGNOSIS

• Unilocular cysts are diagnosed only after they grown to a

tremendous size
• Hydatid disease can be diagnosed by:
o X-ray
o Exploratory cyst puncture
o Immunologic tests
1. intradermal test
2. Precipitin test
3. Complement fixation test
4. Hemagglutination test
5. Bentonite latex slide agglutination test
6. Fluorescent antibody test

EPIDEMIOLOGY

• Echinococcus infection is very rare in the Philippines

• 2 cases reported
o Hydatid cyst in the kidney
o Hydatid cyst in the lung
 • Prevalence in countries (sheep and cattle raising
regions)
o Europe
o China
o Japan
o Vietnam
o Canada
o Alaska
o USA

TREATMENT, PREVENTION AND CONTROL

A. Treatment
1. Surgery
o Precaustion – prevent the spilage of the cyst
fluid or hydatid sand into the operative cavity
lead to the development of secondary cyst
2. Albendazole
o Dosage – 400 mg twice daily for 4 weeks
B. Prevention and Control
1. Personal hygiene
2. Prevent dogs from eating carcasses of sheep, cattle
and hogs

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