Taenia

Parasitology Departm ent , Mansoura University

SUBJECT Geography Morphology Size Scolex Segment Mature segment

TAENIA SAGINATA (BEEF TAPEWORM) Cosmopolitan

TAENIA SOLIUM (PORK TAPEWORM) Cosmopolitan (very rare in Islamic countries )

10 meters Quadrate (1-2 mm in diameter) No rostellum/hooks 2000 Testes numerous (300-400) Ovary bilobed Vaginal opening with sphincter Longer than broad , uterus with 15-20 lat branch Segment detach singly (creeping out without defecation) Shape: spheroid Shell: thick radially striated embyrophore Color: yellowish brown Content: hexacanth embryo (oncosphere) Not infective to man Stained with Zeihl -Neelsen stain

5 meters Globular (1 mm in diameter ) Rostellum with 2 rows of large & small hooks 1000 Testes fewer (150) Ovary trilobed No vaginal sphincter Longer than broad, uterus with 9-11 lat branch Segment detach in group of about 5 with stools Similar to T. Saginata but: 1. Infective to man cysticercosis 2. Not stained

Gravid segment

Egg

Life Cycle Habitat Def host Int host Reservoir Infective stage Adult worm lives in small intestine (SI) Man Cattle No C ysticercus bovis: bladder-like structure lined with germinal layer enclosing a cavity containing fluid developed an invaginated scolex with 4 suckers (1 -2 cm) Onchosphere (Hexacanth embryo) Cysticercus bovis in (IH) Adult in (DH) Ingestion of undercooked beef containing viable Cysticercus bovis In intestine, the scolex is evaginated, attaches to mucosa & the worm Develop to maturity in 10 weeks Small intestine Man Pig No C ysticercus cellulosa

Stages Mode Of Infection

Hexacanth embryo Cysticercus cellulosa Consumption of imperfectly cooked pig s meat containing Cysticercus cellulosa In stomach, the cyst wall is digested out of t he pork flesh In SI, the head evaginates & attaches itself via its suckers to the wall of SI Develop into mature adult in 5-12 weeks 1. T. solium: when man ingest C. cellulosa in pigs muscles the adult parasites develop Disease condition similar to T. saginata 2. Cysticercosis: when man ingest eggs of T. solium develops C. cellulosa in extraintestinal tissues

Pathogenicity Clinical Picture

1. Intestinal disturbances: hunger pain, indigestion, abdominal discomfort, diarrhea, constipation 2. Loss of weight & appetit e 3. Intestinal obstruction 4. Segments of T. saginata migrating out of the anus irritation, itching, insomnia & anxiety 1. Search for gravid proglottids in feces (to differentiate T. saginata from T. solium) If not found give a saline purge & the segment is pressed btw 2 slides & examined for the num ber of lat urine branches on each side 2. Zeihl-Neelsen stain: perianal sc raping

Diagnosis

1. Stool examination: reveals gravid segment, rarely eggs 2. Do not take Zeihl -Neelsen stain Eggs cannot be differentiated from T. saginata morpholo gically but they do not take ZN stain

SUBJECT Treatment

T. SAGINATA 1. Niclosamide (Yomesan) Taken in morning on an empty stomach & well chewed The strobila is often evacuated within a few hours, if not purgative is recommended 2. Praziquantel

T. SOLIUM 1. Atebrine Preferable Leads to expulsion of the parasite Causes nausea & vomiting; anti-emetic must be given 1h before usage 2. Niclosamide & Paramomycin should be avoided It disintegrate the worm releasing a large number of eggs in the lumen of SI which will the possibility of cysticercosis (due to internal autoinfection) 3. Praziquantel 1. Similar to T. saginata 2. Prompt treatment of infec ted patients to eliminate the danger of autoinfection 3. Infected persons should not take emetics or nauseating drugs

Prevention & Control

1. Proper sanitary disposal of human feces 2. Proper inspection of beef for cysticerci at slaughter houses 3. Proper cooking of beef products ( -56C) Freezing at -10C for 5-10d 4. Mass treatment of infected patients 5. Health education

Mu h a m m a d Fu a d J a a fa r | 030 3 2012