Taeniasis

Brijesh Singh Yadav

brijeshbioinfo@gmail.com

Disease Type: Bacterial Disease

Common Name: Taeniasis
Causative Agent: T. saginata and T. solium
Disease Discription:
Taeniasis is a tapeworm (cestode) infection acquired by the ingestion of raw or
undercooked meat of infected animals. Although many species exist, two species,
Taenia saginata and Taenia solium, cause pathology in humans. T. saginata is associated
with the ingestion of the worm's larval form found in infected beef while T. solium is
associated with that of infected pork. . saginata is also commonly known as beef
tapeworm. T. solium is similarly referred to as pork tapeworm.

Both species are worldwide in distribution-- approximately 100 million cases of infection
world-wide annually. Approximately 50 million cases of these cases are T. saginata
while the other 50 million are T. solium related. Incidence of infection of T.solium is also
based on other factors such as religious inhibitions on eating pork, inspection of pork
before distribution for human consumption, and high degrees of sanitation which limits
exposure of the intermediate hosts (such as pigs and cattle) to human feces.
 Fig.Pathgen with their host

Type of disease:

T. saginata, T. solium, and D. latum are transmitted to humans by ingestion of beef, pork,
or fish that contains tapeworm cysts. Gastric acids break down these cysts in the stomach,
liberating them to mature. Mature tapeworms fasten to the intestinal wall and produce
ova that are passed in the feces. Transmission of H. nana is direct from person to person
and requires no intermediate host; it completes its life cycle in the intestine.

Causes of Disease:
T. saginata, T. solium, and D. latum are transmitted to humans by ingestion of beef, pork,
or fish that contains tapeworm cysts. Gastric acids break down these cysts in the stomach,
liberating them to mature. Mature tapeworms fasten to the intestinal wall and produce
ova that are passed in the feces. Transmission of H. nana is direct from person to person
and requires no intermediate host; it completes its life cycle in the intestine. (See
Common tapeworm infestations.)

Causative Agent:
Pathogen Name: T. saginata and T. solium
Pathogen Description: Taenia is a genus of tapeworm that includes some important
parasites of livestock. Not all members of the Genus Taenia have an armed scolex (hooks
located in the "head" region), for example, Taenia saginata has an unarmed scolex, while
Taenia solium has an armed scolex.3

Proglottids have central ovary, with a vitellarium (yolk gland) posterior to it. As in all
cyclophyllid cestodes, there is genital pore on the side of the proglottid. Eggs are released
when proglottid deteriorates, and so a uterine pore is unnecessary.

Taxonoimic Classification:

Kingdom: Animalia
Phylum: Platyhelminthes
Class: Cestodes
Order: Cyclophyllidea
Family: Taeniidae
Genus: Taenia
Species: saginata/ solium

Other Pathogenic Sub speices: T. taeniformis

• T. bremneri (Syn. T. confusa)
• T. africanus
• T. multiceps
• T. serialis
• T. glomerulatus

Morphology and toxin production:

T. saginata:
Larvae - Cysticerci are approximately 7.5 - 10mm wide by 4 - 6 mm in length and are are
found in the cow after ingestion of the worm eggs.

Adults - The adult tapeworms have an average length of ~ 5 meters, consisting of

approximately 1000 proglottids, but may grow up to 25 meters in length. Thus the adult
form of T. saginata may be larger than that of T.
solium.
The scolex has four suckers but no hooks,
which is found on Taenia solium. The scolex in
this tapeworm is slightly larger than that of T.
solium, at approximately 2mm in diameter.
Gravid proglottids are shed either in the feces or
leave the anus on their own. When the
proglottids reach the external environment desiccation occurs and the eggs are released
when the proglottid bursts.

T. solium

Egg: spherical, 6-hooked tapeworm larvae with egg shell.

Larvae - These small cysticerci are approximately 6- 18mm wide by 4 - 6mm in length
when found in the muscles or subcutaneous tissues of their intermediate host (generally,
pigs). The cysticerci may however be found in other tissues such as those of the central
nervous system where they may grow much larger, up to several cm in diameter.

Adults - The adult tapeworms have an average length of ~3

meters, but can grow up to 8 meters in length. The worm
contains between 800 and 1000 proglottids. The gravid
proglottids (right) is approximately 12mm long. T. saginata
has 15 to 20 branches on each side, while T. solium has 7 to
13. The scolex (left) in this
tapeworm may be
differentiated from T.
saginata as it is equipped
with a double crown at approx. 30 hooks.

History:
Researchers believe that about 2 million years ago,
African hominids (our early ancestors), who scavenged
for food or preyed on antelope and other bovids, were
exposed to tapeworm colonization. These worms were using hyena and large cats as
definitive hosts and bovids as intermediate hosts. This occurred before the origin of
modern humans and substantially earlier than the domestication of swine and cattle and
the development of agriculture. The conclusion was inferred from an examination of host
and parasites evolutionary histories and from evidence for the rate of molecular evolution
between species of Taenia.

Rather than humans' acquiring Taenia from cattle and pigs, researchers believe man gave
tapeworms to these domestic animals, since the association between Taenia and hominids
was established before the domestication of these food animals. It was not until about
10,000 years ago, with the development of agriculture, that cattle, swine, and companion
carnivores became intermediate hosts. DNA analysis of the worms also suggest that
prehumans acquired these tapeworms before cattle and swine.

Epidemiology:
The area most affected by taeniasis currently is Irian Jaya, Indonesia, the western half of
New Guinea Island. In field surveys conducted in 2000 and 2001, researchers found that
5 (8.6%) of 58 local people and 7 (11%) of 64 local dogs living approximately 1 km from
the local capital city, Wamena, in Jayawijaya District, harbored adult tapeworms and
cysticerci of T. solium. Due to the prevalence of this tapeworm worldwide and increasing
immigration and foreign travel, T. solium will likely continue to emerge as an important
pathogen in the United States.

Disease Host:
In addition to humans, T. Saginata also persists and has a developmental stages in the
cow. T. solium persists and has developmental stages in pigs.

Disease Transmission:
In humans, it is the ingestion of under-cooked beef (T. saginata) or pork (T. solium)
containing the larval cysts.

Intermediate hosts, such as cows and pigs, are infected with the tapeworm when they
come into contact with the worm's eggs located in the feces of infected humans.

Life Cycle
The life cycles of T. saginata and T. solium are very similar. Life cycle differences
include possible autoinfection route in T. solium, and the different intermediate hosts for
each parasite.

Mechanism:
People infected with adult taenia often are asymptomatic. Infected people may become
aware of infection by noticing proglottid segments of the tapeworm in their feces.
Symptoms of infection, if any, are general: nausea, intestinal upset, vague abdominal
symptoms such as hunger pains, diarrhea and/or constipation, or chronic indigestion.
Increased eosinophils may be a sign of infection.

A more severe form of taeniasis, cystercercosis, can occur upon ingestion of T. solium
eggs found in the feces of infected humans. These eggs hatch in the small intestine and
migrate to various tissues of the body and form cysts. T. saginata rarely causes
cystercercosis.

The pathology associated with cystercercosis depends on which organs are infected and
the number of cysticerci. An infection consisting of a few small cysticerci in the liver or
muscles would likely result in no overt pathology and go unnoticed. Those that form in
voluntary muscle tend to be asymptomatic, but may cause myositis, with accompanying
fever and eosinophilia. On the other hand, a few cysticerci, if located in a particularly
"sensitive" area of the body, might result in irreparable damage. For instance, a
cysticercus in the eye might lead to blindness, a cysticercus in the spinal cord could lead
to paralysis, or a cysticercus in the brain (neurocysticercosis) could lead to traumatic
neurological damage or epileptic seizures. For this reason, cysticerci gather more
attention when they occur in the central nervous system or the eye rather than when they
develop in voluntary muscles.

Incubation Period
It takes about 5 to 12 weeks for the worm to mature into adulthood in the human
intestine. Usually only a single worm is present at at time. However, multiple worms
have been known to inhabit the human body. T. solium may survive up to 25 years or
more.

Signs and symptoms of disease:

Diagnosis:
Taenia eggs and proglottids can be identified though microscopic identification.
However, this technique is not possible during the first 3 months following infection,
prior to the development of adult tapeworms. Microscopic examination of eggs does not
distinguish between the two species. Species can be distinguished, however, by
examining proglottids. Also, immunological tests can detect the presence of cysticerci
and improved imaging techniques such as CAT and MRI can be very useful in detecting
cysticerci in various organs.

Treatment:

Tapeworms are treated with medications taken by mouth, usually in a single dose. The
drug of choice for tapeworm infections is niclosamide. Praziquantel and albendazole can
also be used.

Prevention of disease:
The best way to prevent taeniasis is to make sure meat is cooked thoroughly. Freezing to
-5˚C for 4 days, -15˚C for 3 days, or -24˚C for 1 day kills the larvae as well. As with
most cestodes, treatment involves the use of Praziquantel. Niclosamide is also effective.

For T. solium, extra care and hygiene (such as frequent hand washing) must be used to
keep from ingesting eggs and developing cysticerci in the brain. Surgery, praziquantel,
and albendazole can be used to treat cysticerci.
In the U.S., laws have been passed that requires meat inspection for cysticerci prior to
meat being put on the market of human consumption.
Routine serologic surveillance of cystercercosis and
preventing cattle grazing in contaminated areas will help
prevent worm spread. Adequate cooking of meat destroys the
tapeworm larvae and will prevent infection by tapeworm.
Good hygiene and hand washing after using the toilet will
prevent self-infection in a person already infected with
tapeworms in addition to contamination of foodstuffs by
human feces. Proper disposal of feces, to avoid
contamination of food, soil, and water, is important as well.

Geographical Distribution:
T. saginata infection is common in areas of the world where beef is commonly eaten and
human sanitation is poor. It is commonly found throughout South America and in Africa
but is found in North America as well. T. saginata has worldwide distribution, but unlike
T. solium infection with T. saginata is frequently encountered in the United States.

T. solium is more prevalent in poorer communities where humans live in close contact
with pigs and eat undercooked pork, and is very rare in Muslim countries. Infection with
T. solium is rarely encountered in the United States except areas of high immigration
from Mexico, Latin America, the Iberian peninsula, the Slavic countries, Africa, India,
Southeast Asia, and China.

Disease Statistics:
Hospitalization statistics for Taeniasis:

The following are statistics from various sources about hospitalizations and Taeniasis:

• 0% (2) of hospital consultant episodes were for taeniasis in England 2002-

03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
• 100% of caseds of taeniasis required hospital admission in England 2002-
03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
• 0% of hospital consultant episodes for taeniasis were for men in England
2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
• 100% of hospital consultant episodes for taeniasis were for women in
England 2002-03 (Hospital Episode Statistics, Department of Health, England,
2002-03)
• 50% of caseds of taeniasis required emergency hospital admission in
England 2002-03 (Hospital Episode Statistics, Department of Health, England,
2002-03)
• 3.5 days was the mean length of stay in hospitals for taeniasis in England
2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
 • 3 days was the median length of stay in hospitals for taeniasis in England
2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
• 12 was the mean age of patients hospitalised for taeniasis in England
2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
• 0% of hospital consultant episodes for taeniasis occurred in 15-59 year
olds in England 2002-03 (Hospital Episode Statistics, Department of Health,
England, 2002-03)
• 0% of hospital consultant episodes for taeniasis occurred in people over 75
in England 2002-03 (Hospital Episode Statistics, Department of Health, England,
2002-03)
• 0% of hospital consultant episodes for taeniasis were single day episodes
in England 2002-03 (Hospital Episode Statistics, Department of Health, England,
2002-03)
• 0% (7) of hospital bed days were for taeniasis in England 2002-03
(Hospital Episode Statistics, Department of Health, England, 2002-03)

Refrence:
• Markell, Edward, David John, Wojciech Krotoski. Medical Parasitology.
Philadelphia: W.B Saunders, 1999.

• Warren, Kenneth. Immunology and Molecular Biology of Parasitic Infections.

Boston: Blackwell Scientific, 1993.

• Schantz PM. Taenia solium cysticercosis: an overview of global distribution and

transmission. Chapter in Taenia Solium cysticercosis. From basic to clinical
science. CABI Publishing 2002. pp. 63-74.

• Townes JM, Hoffman CJ, Kohn MA. Neurocysticercosis in Oregon, 1995–2000.

Emerg Infect Dis [serial online] 2004 March. 2004 May 25. Available from:
http://www.cdc.gov/ncidod/EID/vol10no3/03-0542.htm

• Wandra T, Ito A, Yamasaki H, Suroso T, Margono SS. Taenia solium

systicercosis, Irian Jaya, Indonesia. Emerg Infect Dis [serial online] 2003 July.
2004 May 25. Available from: URL:

• http://www.cdc.gov/ncidod/EID/vol9no7/02-0709.htm

• http://www.ars.usda.gov/is/AR/archive/may01/worms0501.htm

• www.nlm.nih.gov