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Hymenolepis nana is the most common tapeworm in humans. It is also known as the dwarf
tapeworm due to its particularly small size (adults are only 15–40 mm long). The disease,
hymenolepiasis is found worldwide. In temperate zones children and institutionalized people are
infected more often. The disease is somewhat common in the eastern Europe.
The life cycle of Hymenolepis nana starts, when microscopic eggs are passed with the stool of an
infected human. They then get ingested either by rodents, humans (definite hosts) or insects
(intermediate hosts). If a person ingests eggs (from contaminated fingers, water, food or soil),
oncospheres (hexacanth larvae) hatch in the small intestine. A larva penetrates an intestinal villus
and develops into a cysticercoid. A cysticercoid develops to look more like an adult having a
scolex (head) and a neck. It bursts out of the villus, attaches to the intestinal mucosa and matures
into an adult in the last part of the small intestine, ileum. Its long neck starts producing segments,
proglottids, which make up the body. A proglottid absorbs nutrients from the surroundings and
grows bigger before it detaches from the tail. Each proglottid has both male and female
reproductive organs. It copulates with itself or with other proglottids of the same individual or
nearby tapeworms. A gravid proglottid releases thousands of eggs through its genital atrium or
when its membrane disintegrates. Eggs are immediately infective when passed with the stool and
cannot survive more than 10 days in the external environment.
If the eggs are ingested by an insect (a beetle or a flea), the larvae develop inside the insect.
Insects infest grains which are eaten by rodents and humans. If the insect is ingested by a rodent
or accidentally by a human, the cysticercoid larvae get inside the intestine and develop into
adults. Infected rodents can contaminate water and food with their feces. According to one study,
30 % of rodents sold in pet stores in Connecticut are infected with Hymenolepis nana.
Some proglottids release eggs or disintegrate themselves already in the small intestine. Larval
oncospheres (hexacanth embryo) might hatch prematurely and penetrate villi without leaving the
body resulting in autoinfection. Hymenolepis nana does not necessarily need an intermediate
host to complete its life cycle. Larvae can develop in spite of the high temperature of a human
body. Adults live 4–6 weeks, but internal autoinfection allows hymenolepiasis to persist for
years.
anal itching
diarrhea (can be bloody)
headache
increased appetite or loss of appetite
insomnia
muscle spasms
nausea
nervousness
seizures
stomach ache
vomiting
weakness
weight loss.
Your health care provider makes the diagnosis by identifying tapeworm eggs in stool.
Sometimes many stool specimens are needed to make the diagnosis. Hymenolepis nana starts
laying eggs within a few weeks of the start of the infection and only after that it is possible to
find eggs. Alternatively adult worm can be identified during endoscopic examination.
Hymenolepiasis is usually treated with a prescription drug called praziquantel which causes the
tapeworm (both adults and larvae) to dissolve. A single dose of praziquantel has an efficacy of
96 %. If praziquantel is not available, niclosamide or albendazole can be used instead.