Taenia species

Dr. Talal Saeed Alwajeeh

‫المحاضرة الرابعة‬
Taenia species cause two types of manifestations in humans—intestinal taeniasis and
cysticercosis.
Classification:
Two important members are known to infect man :
1. T. saginata (also called as beef tapeworm) causes intestinal taeniasis in man.
2. T. solium (also called as pork tapeworm) causes both intestinal taeniasis and
cysticercosis in man.
Distribution
Taenia saginata and Taenia solium have a worldwide distribution.
Habitat
The adult worms of both T. saginata and T. solium live in the small intestine of
human, commonly in the jejunum.
Morphology
Adult worm of T. saginata:
The adult worm of T. saginata is dorsoventrally flattened and segmented, measuring
5 – 10 m in length.
The adult worm consists of head (scolex), neck and strobila (body).
The scolex (head) of T. saginata is about 1–2 mm in diameter, bearing 4 suckers for
attachment.
The scolex has no rostellum or hooklets.
The neck is long and narrow.
The strobila consists of 1000–2000 proglottids.
They are hermaphrodites.
The gravid segments are about 20 mm long and 5 mm broad and each gravid
segment has 15–30 lateral uterine branches.
The gravid segments break away and are expelled singly out through the host’s anus.
The gravid segment can be seen moving actively.

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Adult worm of T. solium:
The adult T. solium is dorsoventrally flattened and segmented, measuring 2–3 m in
length.
The scolex of T. solium is about 1 mm in diameter, bearing 4 suckers for attachment.
The scolex has rostellum and hooklets.
The neck is short.
The strobila consists of less than 1000 proglottids.
They are hermaphrodites.
The gravid segments are about 12 mm long and 6 mm broad and each gravid
segment has 7–13 lateral uterine branches.
The gravid segments are expelled in chains through the host’s anus.

Adult worm of Taenia spp

Scolex of : T. saginata T. solium

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Mature Proglottids of: T. saginata T. solium
Eggs:
Eggs of T. solium and T. saginata are identical.
• They are brown and spherical, measuring 31–43 μm in diameter.
• The shell is radially striated.
• The embryo (oncosphere) has 6 hooklets.

Larva:
• The larval stage of Taenia is called as cysticercus.
• Cysticercus bovis (infective stage to humans) is the larva of T. saginata.
• Cysticercus cellulosae (infective form of the parasite to humans) is the larva of T.
solium.
Life cycle of Taenia saginata
Host: Man act as the definitive host and cattle serve as the intermediate host.
Infective stage: Cysticercus bovis (larval stage) is the infective stage to man while
eggs are infective to cattle.

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Mode of transmission: Man acquires the infection by ingestion of undercooked
beef containing encysted larval stage (cysticercus bovis).

Life cycle of Taenia solium

Life cycle of T. solium depends on the disease it causes.
When it causes intestinal taeniasis, the life cycle is exactly similar to that of T.
saginata except:
The intermediate host is pig (hence called as pork tapeworm).
Infective stage: Cysticercus cellulosae (larval stage) is the infective stage to man
while eggs are infective to pig.
Mode of transmission: Man acquires the infection by ingestion of undercooked pig
containing encysted larval stage (Cysticercus cellulosae).

But when it causes cysticercosis, the life cycle is different and given as below:
Host: Man acts as both definitive and intermediate host.
Infective stage: Eggs of T. solium.
Mode of transmission: Man acquire the infection by ingestion of contaminated food
or water with eggs of T. solium and by autoinfection.

Eggs or gravid proglottids in faeces of infected humans are passed out.

Cattle (T. saginata) and pigs (T. solium) become infected by ingesting vegetation
contaminated by eggs or gravid proglottids.

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Oncospheres hatch, penetrate intestinal wall and circulate to muscles to develop into
cysticerci.
Humans acquire infection by ingesting raw or undercooked infected meat containing
the larvae.
Adults develop in the small intestine of human and scolex attaches to the mucosa of
the small intestine.

Pathogenesis and Clinical Features

Intestinal taeniasis can be caused by both T. saginata and T. solium. It is mostly
asymptomatic.
In symptomatic infection, patient presents with abdominal pain, indigestion,
nausea, diarrhoea and weight loss.
Cases of acute intestinal obstruction and acute appendicitis have been reported.
Cysticercosis is caused by larval stage (cysticecus cellulosae) of T. solium.
Humans acquire infection after ingesting eggs of T. solium in contaminated food or
water.

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Any organ or tissue may be involved, the most common sites are central nervous
system (CNS), subcutaneous tissue, skeletal muscle and eyes.
The cysticercus is surrounded by a fibrous capsule except in the eye and ventricles
of the brain. The degenerating larvae evoke a cellular reaction with infiltration of
neutrophils, eosinophils, lymphocytes and plasma cells. This is followed by fibrosis
and death of the larva which eventually calcify.
The clinical features depend on the site affected.
Subcutaneous nodules are mostly asymptomatic.
Muscular cysticercosis may cause acute myositis.
Neurocysticercosis (cysticercosis of the brain) is the most common and most serious
form of cysticercosis. The most common manifestation of neurocysticercosis is the
majority of adult onset epilepsy and headache.
In ocular cysticercosis, patients may present with blurred vision or loss of vision.
Laboratory Diagnosis

Diagnosis of Taeniasis
1. Microscopic examination
♦ Detection of characteristic eggs or segments of Taenia spp. in faeces.

♦ Eggs can also be detected around the perianal region by cellophane swab
technique.
2. Molecular diagnosis
♦ PCR on faecal sample.

Diagnosis of Cysticercosis
1. Serological diagnosis
By detection of antigen and antibody.
2. Biopsy
Examination of biopsy lesion to show the invaginated scolex with suckers and hooks.
3. Imaging
X-ray of the skull may demonstrate calcified cyst in the brain.
CT scan of brain is the best method for detecting dead calcified cysts.

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MRI scan of the brain is more helpful in detection of non-calcified cysts and
ventricular cysts.

Treatment
1. Intestinal taeniasis
♦ Praziquantel: Single dose of (10 mg/kg orally) is the drug of choice and is highly
effective.
♦ Niclosamide: (2 g orally in a single-dose therapy) is an alternative drug and also
effective but is not widely available.
2. Cysticercosis
♦ Excision is the best method, where the cysts are accessible.
♦ For cerebral cysticercosis, praziquantel (50 mg/kg in 3 divided doses daily for 15

days) and albendazole (15 mg/kg daily for 8 days) may be administered.
♦ Corticosteroids may be given along with praziquantel or albendazole to reduce the

inflammatory reactions caused by the dead cysticerci.

♦ Surgical intervention is indicated for hydrocephalus.

Prevention and Control

1. Proper cooking of beef and pork
2. Proper sanitation
3. Personal hygiene
4. Avoid eating raw vegetables grown in polluted soil to prevent from acquiring
cysticercosis.
5. Treatment of cases with Taenia solium as they can develop cysticercosis due to
autoinfection.