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Diphylobotri

oza

Epidemiology

Epidemiology

The fish tapeworm occurs worldwide (Europe, northern


Siberia, North America, western Africa, South-East Asia,
Japan, Australia)

Humans become infected by eating raw or undercooked


fish (e.g. pike, perch, salmon)

Besides humans, as an important final host, wild and


domestic carnivore animals serve as reservoir hosts

Life cycle of Diphyllobothrium latum

Life cycle of Diphyllobothrium latum

Pathology

Pathology provoked in
most cases by a single
worm is light
Hosts might be depleted of
vitamin B12, resulting in
rare cases in a macrocytic
anaemia (especially in
Scandinavia)

Scolex of D. latum.

Diphyllobothrium latum morphology

A. Scolex

The fish tapeworm of humans has a


world-wide distribution. Infected
persons are usually asymptomatic
but may have diarrhea or
abdominal pain. Prolonged
infection results in vitamin B 12
deficiency.

B. Proglottid.

C. Egg.

Close-up of a few of the


proglottids, showing the
rosette-shaped uterus at
the center of each
proglottid.

Section of an adult D.
latum
containing many
proglottids.

Proglottids of Diphyllobothrium latum.


These proglottids tend to be passed in strands of variable
length in the stool. The proglottids tend to be broader than
long.

Proglottids of
Diphyllobothrium latum.
The species characteristics
are: the proglottid is broader
than it is long; size 2 to 4
mm long by 10 to 12 mm
wide; uterus coiled in rosette
appearance; genital pore at
the center of the proglottid.

Carmine-stained proglottids of D. latum, showing the rosetteshaped ovaries.

The main body of the worm is virtually filled with male and
female reproductive organs allowing it to produce an
incredible number of eggs, often more than 1,000,000 a day.

Diphyllobothrium latum
in human intestine.

It is the longest tapeworm invading humans with as many as


4,000 segments (proglottids).

The adult is ivory or grayish-yellow in color and can live in


humans for 20 years.

Some people are constantly hungry because the tapeworms


are eating most of the food. There are times when the worm
gets so large that it will cause a colon blockage.

In some people a severe anemia may develop, because of this


tapeworm's ability to consume most of its host's vitamin B12.

Diagnostic methods

Parasitological
diagnosis
Patients often
observe short
segments of the
tapeworm (chain of
proglottids) in their
stools.
It is not difficult to
confirm diagnosis by
detecting the
numerous eggs by
microscopy.

Treatment

The standard treatment for diphyllobothriasis, as well as many


other tapeworm infections is a single dose of Praziquantel, 510 mg/kg PO once for both adults and children.
An alternative treatment is Niclosamide, 2 g PO once for
adults or 50 mg/kg PO once (8).

Prevention and Control

Cestode larvae in fish are killed by heat or after freezing


The control of transmission is difficult due to many reservoir
hosts