Cestodes

Dr:Selma Osman Ahmed

Associate prof. in
Microbiology
Cestodes (tapeworms) Characteristic :
 Endoparasitic ( adults in the intestine).
 Flattened dorso-ventrally and bilaterally symmetrical.
 Consists of a head ,neck & strobili ( long chain of segments ).
 Absence gastro intestinal tract and body cavity.
 Hermaphroditic
Parts of Adult tapeworm
 Scolex
 Neck
 Strobila
- immature segment
- mature segment
- gravid segment
 Intestinal Tapeworms
1-TAENIA SAGINATA
 Taenia saginata commonly known as the beef tapeworm, is a
zoonotic tapeworm belonging to the order Cyclophyllidea and genus
Taenia.
 It is an intestinal parasite in humans causing taeniasis (a type of
helminthiasis) and cysticercosis in cattle.
 Cattle are the intermediate hosts, where larval development occurs,
while humans are definitive hosts harbouring the adult worms.
 It is found globally and most prevalently where cattle are raised and
beef is consumed. It is relatively common in Africa, Europe, Southeast
Asia, South Asia, and Latin America.
 Humans are generally infected as a result of eating raw or
 undercooked beef which contains the infective larvae,
called cysticerci.
 As hermaphrodites, each body segment called proglottid
has complete sets of both male and female reproductive
systems. Thus, reproduction is by self-fertilization.
 From humans, embryonated eggs, called oncospheres, are
released with faeces and are transmitted to cattle through
contaminated fodder. Oncospheres develop inside muscle,
liver, and lungs of cattle into infective cysticerci
 T. saginata is the largest of species in the genus Taenia. An adult worm is
normally 4 to 10 m in length, but can become very large; specimens over 22 m
long are reported.
 Typical of cestodes, its body is flattened dorsoventrally and heavily segmented.
It is entirely covered by a tegument.
 The body is white in colour and consists of three portions: scolex, neck, and
strobila.
 The scolex has four suckers, but they have no hooks. Lack of hooks and a
rostellum is an identifying feature from other Taenia species. The rest of the
body proper, the strobila, is basically a chain of numerous body segments called
proglottids.
 The neck is the shortest part of the body, and consists of immature proglottids.
 The midstrobila is made of mature proglottids that eventually lead to the gravid
proglottids, which are at the posterior end. An individual can have as many as
1000 to 2000 proglottids.
 T. saginata does not have a digestive system, mouth, anus, or digestive tract. It
derives nutrients from the host through its tegument, as the tegument is
completely covered with absorptive hair-like microtriches.
 It is also an acoelomate, having no body cavity.
 The inside of each mature proglottid is filled with muscular layers and complete
male and female reproductive systems, including the tubular unbranched uterus,
ovary, genital pore, testes, and vitelline gland.
 In the gravid proglottid, the uterus contains up to 15 side branches filled with
eggs.
Taenia saginata proglottid stained
to show uterine branches
Life Cycle
 Adults reside in the jejunum of humans, and gravid proglottids of T. saginata
detach singly from the strobila and pass to the outside with feces.
 The eggs of T. saginata, are ingested by a suitable intermediate host, such as
cattle or other ungulates.
 The liberated oncosphere penetrates the intestinal wall and is carried by the
lymphatic or blood circulatory system to intramuscular connective tissue where
it develops into a cysticercus known as Cysticercus bovis.
 Humans become infected by ingesting cysticerci in
undercooked or raw beef, particularly in muscles of the
head and heart.
 Following evagination of the scolex and subsequent
attachment to the jejunal wall, the worm develops to
sexual maturity in 8 to 10 weeks.
Epidemiology
 Taenia saginata is distributed throughout the world.
 Humans acquire infection by eating raw or insufficiently cooked beef
infected with the cysticerci.
 Cattle acquire Cysticercus bovis by grazing in fields upon which human
excrement has been deposited either through fertilization with “night soil” or
from poor sanitation.
 Pastures flooded by rivers and creeks contaminated with human excrement
provide another source of infection for cattle.
 Under such conditions, eggs may remain viable for 2 months or longer.
 Thorough cooking of beef at 57C until the reddish color disappears or
freezing at 10C for 5 days effectively destroys infective cysticerci.
Symptoms and Diagnosis
 Saginatus taeniasis (taeniosis) in humans is often characterized by such
symptoms as abdominal pain, greatly diminished appetite, and weight
loss.
 These symptoms are especially common in patients already debilitated
by malnutrition or other illness. the prognosis is generally good.
 Identification of proglottids in feces is the most reliable method of
diagnosis. Since most taenioid eggs are morphologically
indistinguishable, positive diagnosis is established by examination of
gravid proglottids to determine the number of main lateral uterine
branches.
 The morphology of the scolex, particularly the rostellum, is also useful
in diagnosis; T. saginata has no rostellum and its scolex bears no hooks,
making it easily distinguishable from T. solium, which has an armed
rostellum.
Echinococcosis(Hydatidosis)
 Echinococcosis is a zoonotic infection caused by adult or larval
(metacestode) stages of cestodes belonging to the genus Echinococcus and
the family Taeniidae.
 At present, four species of Echinococcus are recognised, namely
Echinococcus granulosus, E. multilocularis, E. oligarthrus and E. vogeli.
 The parasite life-cycles with carnivores as definitive hosts, which harbour
the adult worm in the intestine, and intermediate host animals
(sheep,goat,camel and cattle) in which the infective metacestode stage
develops after infection with eggs.
 Metacestodes may incidentally also develop in humans causing various
forms of echinococcosis, and this may also occur in various animals
species, which do not play a role in the developmental cycle of the parasite,
( accidental hosts).
Transmission:
 Domestic dogs can carry thousands of the tiny adult tapeworms in their
intestines without any sign of infection. Tapeworm eggs are passed in the dog’s
faeces and may survive in soil, pastures and gardens for several months.
 Animals such as sheep, cattle, goats, pigs, camels, horses, become infected by
eating grass contaminated with eggs in dog faeces.
 Hydatid cysts form in the meat and organs of these animals; the cycle is
completed when dogs are infected by eating the cysts in uncooked meat and offal
of infected animals.
 Dogs will start passing the eggs about 5 – 7 weeks after they are infected. Even
without treatment the infection will clear in dogs within 6 months to a year; but
the dog can be reinfected if it eats contaminated meat.
 Human infection occurs when a person swallows tapeworm eggs. This may
occur by patting a dog then touching your mouth, by kissing a dog, through
contact with contaminated soil or through consuming food or water
contaminated with dog faeces containing tapeworm eggs.
 Humans can only be infected by eating eggs passed by an infected dog.
 Hydatid disease is not transmitted from person to person, or by a person eating
the meat of an infected animal.
The disease in human
 Persons with cystic echinococcosis often remain asymptomatic until
hydatid cysts containing the larval parasites grow large enough to cause
discomfort, pain, nausea, and vomiting.
 The cysts grow over the course of several years before reaching
maturity and the rate at which symptoms appear typically depends on
the location of the cyst.
 The cysts are mainly found in the liver and lungs but can also appear in
the spleen, kidneys, heart, bone, and central nervous system, including
the brain and eyes.
 Cyst rupture is most frequently caused by trauma and may cause mild to
severe anaphylactic reactions, even death, as a result of the release of
cystic fluid.
Diagnosis
 The presence of a cyst-like mass in a person with a history of exposure to dogs
in an area where E. granulosus is endemic suggests a diagnosis of cystic
echinococcosis.
 Imaging techniques, such as CT scans, ultrasonography, and MRIs, are used to
detect cysts.
 After a cyst has been detected, serological tests may be used to confirm the
diagnosis.
Chest X-rays and CT scans of HC in the lung
(1A) Chest X-ray showing a ruptured HC in the left lung with water lily sign. (1B) Chest X-
ray showing a simple HC on the right and hydropneumothorax with a chest tube on the
left after the rupture of HC. (1C) CT scan of the complex HC with multiple daughter
cysts in the left hemithorax extending into the left chest wall. (1D) CT scan of a simple
HC in the left lung.
Treatment
 In the past, surgery was the only treatment for cystic echinococcal cysts.
Chemotherapy, cyst puncture, and PAIR (percutaneous aspiration,
injection of chemicals and reaspiration) have been used to replace surgery
as effective treatments for cystic echinococcosis.
 However, surgery remains the most effective treatment to remove the cyst
and can lead to a complete cure.
 Some cysts are not causing any symptoms and are inactive; those cysts
often go away without any treatment.