CLASS CESTODES

The Tapeworms
 Classification
• Less medically important:
1. Order Cyclophyllidea
– Order Cyclophyllidea
1. T. saginata,
• T. multiceps
2. T. solium,
• Dipylidium caninum
3. Hymenelopis sps
• Echinococcus
4. Echinococcus granulosus
multicuralis.
2. Order Pseudophyllidea
– Order Pseudophyllidea
1. Diphyllobothrium latum • Spirometra species
Cestodes with Medical and Veternary includes
Taenia species (Taenia saginata/Taenia solium)
Hymenolsis nana/dimunta
Dipylidium caninum
Dipyllobothrium latum
Echinococus granulosus
General characteristics:
Adult

• Segmented long tape-like worms

• Vary from few mm to several meters
• No mouth/digestive system.
• Obtains its nutrient by absorption
through body surface.
• Sex:- Hermaphrodites
• Have well developed
reproductive system.
• Reproduction
– Sexual-Oviporous
– Asexual-Sometimes
multiplication with in larval
forms
Morphology

Body is divided into three main regions

a. Scolex (head)
b. Neck
c. Strobila :made up of proglottids i.e
is the entire chain of proglottids
Strobilia can be: Immature, mature and
gravid segment (sex organ):
found at the tail end, uterus is filled with eggs
 Proglottids/segment
• Proglottid
– Set of reproductive organs
– Includes male and female organs and genital
pore

• Segment
– Segments may have one or more proglottids
– Body divisisions
– More mature as gets farther from neck
• Size and shape of segment along with number of
proglottids and location of genital pore are key
to identification many of the tapeworms.
Egg
• Two type
– Operculated, immature when voided to the external environment.
– Non-operculated ,fully embryonated when voided to the external
environment.
Larvae
• Generally two types
1. Solid :
– eg. Procercoid, Plerocercoid, cysticercoid
2. Cystic ( true bladder) can be with:
– Single scolex
eg. Cysticercus;
– Many scolexes and/or with daughter cyst
eg. hydatid cyst, coenurus cyst, etc
 Life cycle

• Complete in two host (except H.nana)

• Haibtat:- Adult live in small intestine
• Man is:-
– The only/main DH for T. saginata, T. solium, H. nana and D.
latum
– IH for E. granulosus and E. multilcolaris
– DH & IH for H. nana and T. solium
 Taenia species

• Geographical Distribution:-
– T. saginata
• World wide distribution where cattle are raised and beef is eaten raw or
under cooked.
• Very common in Ethiopia

– T. solium
• Not widely distributed as T saginata.
• Common in all areas where raw or partially cooked pork is eaten.
• Common throughout Mexico, South America and southern Africa &
southern Europe.
• Not reported from Ethiopia
 Morphology:

T. saginata T. solium
• Adult • Adult
– Size: 4-10 m long (can
– Size: 2-3m
reach up to 20 m)
– Colour: ivory white – Colour: pale blue
– Strobila : 1000-2000 – Strobila: 800-1000
proglottides Proglottides
– Mature segment: 1-2cm – Mature segment :0.5-
long 1.5 cm
Taenia saginata
Scolex (head):
• Quadrate, with four suckers, no hooks,
no rostellum on scolex
• Size-2mm across
Taenia solium
Scolex has
• Four sucker
• two rows of hooks on a prominent
rostellum
• Size-1mm
 Transmission and life cycle
• Transmission
– Humans become infected by ingesting raw or
undercooked meat infected with cystcerus larvae:
• Beef- T saginata
• pork meat –T.solium

– T. solium can also be transmitted by :

• Ingesting ova in food or water
• Internal autoinfections
 Taenia solium
• Distinct difference with T. saginata is that humans can
be infected with egg stage and onocosphere migrates to
some site in body and develops into cycticercus
• This can be serious, called Cysticercosis
 Clinical manifestation
T. saginata
– Taeniasis.
• Usually asymptomatic but may cause dizziness, abdominal
pain, diarrhea, headache and nausea.
– Proglottids obvious in feces.
– Proglottides have a strong tendency to crawl from the anus
during the day when its host is active
T. solium
– Taeniasis
• Major symptoms of taeniasis are as a result of the adult worm.
• These include abdominal pain, loss of appetite, and
– Cysticercosis
• T. solium ( when infected by eggs) cause cysticercosis (larval
cysts in lung, liver, eye and brain) resulting in blindness and
neurological disorders.
 Laboratory Diagnosis

• Detecting eggs in faeces .

• Identifying macroscopically
– gravid segments in faeces
– scolex recovered from clothing or passed
in faeces.
• In addition
• T.saginata-
– ova on perianal skin (cellotape slide)
• T.solium ( cysticercosis)
– Finding calcified larvae in histological or
X-rays examination .
 Cont…

• Morphologically eggs of
T.saginata and T. solium are
indistinguishable unless
stained by AFB
• T. saginata ova stains red (acid
fast) in Ziehl-Neelsen stain
 This character helps to
differentiate it from T.solium
which do not have red color in
such staining ( not acid fast)
 Hymenolepis nana
Dwarf Tapeworm
– Vampirolepis nana
• Definitive Host: Humans, rodents
– Most common tapeworm of humans in the
world
– 1% rate of infection in the southern U.S.
– 97.3% rate of infection in Moscow, Russia
• Intermediate Host: Larval and adult
beetles (but optional)
– Larval stage, cysticercoid, can develop in D.H.
if it eats the eggs
• Probably a recent evolutionary event
• Small tapeworm
• Scolex has rostellum with
row of hooks
• Proglottids are wider
than long with lateral
genital pore
• Geographical Distribution:-
– H.nana is widely distributed in countries with warm
climates than in cold climates and fairly common in
Ethiopia.
– Children are more commonly infected than adults.
• Mode of Transmisssion: -
– Ingestion of egg with contaminated food, drink or finger.
– Autoinfection.
• Life Cycle: H. nana has a direct life cycle with a human
host serving as both definitive and intermediate host.
Hymenolepis dimunata

• Slight larger than H.

nana but still very
small.
• Scolex has very small
rostellum with no
hooks
• Proglottid same as H.
nana but larger.
• Egg: H nana
– Size: 35-50m
– Shape: oval, almost round
– Shell: double; thin external
membrane and internal
membrane often thicker at the
poles. Thread like polar filaments
coming from both poles
– Colour: colour less or very pale
gray
– Content: Rounded mass (embryo)
with six refractile hooklets
arranged in fan shaped.
Egg: H dimunata
• Color:-Yellow-brown or bile pigmented.
• Size:-70 by 60μm
• Shell with double shell and with out thread like polar
filaments.
• Content: A rounded embryo containing six hooklets arranged
in fan shape.
 Echinococcus granulosus
• Sheep Tapeworm
• Definitive Host: Carnivores including dogs,
wolves, and coyotes
• Intermediate Host: Herbivores including sheep
and mice.
• Occasionally infect humans.
• The hyatid cysts growin humans very slowly and
can overcrowd organs
• Geographic Distribution: Most common in sheep
raising countries
– New Zealand and Australia highest incidence
 MORPHOLOGY
• Smallest of all tapeworms
– Scolex, neck, 3 segments
– Segments look like Taenia sp.
• Largest larval stage of all
tapeworms
– Hydatid cyst
 Clinical feature and Pathology:
 The symptoms, depend upon the location of the cyst.
• Large abdominal cysts produce increasing discomfort.
• Liver cysts cause obstructive jaundice.
• Peribronchial cysts may produce pulmonary abscesses.
• Brain cysts produce intracranial pressure and Jacksonian epilepsy.
• Kidney cysts cause renal dysfunction.
• The contents of a cyst may produce anaphylactic responses
Laboratory Diagnosis
• Histological examination to find larvae
• X-ray examination to find larvae
• Examination of cystic fluid for brood capsules and protoscoleces
• Casoni's skin test
E. granulosus
hydatid cyst
 Dipylidium caninum
Dog Tapeworm
• World wide Distribution Habitat:
• Dogs or cats (humans • Adult: mucus membrane of small
rarely) as the definitive intestine of carnivores such as dog, cat,
host Man
• Fleas or lice are the • Cysticercoid larvae: In the body cavity
intermediate host.  of insects
• Egg: in the faeces of dog, cat, man
 Dipylidium caninum
• Flea or louse ingests
the eggs in the
perianal region of the
dog or cat. 
• The dog or cat (or
human) is infected
when they ingest a
flea or louse infected
with the metacestode
state (cysticercoid)
Dog flea
 Dipylidium caninum

Proglottids of Dipylidium
caninum compared to a match
stick. 
These are often passed intact in
the feces of an infected dog. 
When the proglottids dry, their
appearance is similar to grains of
rice. 
Dipylidium caninum

• Egg: 5-15 eggs in

capsule
• 40m in size and
yellowish brown in color
Taenia sp.

Diphyllobothrium H. dimunata
latum
H. nana

Eggs
Dipylidium
caninum
 Diphyllobothrium latum
Fish tapeworm
• Important parasite of man.
• Definitive hosts can be
humans, dogs, foxes, cats,
mink, bears, and seals. 
• Site of attachment : small
intestine.
Geographical Distribution:-
– Widely distributed in the lake
areas of Europe, Asia, Far
East, North America, South
America and Central Africa .
 Diphyllobothrium latum
Fish tapeworm
• humans are infected
with the plerocercoid .
• In humans the
tapeworm can reach a
length of 10 meters
(>30 feet) and produce
over a million eggs a
day! .
 Diphyllobothrium
latum

• Scolex has bothria

– Shallow groove
• Segments have one
proglottid
– Wider than long
egg-
58-76µm by 40-51µm
Broadly ovoid
Light golden yellow,
Operculated
Thick shell
Contains immature
embryo
Clinical feature and Pathology :
– Clinical symptoms may be mild, depending on the
number of worms.
– They include abdominal discomfort, loss of weight, loss
of appetite and some malnutrition.
– Anemia and neurological problems associated with
vitamin B12 deficiency are seen in heavily infected
individuals.
Laboratory Diagnosis
– Eggs in the faeces
– Scolex in the faeces
– Adult worms in the faeces
 Egg:

• 58-76m by 40-51m
• Broadly ovoid
• Light golden yellow,
Operculated
• Thick shell
• Contains immature
embryo