Taeniasis and Cysticercosis as a Result of Tapeworm Infection
Taeniasis and Cysticercosis, both caused by the ingestion of T. Solium, are parasitic infections that are most commonly acquired by eating raw or undercooked pork. Although the intestinal infection of T. Solium causes minor symptoms, the spread of worm segments in the body can severely impair and even kill the infected person (CDC 2013). The most severe disease caused by the worm is cysticercosis, which is acquired when the larvae of T. Solium invade the central nervous system (CDC-A 2010).
Fortunately, the initial infection of T. Solium is harmless and treatable by taking prescription antibiotics. However, those who are the most at risk are the least able to receive treatment before more serious T. Solium related illnesses like cysticercosis occur.
Transmission of Taeniasis and Cysticercosis
Taeniasis and Cysticercosis are both caused by T. Solium, but their life cycles and transmission cycles are slightly different from one another. Taeniasis is an intestinal infection caused by the unintentional ingestion of T. Solium larval cysts. Once these cysts are in the body, the cysticerci grow and become adult tapeworms that live and thrive in the intestine. These tapeworms are made of many segments (proglottids) that pass through feces and spread the T. Solium eggs elsewhere in the body (WHO 2013).
Cysticercosis is acquired if a human ingests the eggs or proglottids from infected feces, dirt, or water (MP 2013). If eggs and proglottids spread to other parts of the body besides the intestines, devastating consequences can occur. An infection of T. Solium in the central nervous system, or cysticercosis, can often be fatal or cause irreparable damage if left untreated (WHO 2013).
Because the worm is most often spread through pigs, people who work around animals, on farms, or in meat processing plants are at a higher risk than others. This is especially true for people who work with animals in Latin America, Africa, and Southeast Asia where sanitation standards are not as strict as in the United States (MNT 2009). Taeniasis and Cysticercosis primarily affect the health and proficiency of subsistence farming communities in the previously listed regions. These diseases from tapeworms can cause epilepsy and death in humans, and since T. Solium is transmitted from pork, the market value of pigs in these regions is extremely low. Many of the animals raised on these farms are unsafe to eat, but in an area where meat is scarce, people choose to eat these animals anyway (WHO 2013).
Have you (or someone you know) been infected with T. Solium?
Symptoms and Diagnosis of Taeniasis and Cysticercosis
Comparatively, the symptoms of Taeniasis and the symptoms of Cysticercosis vary in severity. Taeniasis presents itself with very mild or even nonexistent symptoms; sometimes the only way to know if a T. Solium infection is present is by allowing a doctor to inspect the stool. Laboratories often use microscopic identification methods to detect the eggs or tapeworm segments in multiple fecal samples because eggs and segments are not released in a regular pattern in the stool (MNT 2009).
Some of the most common side effects of Taeniasis include:
- abdominal pain
These symptoms can continue to occur until the tapeworms have been removed from the intestinal tract. If left untreated, the worm can live many years (WHO 2013).
Often times Cysticercosis is difficult to diagnose because the infection with T. Solium is hard to diagnose. The most effective way to determine an infection is by an MRI scan, which can show the lesions created by the infection more so than a CT Scan can. However, these scans are not needed unless other tests are done beforehand that hint at an infection. Antibody tests and other immunology tests are often conducted before brain scans are done (NEURO 2013).
Since cysticercosis is simply the term for a T. Solium infection in the central nervous system, there are numerous ways for it to present itself. The most common manifestation of cysticercosis is epilepsy, which occurs in over 70% of infected patients. Another common side effect of an infection is intracranial hypertension, which occurs when cysts restrict the ability of the blood vessels to function inside the brain, causing dizziness, headaches, and lack of consciousness. Encephalitis and Meningitis, though rare, have also been reported as potential side effects of cysticercosis (NEURO 2013).
- Strict meat inspection regimens
- vaccination of pigs
- thorough cooking of pork
- sound hygiene practices
- cleaner water and sanitation practices
- elimination of open defecation
Treatment, Prevention, and Control
If one thinks they have Taeniasis, he/she should go to the nearest medical center to get treatment. Here, a doctor will prescribe a medication such as Praziquantel that will remove the tapeworm from the intestine (MP 2013). Praziquantel, which is taken every 4 to 6 hours orally in a single day works by paralyzing the worms and allowing the body to remove them naturally through bowel movements (MN 1996-2014). Praziquantel and other similar biltricides are 95% effective in removing tapeworms from the intestine. However, if the infected person does not wash his/her hands thoroughly after using the restroom, they could reinfect themselves (MNT 2009). Treatment for cysticercosis is much more difficult. The success rates vary greatly and in some cases, the treatment methods have failed to remove T. Solium from the central nervous system. Cysticercosis treatment may include long courses with Praziquantel or a similar biltricide, in addition to supporting therapy with anti-epileptic drugs, corticosteroids, and in the most severe cases, surgery (WHO 2013).
In order to halt the spread of T. Solium infections, particularly cysticercosis, several prevention measures have been started in endemic countries. Strict meat inspection regimens, vaccination of pigs, and thorough cooking of pork help prevent the initial digestion of cysticercosei. Sound hygiene practices and cleaner water and sanitation practices, mostly elimination of open defecation, will halt the spread of T. Solium to people who inhabit these regions (WHO 2013). However, it is often difficult to implement these practices on large-scale terms due to the fact that epidemiological data on the distribution of T. Solium related illnesses is often unreliable (WHO 2013)
The Effect of a Region’s Socioeconomic Status and Culture on the Prevalence of T. Solium
Taeniasis and Cysticercosis are endemic to developing countries, primarily those in Latin America, Southeast Asia, and Africa because countries in these regions are most susceptible to poor socioeconomic conditions. In an area with a low socioeconomic status, income is low, the majority of occupations involve cheap labor, and education is less important that survival. Since the majority of the people living in these areas are uneducated and bring in little income, hospitals are not as well maintained as they are in areas with a higher socioeconomic status. Along with hospitals, sanitation in restaurants and homes are not taken as seriously as they are in the United States. In most endemic regions for T. Solium, there are not health inspectors ensuring that food preparation spaces are clean and that the food is cooked thoroughly. This makes the transmission of T. Solium to the general population easier since the lack of cleanliness gives the tapeworm a place to thrive (NEURO 2013).
Often times an area’s culture has an effect on the spread of T. Solium. Religion plays an important role in the number of Taeniasis and Cysticercosis cases reported each year. Areas with many Jews and Muslims who choose to adhere to their religious beliefs do not eat pork. Because pork is rarely eaten, the chances of eating infected pork meat and becoming infected are extremely slim (NEURO 2013). According to a study done on Neurocysticercosis, deaths from T. Solium infections are extremely rare in Middle Eastern countries due to their abstinence from pork meat (NEURO 2013).
The Spread of T. Solium to the United States of America
Modern transportation has made it much easier for T. Solium to spread to developed countries like the United States. The prevalence of T. Solium infections has increased because of infected immigrants entering the country from Mexico and Latin America. Places with a large Latino population – particularly California and the Southwest United States – are most likely to come in contact with T. Solium (CDC-A 2010). According to a study conducted by the Centers of Disease and Control and Prevention, there were a total of 221 deaths due to Cysticercosis between the years of 1990-2002 in the United States. The majority of those affected were immigrants from other countries, primarily Mexico. Only 33 of the 221 deaths were from those native to the United States (CDC-A 2010).
The CDC suggests that travel and immigration are the primary reason that tapeworms are spread across the United States. Of all states, the most cysticercosis infections were documented in California, though there were routine infections in both New York and Florida. This indicates that areas with a large tourist population with many travellers from endemic countries are at a higher risk of catching the disease (CDC-A 2010).
Despite the efforts of the World Health Organization to control the spread of Taeniasis and Cysticercosis, these diseases still take the lives of many people every year. If the proper precautionary methods are put in place, harmful diseases caused by T. Solium could be eradicated.
However, places that are endemic for Cysticercosis and Taeniasis are often the places with the least income and worst sanitation. These factors severely inhibit these countries’ ability to rid themselves of the disease.
In many cases like the United States, advancements in transportation and an increase in immigration have allowed T. Solium to spread to places in the world they would not otherwise be. This poses a threat to not only endemic countries, but also those with a large tourist population.
For these reasons, it is imperative that we implement stricter sanitation rules, begin vaccinating pigs, and thoroughly cook pork to prevent the spread of Taeniasis and the deaths from Cysticercosis.