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Taeniasis - Causes, Symptoms and treatments
Definition:
Also called tapeworm disease or cestodiasis, taeniasis is a parasitic infestation by Taenia saginata (beef tapeworm), Taenia solium (pork tapeworm), Diphyllobothrium latum (fish tapeworm), or Hymenolepis nana (dwarf tapeworm).
Taeniasis is usually a chronic, benign intestinal disease; however, infestation with T sulium may cause dangerous systemic and central nervous system (CNS) symptoms if larvae invade the brain and striated muscle of vital organs.
Causes of Taeniasis:
T saginata, T solium, and D. latum are transmitted to humans by ingestion of beef, pork, or fish that contains tapeworm cysts. Gastric acids break down these cysts in the stomach, liberating them to mature. Mature tapeworms fasten to the intestinal wall and produce ova that are passed in the stools.
Transmission of H. nana is direct from person to person and requires no intermediate host; it completes its life cycle in the intestine.
Signs and symptoms of Taeniasis:
Taeniasis may produce mild symptoms, such as nausea, flatulence, hunger sensations, weight loss, diarrhea, and increased appetite, or no symptoms at all. Occasionally, worm segments may exit through the anus and appear on bedclothes.
Diagnosis of Taeniasis:
Tapeworm infestations are diagnosed by laboratory observation of tapeworm ova or body segments in stools. Because ova aren't excreted continuously, confirmation may require multiple specimens. A supporting dietary or travel history aids confirmation.
Treatment of Taeniasis:
Niclosamide offers a cure in up to 95% of patients. In beef, pork, and fish tapeworm infestation, the drug is given once; in severe dwarf tapeworm infestation, twice (5 to 7 days each time, spaced 2 weeks apart). Another anthelmintic agent, praziquantel, may also be effective.
After drug treatment, all types of tapeworm infestation require a follow up laboratory examination of stool specimens during the next 3 to 5 weeks to check for any remaining ova or worm segments. Of course, persistent infestation typically requires a second course of medication.
Special considerations and Prevention tips of Taeniasis:
- Obtain a complete history, including recent travel to endemic areas, dietary habits, and physical symptoms.
- Dispose of the patient's excretions carefully. Wear gloves when giving personal care and handling fecal excretions, bedpans, and bed linens; wash your hands thoroughly and instruct the patient to do the same.
- Tell the patient not to consume anything after midnight on the day niclosamide therapy is to start because the drug must be given on an empty stomach. After administering the drug, document passage of strobilae.
- In pork tapeworm infestation, use standard precautions. Avoid procedures and drugs that may cause vomiting or gagging. If the patient is a child or is incontinent, he requires a private room. Obtain a list of contacts.
- Document level of consciousness and be alert for changes. If CNS symptoms appear, keep an artificial airway or padded tongue blade close at hand, raise side rails, keep the bed low, and help with walking as needed.
- To prevent reinfestation, teach proper handwashing technique and the need to cook meat and fish thoroughly.
- Stress the need for follow-up evaluations to monitor the success of therapy and to detect possible reinfestation.
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