A young man of about 30 years developed unexplained dizziness and weakness. After various tests, he was diagnosed with tapeworm infestation. Tapeworms are parasites which affect human health in many ways. They are basically of two types - taenia saginata and solium. Taenia saginata or beef tapeworm commonly enters the human body through consumption of under cooked or uncooked beef. This 3 to 10-metre long tapeworm resides in the intestines and takes cystic form. When under cooked beef is ingested, this form enters human body. The affected person may experience minimal abdominal discomfort, pain, nausea and or anal discomfort. He may notice passage of segments in the feces. With recurrent or chronic infections, the affected person develops loss of appetite. Over time one can get asthenic and malnourished. The other tapeworm Taenia solium popularly known as pork tape worm is smaller in size in contrast to the beef tape worm. Pigs are intermediate hosts and this infestation occurs due to consumption of uncooked or undercooked pork. Like beef tape worm, it can also lead to chronic abdominal pain and malnutrition. The cysts of this tapeworm pass from intestines to other body tissues, having an affinity for brain and skeletal muscles. Involvement of the skeletal muscles causes aches and pains in the body. Neurological involvement (neurocysticercosis) can lead to seizures, paralysis of various body parts, neck stiffness, unconsciousness, coma and even death. Diagnosis of tape worm infestation is done by microscopic examination of the stool of the patient, which shows the segments or eggs of the worm. Neurocysticercosis is diagnosed by means of C.T. scans or M.R.I. (magnetic resonance imaging), through which cysts of the brain are visualised. Treatment is by the antihelminthic medications. For beef tape worm single dose is adequate, whereas for pork tape worm longer duration of treatment is needed. Though these tapeworms commonly occur due to eating contaminated beef and pork, vegetables are not immune to them. Eggs of the worms are passed in the open ground. Vegetables can also be contaminated and if consumed raw without washing carry equal risk of making a person sick with taenia saginata or solium. First important step in prevention of tape worms is proper disposal of human faeces, because passage of the eggs in the stools, maintains the cycle of spread. Good hygiene while cooking, serving and eating of food is very necessary to prevent these worm infestations. Sometimes because of poor hygiene a person may auto inoculate the worms (ingest himself unknowingly), because of not washing hands adequately after passing stool. Good inspection of the meat should be done before buying. Beef or pork should be adequately cooked before consumption. Cooking at temperatures around 50 to 60 degrees Celsius for about five minutes destroys the cystic forms of these worms. Salting can also help to reduce the infection. Use of meat kept for long or cooked stale meat should be avoided as it carries a high risk of intestinal infections. Vegetables and fruits should be washed thoroughly if used raw. Tape worm infestation should be taken seriously. It does not cause suffering to one or some individuals, but one affected person can become a source of infection and lead to a chain of many getting infected. It is loss of effective man power and diminished productivity in a society. Therefore, health education is needed to make people aware of these infections. Adequate measures need to be taken at the level of individual and community at large to prevent them. Dr Rachna Pande is a specialist in internal medicine at Butaro Hospital.
