Tapeworms are one of the helminthes, which after entering the human body affect the health in many ways. These cestodes (tapeworms) are basically of two types, taenia saginata and solium. Taenia saginata or beef tapeworm as it is commonly known enters the human body through consumption of under cooked or uncooked beef. This 3 to 10 meters long tapeworm resides in the upper jejunum. It gets attached to the lining or mucosa of the intestine by means of suckers present on the head or scolex. Its head is connected to segments called proglottids. It is because of this longitudinal shape, resembling a ribbon or tape that gives its name as tape worm. The proglottids or segments are about 1000 – 2000. Eggs passed by the gravid proglottids can live up to months or years till they are consumed by the cattle. The embryo released after ingestion will invade the intestinal wall of the cattle, where it transforms into a cyst. When under cooked beef is ingested, this form enters human body. The affected person may experience minimal abdominal discomfort, pain or nausea. He may notice passage of proglottides in the faeces. There may be a discomfort in the anal region, during passage of the segments of the worm. Though these symptoms seem to be trivial, they are the cause of much morbidity. With recurrent or chronic infections, the affected person tends to develop loss of appetite. There is weight loss, chronic abdominal pain. 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 (about 3 meter) and has fewer segments, about 1000. Pigs are the intermediate hosts and this infestation occurs due to consumption of uncooked or undercooked pork. Invasion of the intestines by the pork tapeworm is usually asymptomatic or mild symptoms may be present in the form of mild abdominal pain and discomfort. As for the beef tape worm it can also give rise to anorexia, chronic malnutrition and weight loss. The cysts of this tapeworm can 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 can lead to seizures, paralysis of various body parts, neck stiffness, unconsciousness, coma and even death. Possibility of neurocysticercosis, i.e. affection of brain by cysts of tapeworm should be considered in case of sudden onset of paralysis or seizures in a young adult. How to detect infection? Diagnosis of tapeworm 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 MRI in which the cysts are seen. Treatment is by the antihelminthic medications. Niclosamide or praziquantel is used as a single dose for beef tape worm. While in case of pork tape worm it is given for 15 days to 6 weeks, particularly if neurological involvement is present. Sometimes surgical intervention is needed to treat neurocysticercosis. One can clearly see how a small carelessness in washing or cooking meat can give rise to so many problems. In place of suffering so much physically and spending money and time in tests and treatment, it would be better if one takes little precautions to avoid these infestations. 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. Prevention of tapeworms First important step in prevention of tapeworms is proper disposal of human faeces, because passage of the eggs in the stools, maintains the cycle of spread of infestation. 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 inadvertently maintain cycle of infection. He may auto inoculate the worms (ingest himself unknowingly), especially if 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 degree Celsius for about 5 minutes destroys the cystic forms of these worms. Salting can also help to reduce the infection. Freezing at about minus 10 degrees can help keeping the raw meat safe for long. In other conditions, 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 also be washed thoroughly if used raw or cooked sufficiently before being eaten. Adequate measures need to be taken at the level of individual and community to prevent tapeworm infections. The writer is a medical Doctor at Ruhengeri Provincial Hospital rachna21002@yahoo.co.uk
