Background: Tapeworms are long, segmented worms of the class Cestoda, which comprise 1 of 3 classes of parasitic worms (worms that require a host within which to mature). The other classes are Nematoda and Trematoda. These worms lack an intestinal tract and instead are able to absorb nutrients through their integument. The adult consists of a head (scolex), where the worms attach to the mucosa of the intestine; a neck; and a segmented body that contains both male gonads and female gonads (proglottids).
Cestodes include the following:
Taenia solium
Taenia saginata
Diphyllobothrium
Hymenolepis
Dipylidium caninum
Echinococcus
Spirometra
Taenia multiceps
Pathophysiology: Typically, a cestode requires one or more intermediate hosts in their life cycle. The life cycle is as follows:
The eggs are passed into the soil from the primary host.
The fertile eggs are ingested by an intermediate host in which they hatch.
The larvae enter the tissues and encyst.
The primary host ingests the cysts in the flesh of the intermediate host.
When humans are the primary host, the adult cestode is limited to the intestinal tract. When humans are the intermediate hosts, the larvae are within the tissues, migrating through the different organ systems.
Typically, the cestode requires one or more intermediate hosts in its life cycle. Eggs are passed into the environment from the primary host. An intermediate host ingests the fertile eggs, and they hatch inside this second host. Next, the larvae enter the tissue and encyst. Finally, the primary host ingests the cysts by ingesting the flesh of the intermediate host.
In most cestode infestations (ie, T solium, T saginata, Diphyllobothrium species, Hymenolepis species, and D caninum), humans are the primary hosts. Adult worms survive inside their human hosts, where they are limited to the intestinal tract. Human fecal contamination of the environment is needed to sustain these life cycles.
In the remaining cestodes (ie, Echinococcus species, Spirometra species, and T multiceps), humans function as the intermediate hosts. Larvae exist within the tissues and migrate through different organ systems.
Hymenolepis species and T solium are the only cestodes for which humans can function as both primary hosts and intermediate hosts. Hymenolepis diminuta is primarily a parasite of rodents, although humans can be a rare and accidental host in the life cycle. Humans are infected by swallowing insects that contain cysticercoid larvae, most often by ingesting mealworms or grain beetles that infest dried grains, cereals, flour, and dried fruit.
Cestodes and Their Hosts
Cestode Primary Host Intermediate Host
T solium Humans Pigs, humans, dogs, cats, sheep
T saginata Humans Cattle
Diphyllobothrium Humans Fish
Hymenolepis═ Humans Hymenolepis nana: None; Hymenolepis diminuta: Rodents
D caninum Humans, dogs, cats Fleas on dogs/cats
Echinococcus Dogs Humans, sheep, cattle, goats, horses, camel
Spirometra Humans
T multiceps
Hares, rabbits, squirrels, humans (rarely)
Frequency:
In the US: Although many cestode infestations occur worldwide, only a few are common in the United States.
Diphyllobothriasis is an infection that occurs from eating raw or undercooked fish infected with Diphyllobothrium species. Diphyllobothrium organisms are present in lakes, rivers, and deltas of freshwaters. Eskimos in western Alaska and the West Coast of the United States are frequent hosts.
Echinococcus multilocularis causes alveolar echinococcosis, which occurs only in the northern hemisphere. In the United States, it occurs particularly in Alaska. Echinococcus granulosis causes hydatid disease, which occurs worldwide.
Although infection with T saginata (obtained from raw or undercooked beef) occurs worldwide, the prevalence in the United States is less than 1% because most cattle in the United States are free of the parasite. Infection with T solium is rare, but with the growing number of immigrants from endemic areas, the frequency is changing.
Infection with H nana is the most frequently diagnosed cestode infection in the United States.
Spirometra species cause sparganosis, which occurs accidentally in humans who ingest polluted water or raw or inadequately cooked flesh of snakes or frogs. It has been reported mainly in the southeastern region of the United States.
Internationally: T saginata has a high endemicity in Latin America, Africa, Middle East, and central Asia and has a moderate endemicity in Europe, south Asia, Japan, and the Philippines.
T solium is prevalent in Latin America, the Slavic countries, Africa, southeast Asia, India, and China. The prevalence of T solium infection is low in northwestern Europe and is rare or absent in Canada.
Cysticercosis, caused by infection with the larvae stage of the tapeworm, is endemic in all Latin American countries (except Chile, Argentina, and Uruguay).
http://www.nhsdirect.nhs.uk
http://symptoms.rdoctor.com
http://www.nlm.nih.gov/medlineplus
http://www.ncbi.nlm.nih.gov
http://www.cdc.gov
http://www.kavokin.com
http://www.symptomat.com
http://www.webmd.com
http://magazine.jhsph.edu
Diphyllobothrium infection is prevalent in northern Europe (Finland, east Prussia, Russian Karelia), Canada, Africa, Japan, Taiwan, Manchuria, Siberia, Papua New Guinea, Australia, and South America.
H nana infection is the most common cestode of humans. It is prevalent in areas of poor hygiene and sanitation, especially in the warm and arid countries of the Mediterranean, Indian subcontinent, and South America. The prevalence in children in these areas may reach 20%. Infection rates are highest among children.
http://www.emedicine.com/emerg/topic567.htm
E multilocularis infection occurs only in the northern hemisphere, especially in central Europe, Russia, China, Japan, Canada, and north Africa. Few regions in the world are completely free from E granulosis. Echinococcus vogeli and Echinococcus oligarthrus infections occur in Central America and South America.
Infection with Spirometra species has been reported worldwide but especially in east Asia (China, Japan, and Korea) and southeast Asia (Malaysia, India, and the Philippines).
2006-07-25 22:20:52
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answer #1
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answered by Joan RN 2
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