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Tapeworm Tapeworms signs and symptoms
contents
- Anatomy and occurrence of tapeworms
- Origin and way of life: From the larva to the worm
- Symptoms of tapeworms
- Signs of dog tapeworms
- Symptoms of fox tapeworm infestation
- Symptoms of fish tapeworms
- Cattle tapeworms: typical signs of disease
- Symptoms of pork tapeworm infestation
- Signs of a dwarf tapeworm infection
- Diagnosis of tapeworms
- Therapy and treatment
- Naturopathic treatment
- Tapeworm diet and other curios
- Precaution: To protect yourself from a tapeworm infestation
Anatomy and occurrence of tapeworms
As endoparasites tapeworms are in the gut of vertebrates at home, with different genera have specialized in different hosts. Often, the name of the tapeworm already indicates the respective host animals, such as the fox tapeworm, dog tapeworm, cattle tapeworm or fish tapeworm. However, this does not mean that they only infest the eponymous animals.
With the help of barbs and suckers on his head, the tapeworm gets stuck in the gut. (Image: Juan Gärtner / fotolia.com) The anatomy of the tapeworms is adapted to the living conditions in the intestine. In order to dock on the intestinal wall, they have special, provided with suction cups and hook ring organs (usually a so-called scolex at the front end of the worm, rarely a rosette organ at the rear end). Before the digestive enzymes in the intestine, they are protected by their outer shell in the form of a so-called Neodermis. It also serves to absorb food by absorbing nutrients directly from the intestine of the host.
However, the worms do not have their own intestinal tract. The size of the tapeworms varies depending on the genus between a few millimeters and several meters. For example, fox tapeworms only reach a maximum length of about 3.5 millimeters, the gyrocotylids become a maximum of 20 centimeters long. The fish tapeworm can reach up to 20 meters in length.
Origin and way of life: From the larva to the worm
Tapeworms are basically differentiated into the so-called monozoic tapeworm species and the true tapeworms. Their body shape is similar to a flat band, with the true tapeworms have a certain segmentation in the form of so-called proglottids. The proglottids usually contain both sex organs (almost all tapeworm species are hybrids) and can be individually pinched together with fertilized eggs.
The monozoic tapeworm species do not have this peculiarity of proglottids, but also have mostly female and male genitalia. Fertilized eggs or Proglottiden are excreted with the feces of the host and in them develop the so-called oncospheres (first larval stage of tapeworms).
When ingested by suitable intermediate hosts, they grow into tapeworm larvae (also called Finns), most of which can attach to the tissue of various intermediate hosts as so-called metacestodes. There they stay in the fin stage, until the intermediate host is again taken in by a suitable main host. In the intestine of the main host, the larvae can also absorb nutrients due to their special anatomy and it begins the development of the adult tapeworm.
Symptoms of tapeworms
Depending on the type of tapeworm, infestations can cause a great deal of discomfort. While many types of worms hardly harm the human organism and cause no symptoms, others can have life-threatening consequences. Particularly noteworthy here is the potentially life-threatening echinococcosis, which is not caused by the adult worms, but by the larvae in the fin stage.
Signs of dog tapeworms
The dog tapeworm can be transmitted to humans by direct contact with the feces of infected dogs. This is possible if the oncospheres, for example, stick to the hands and then taken orally.
Sometimes the tapeworm eggs get into the organism via contaminated food. They penetrate the intestinal wall and migrate through the bloodstream until they become lodged in the tissues of various organs such as the liver, lungs, spleen, kidneys or brain.
The organism then attempts to "encapsulate" it by forming a connective tissue layer around the fins. Hundreds of tapeworm larvae are able to grow in this blister-like cyst (also called hydatides), which are released in the organism during a rupture of the hydatides.
The expansive growth of cysts in the so-called cystic echinococcosis also leads to a displacement of the healthy tissue, which may cause further discomfort. According to the Robert Koch Institute (RKI), cysts are most commonly found in the liver (70 percent) and the lungs (20 percent).
If cystic echinococcosis causes larger cysts in the liver, this can lead to narrowing of the blood vessels and a backflow of blood flow in the area of the portal vein. This in turn is known, for example, as a possible trigger of a so-called ascites (ascites). The displacement of surrounding tissue structures often leads to abdominal pain.
The pronounced formation of cysts in the liver can cause impairment of bilirubin metabolism, which in turn is associated with the development of jaundice (jaundice). This is colloquially referred to as jaundice, as in the course of increased bilirubin levels in the blood typically yellowing of the skin and yellow eyes occur.
Frequently, the hydatids also form in the area of the lungs in a dog tapeworm infestation. This so-called pulmonary echinococcosis is accompanied by symptoms such as pain, respiratory distress and massive cough, especially when ruptured with subsequent larval release.
If the kidneys are affected, increased formation of the hydatides can lead to clearly perceptible symptoms, such as kidney pain, flank pain or blood in the urine. If the tapeworm larvae have become fixed in the brain or spinal cord of the patient, corresponding neurological deficits are to be observed as a possible consequence, depending on their localization.
In general, rupture of the cysts and subsequent release of the fins may allow the organism to respond with an overreaction of the immune system in the form of an anaphylactic shock.
Symptoms of fox tapeworm infestation
The fox tapeworm in its adult form is rather harmless to humans, whereas the larvae can cause a life-threatening echinococcosis. The tapeworm eggs are eliminated with the feces of the main hosts and can survive in the environment for a long time undamaged.
If these are taken orally by humans, for example by means of contaminated foods, they reach the digestive tract and reach the small intestine. They penetrate the intestinal wall and are transported via the bloodstream into various organs such as the liver, lungs, spleen, bile or the brain.
The transmission of fox tapeworm eggs is possible, for example, over soil contaminated with the feces of infected foxes. (Image: hecke71 / fotolia.com) There, the tapeworm larvae settle in the tissue and it initially forms a cyst, which is surrounded in the course of the so-called budding of the Finns of other daughter cysts. This is also the name of this form of tapeworm infection, which is referred to in the art as alveolar (vesicular) echinococcosis. In contrast to the dog tapeworm infestation, "however, no closed cyst forms, but there is an infiltrative growth of the larva, comparable to the growth of a malignant tumor," reports the RKI.
The newly formed Finns can spread through the blood and lymph channels in the body and so attack other organs. In the course of the disease, more and more foci of the disease form, which usually results in the death of the patients if treatment is omitted. However, the parasitic infections may go unnoticed for years, before the first symptoms are caused by the expansive growth of the Finns.
These often remain inconspicuous at first. For example, abdominal pain, general weakness and chronic fatigue may be the first signs of alveolar echinococcosis. The already mentioned jaundice is another possible component of the symptoms. As a rule, however, the symptoms do not show until massive involvement of several organs. Depending on the affected organ numerous other, often life-threatening symptoms are observed.
Symptoms of fish tapeworms
The fish tapeworm is considered the largest parasite that can affect humans. It only grows in the body to its considerable length of up to 20 meters. The infection takes place via the inclusion of so-called Plerozerkoiden (second larval stage of the fish tapeworm), which occur in raw fish.
In the intestine of cats, humans or dogs the Plerozerkoiden then grow up to adult fish tape worms. Their growth in the intestine is around nine to 15 centimeters per day. Up to 25 years, a fish tapeworm can survive in the intestine of humans, due to the enormous size of parasites usually only one tapeworm per host occurs.
The majority of patients do not show any symptoms in the course of the fish tapeworm infestation (diphyllobothriasis). In rare cases, however, the vitamin B12 intake is impaired in such a way that anemia (anemia) and disorders of the nervous system (neuropathies) may occur. Furthermore, in the course of Diphyllobothriasis general symptoms such as fatigue, dizziness and diarrhea can sometimes be observed.
Rarely, those affected develop a gallbladder and / or bile duct infection as a result of the fish tapeworm infestation, which in turn may be accompanied by complaints such as upper abdominal pain on the right side, nausea and vomiting or the development of jaundice. Occurs occlusion of the bile ducts, are often a light bowel movement and dark urine the result.
Cattle tapeworms: typical signs of disease
In cattle tapeworm man is the only known end host, but infections are rather rare in Germany because of the regular veterinary meat analysis. In addition, the tapeworm larvae are killed when roasting the meat and during deep freezing (below -18 degrees Celsius).
Cattle and pigs serve the larvae of the cattle tapeworm as an intermediate host. However, the development towards adult adult adult tapeworms takes place only in the human digestive tract. These can reach a length of over ten meters.
Often, the infection goes completely unnoticed, but may experience symptoms such as abdominal pain, diarrhea, constipation, nausea, loss of appetite, a significant weight loss, headache and chronic fatigue.
Bovine tapeworm infection often goes unnoticed, but may also be associated with symptoms such as abdominal pain and nausea. (Image: Viacheslav Iakobchuk / fotolia.com) Many patients also have unpleasant after-effects. Rarely does the infection take a life-threatening course. This may be the case, for example, when the worms cause bowel obstruction, acute appendicitis, or acute pancreatitis.
Symptoms of pork tapeworm infestation
If the pork tapeworm affects humans as the final host, this usually does not cause any noticeable symptoms, because the parasites are optimally prepared for life in the human intestine. However, ingestion of tapeworm eggs may cause humans to act as false intermediate hosts, with the fins trapped in the tissue and different symptoms depending on the location.
Possible consequences include headache, neurological deficits and potentially life-threatening meningitis. The adult pig tapeworms can reach a length of up to seven meters in the human body. Again, movements of the worms are similar to the cattle tapeworm sometimes felt as rooting or grumbling in the digestive tract.
Signs of a dwarf tapeworm infection
In addition to rodents and primates, humans form the most important end host for the dwarf tapeworm. This particular tapeworm genus can multiply completely without an intermediate host and rarely causes discomfort. If the infection remains undetected for a long time, symptoms such as diarrhea, bloating or abdominal pain can sometimes be observed in the course of the massive multiplication of the dwarf tapeworms. Overall, the damage of the dwarf tapeworm - especially in comparison with other tapeworm species - extremely low.
Diagnosis of tapeworms
In many tapeworm species, the proglottids are visible in the stool, which makes the diagnosis relatively simple. A microscopic examination can already bring clarity here. In general, the examination of a stool specimen in adult tapeworm infections provides fairly reliable information on the present disease, although further studies may be required to determine the exact tapeworm genus.
Far more threatening to humans are the already mentioned echinococcoses, which are more difficult to detect. In the early stages of the disease, the diagnosis is usually extremely complicated. Decisive diagnostic procedures are ultrasound examinations for echinococcosis and computed tomography (CT) or magnetic resonance imaging (MRI) in case of doubt..
Blood and stool samples as well as imaging techniques are important tools for the diagnosis of tapeworm infestation. (Image: StudioLaMagica / fotolia.com) Furthermore, blood tests often give indications of the disease, but negative results of the serological diagnostic methods do not completely exclude an infection. In case of doubt, only the removal and subsequent examination of a tissue sample brings definitive diagnostic certainty.
Therapy and treatment
Against an infestation with adult tapeworms is usually proceeded with the help of appropriate medicines, which should cause a death of the parasites. Niclosamide, mebendazole and praziquantel have proven to be the most effective agents here. For example, pork tapeworm infection is primarily treated with mebendazole or praziquantel. The fish tapeworm usually praziquantel or niclosamide (rarely mebendazole) are used. Niclosamide is mainly used against the cattle tapeworm, alternatively, the use of praziquantel or mebendazole is an option.
Overall, the drug therapy allows a relatively effective treatment of the various tapeworm species. However, according to the RKI, side effects such as abdominal pain, hypersensitivity reactions, nausea and vomiting may occur with the various remedies. Other possible side effects include inappetence, headache, dizziness, weakness, drowsiness, tiredness, urticaria or temperature elevations.
The treatment of echinococcosis is considerably more difficult than the treatment of adult tapeworm infection. Accordingly, the Robert Koch Institute recommends that patients be treated in specially designated centers where interdisciplinary care is guaranteed. At the time of diagnosis, the echinococcosis is often already advanced to the extent that a complete recovery of the patient is hardly possible.
Basically, however, there is definitely a chance of recovery, especially if diagnosed early. For example, in the early stages of cystic echinococcosis, the affected tissue can sometimes be completely radically surgically removed. If the disease is already more advanced, however, often only the possibility of drug containment remains.
The administration of benzimidazoles such as mebendazole in this case slows or prevents the growth of the cysts. However, a cure based solely on the remedies is not possible here. According to the RKI, the drugs must therefore be taken for life in inoperable cases, and for "curatively resectable findings, the benzimidazole therapy is administered for at least two years."
According to the RKI, for alveolar echinococcosis, "depending on the clinical picture and cyst stage, there are several therapeutic options." For example, "in inactive cysts that do not cause functional problems" is followed by a "watch-and-wait" strategy. In question is also a sole drug treatment with albendazole with accompanying control examinations or surgical removal of the affected tissue. Following the operation, medical treatment is usually also required.
Conceivable is the possibility of a so-called "puncture-aspiration-injection-Reaspiration" (PAIR), in which a sterilizing substance (95 percent alcohol) is introduced into the cysts to prevent further growth. Since most patients can no longer achieve complete healing, lifelong medication is usually required.
Naturopathic treatment
Naturopathy can do little against the echinococcoses. Against the infestation with adult tapeworms, however, it offers quite promising starting points. In the first place special diets should be mentioned, with which the parasite nutrient uptake is to be made so difficult that these die off. For up to three weeks, a diet can be used to target the diet to low carbohydrate and fermented foods (due to the presence of lactic acid bacteria).
Onions and garlic are said to have a healing effect on parasite infestation. (Image: BillionPhotos.com/fotolia.com) Ginger, garlic, onions, juniper berries and the essential oil of oregano have a curative and preventive effect on tapeworm infections. How exactly the change in diet should look depends, among other things, on the constitution and the individual symptoms of the patient. It is also important to consider possible pre- and concomitant diseases.
Tapeworm diet and other curios
The idea of attaining customer success through a parasite in the gut seems at first glance quite comprehensible - albeit disgusting. In appropriate forums, numerous hints can be found on the earning potential of tapeworm eggs and although it is expressly warned before taking it, people try it again and again as a diet method.
Danger: The intake of eggs can not cause weight loss and in the worst case life-threatening consequences. Because, as already shown:
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The self-attempts of the Japanese doctor and author Koichiro Fujita, in which he has successfully treated his hay fever by means of Japanese fish tapeworms, caused shortly after the turn of the millennium for increased media interest. The doctor has become infected with the ingestion of tapeworm larvae. Since then, his immune system was busy with the defense of the parasites and the reaction to the pollen has normalized, the doctor said in a conversation with "Time Online" in 2001.
Fujita had at the time three Japanese fish tapeworms in his gut. However, although he was extremely satisfied with the success of his measure, the physician does not advocate a broad use of tapeworms for therapeutic purposes. First of all, it should be clarified scientifically whether the tapeworms have actually resolved the allergy.
Further research in this direction, however, seems quite appropriate, especially as the number of people with allergies has risen dramatically in recent years and may not affect the tapeworms themselves, but substances secreted by them, the immune response.
Regular hand washing is an important preventive measure for tapeworm infections. (Image: cirquedesprit / fotolia.com) Precaution: To protect yourself from a tapeworm infestation
In the intestine of humans different tapeworm species can occur. Depending on the species, the transmission may take place, for example, over finely-contained, raw beef (cattle tapeworm) or contact with soil containing feces of infected foxes (fox tapeworm).
This is how you can protect yourself from a worm infection:
- Avoid eating raw or insufficiently heated meat.
- Avoid insufficiently heated fish dishes (for example sushi).
- Always clean fruit, vegetables and salad thoroughly before eating.
- Do not eat unwashed berries or mushrooms.
- Wash your hands regularly - especially after using the toilet, before every meal, after gardening and after contact with pets.
- Make sure your children wash their hands thoroughly after playing with soil or in the sandbox.
- Have your pets dewormed regularly at the vet.
- Avoid "giving kisses" and licking the face of dog and cat.
- Always remove dog droppings on the shoes thoroughly and do not carry them into the apartment. (fp, no, last changed on 28.10.2016)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)
