taenia solium- taenia saginata and hydatid disease class taken for 3rd year MBBS students by me.

1. TAENIASIS and HYDATID DISEASE
Dr. Mamta T.G.
Asst. Prof., Community Medicine
Mamata Medical College

2. TAENIASIS

3. • Phylum- Platyhelminthis
• Class – Cestodes
• Zoonotic disease
• Cyclozoonosis
Strobila

4. Taenia saginata
• Live in small intestine
• 5-12 m long up to 24m
• 4 suckers
• No rostellum or hooklets
• 1000-2000 proglottids are seen

5. Taenia solium
• Lives in jejunum
• 2-3 m long
• 4 large cup like suckers
• 20-50 hooks
• <1000 proglottids

6. Rostellum

7. T.saginata
Man
Cow
T.solium
Man
Pig
Definite host:
Intermediate host:

8. Hooklets
Bile stained egg and doesn’t float in salt solution

9. Scolex of larva invaginated in cyst

10. • Agent : Cysticerci (larval cyst of Taenia)
• Host : Man
• Environmental : undercooked meat,
contaminated food,
reinfection
Epidemiological determinants

13. T.solium

15. T.saginata

16. • Ingestion of infected Cysticerci in undercooked
Beef / Pork.
• Ingestion of food, water or vegetables
contaminated with eggs.
• Reinfection – transport of eggs from bowel to
stomach.
• Incubation period 8 to 14 weeks
Mode of infection

17. Symptoms
• Abdominal discomfort
• Chronic Indigestion
• Anorexia
• Acute abdominal obstruction
• Appendicitis and cholangitis
These are due to adult worms

18. Diagnosis
• Eggs and proglottids in stool
• Species identification based on
proglattid morphology
• Scolex identification
• Stool PCR or ELISA

21. Comparison of Gravid Proglottids
T.saginata T.solium
>12 branches per side 10 branches

22. • Praziquantel 10mg/kg body wt. single dose.
• Niclosamide single dose 4 tabs. of 2gm.
Given in morning with empty stomach chewed and
swallowed.
Treatment

24. • Agent : Embryonated eggs
• Host : Man
• Environmental : Unhygienic conditions
Human Cysticercosis

25. • Hetero infection ingestion of eggs of T.solium in
contaminated water or food.
• Auto infection  regurgitated eggs into
small intestine.
Mode of infection

27. Cysticercosis

28. Occular Cysticercosis
Clinical disease

29. Neurocysticercosis
Neurological deficits depending upon their locations

30. Hydrocephalus
Hydrocephalus / Coma / Death

31. Muscular Cysticercosis

32. • Biopsy whenever possible
• Physical (palpation) and radiological evidence.
• Enzyme linked immunoblot serological test, can be as high as 98%
sensitive , 100% specific.
• MRI
Diagnosis

33. MRI

35. Treatment
• Surgical removal of cysticerci.
• Steroids during time of neurological symptoms.
• Praziquental 50mg/kg/day 3 divided doses for 15 days.
• Albendazole 400mg/BD with fatty meal for 14 days.
3monthssubarachnoid and ventricular cysts
• Anticonvulsants (e.g.Dilantin).

36. • Treatment of infected persons
• Meat inspection
• Health education
Preventive measures

37. Meat inspection
• Beef and pork is adequately cooked.
• Freezing meat below -50c for more than 4 days
will kill cysticerci.
• Meat should be routinely inspected for evidence of Taeniasis at slaughter.
• Proper housing and feeding of pigs and cattle.

38. • Washing hands before eating and after defecation.
• Avoid usage of raw sewage for irrigation of pasture
soil.
• Prevent the pollution of soil, water and food with
human faeces.
Health education

39. Hydatidosis

40. HYDATID DISEASE

41.  Zoonotic disease caused by metacystode stage of the canine
intestinal tapeworm – ECHINOCOCCUS.
 With dog as definitive host and man as accidental
intermediate host.
HYDATID DISEASE

43. History
• Hippocrates was the first to
describe hydatid cyst .
• Goeze recognized their
relationship to tapeworms by
studying their scolices in 1782 .

44. ECHINOCOCCUS: MORPHOLOGY
 ECHINOCOCCUS species are small tape
worms rarely more than 7 mm in length.
 The scolex bears 4 suckers, 2 rows of hooks.
 No. of proglottids varies from 2-6.
 At present 4 species are regarded.

45. Species Distribution Type
Echinococcus.
granulosus
World wide Unilocular
Hydatidosis
E. multilocularis Northern
hemisphere
Alveolar
E. oligarthus Central and south
America
Hydatidosis
E. vogeli Central and south
America
Polycystic
Hydatidosis

46. Epidemiology
Distribution & frequency of disease:
 A public health problem of nearly global dimensions.
 Found in all sheep raising countries
(Aus, USSR, middle .E. countries. etc)
 Foci also exist in INDIA where AP & TN has highest
 Prevalence.
 Latin America 84.3/10,000

47. Geographical distribution

48. Determinants
Agent factors
• Agent : Echinococcus granulosus
• Source of infection: contaminated
food and water
• Reservoir :
• Definite : dog , cat , fox
• Intermediate : sheep , cattle

49.  Host factors:
 Not a successful parasitism since there is no portal of exit in man.
Incubation period: from months to years depending on
No of cysts
location of cysts
rapidity of growth
 Human behavior in relation to dogs and cats.
 Uncontrolled slaughter.
 Indiscriminate disposal of offal.

50.  Eating habits of people
play an important role in
epidemiology of disease.
Hydatid disease is an occupational
disease in certain groups.
e.g., shepherds, butchers and
shoe makers.

51. Modes of transmission:
 Indirect transmission
 Inhalation of dust contaminated with infected
eggs
• Ingestion of eggs of Echinococcus with food,
unwashed vegetables and contaminated water.
• Hand to mouth transfer after handling/ playing with infected dogs.
 NO MAN TO MAN TRANSFER

53. • PATHOGENESIS:
• Cysts obstruction
pressure symptoms
hepatomegaly
hypersensitivity
• INCUBATION PERIOD : months to years

54. CLINICAL FEATURES
 The manifestations are usually several years after exposure.
 The manifestations may differ based on size of cyst
and its site.
SIZE: pin head – asymptomatic
largest – pressure symptoms
e.g.: jaundice in liver cysts

55. SITE:
70% - Rt. lobe of liver
30% - Lungs, brain, long bones and kidney. In vital organs it may cause severe
symptoms and even death.

59. DIAGNOSIS
CLINICAL:
 H/o of residence in an endemic
area.
 H/o close association with dogs.
 H/o slowly growing cystic tumor.

60. Radiological :
 plain x- ray
 CAT scan
 USG

62. SEROLOGY:
 Indirect IFA
 ELISA
 CASONI
Multiple pseudopodia like eruptions in half an hour

64. TREATMENT
• No specific treatment except the surgical
removal of the cysts.
 But it is not without considerable risk such as
accidental penetration of one of the cyst lead to Anaphylactic shock - fatal
Mebendazole (vermox) tried & found effective in mice

65.  Puncture
 Aspiration
 Injection
 Reaspiration

67. PREVENTION & CONTROL
Controlling the reservoir
 Elimination of stray dogs.
 Drastic reduction of dog population.
 Effective dog – registration system.
 Surveillance of dogs based on periodic stool examination.
 Treatment for infected dogs: a single oral dose of teanifuge 5
mg/kg of body weight.

68. Interruption of transmission:
 Proper washing of hands after handling/playing.
 Wash the vegetables thoroughly.
 Prevent contamination of water with faeces from infected dogs.
 Proper meat inspection.
 Preventing dogs from gaining access to raw offal at slaughter houses.

69.  The susceptible host:
 Health education of the public particularly butchers, dog owners, animal
breeders and shepherds is the basis of effective prevention since no specific
treatment or immunization is available for this disease.

70. Lets see what you understood today