Teniarinhoz( bovine tapeworm) - Causes, symptoms and treatment. MF.

Teniarinhoz is a chronic course of biohelminthosis, which is recorded everywhere. A high incidence of this disease is registered in countries of Africa, South America, Australia. On the territory of Russia, a high incidence is recorded in the Yamalo-Nenets Autonomous District, the Chechen Republic, the Altai Republic, the Komi Republic, Dagestan and others, where the indicator ranges from 1.1 to 10 or more cases per 100,000 population. In Russia, in addition to the regions described above, shadyarinhoz occurs with a certain frequency in Udmurtia, Perm Krai, the Krasnoyarsk Territory, the Novosibirsk Region, the Krasnodar Territory, the Orenburg Region, the Republic of Mari El. In other territories of the Russian Federation, single cases of arthritis with a low incidence rate in the region can be recorded.

TENIARINHOSH is a parasitologic disease of a person that is caused by helminth bovine tapeworm, and is characterized by impaired function of the gastrointestinal tract and a tendency to chronic course of the disease.

Causes of development of shadyearhoza

The causative agent of helminthiasis is a representative of the class of Terran worms, the species Chain - bovine tapeworm( Toeniarhinchus saginatus).This is a fairly large worm length of an average of 6-7 meters( from 4 to 12 meters).Bovine tapeworm consists of a head, neck and proglottids or strobiles( segments), the number of which is large - up to 2000 pcs. Mature segments, like other helminths, are located in the distal areas and have a mature uterus( respectively the parasite is a hermaphrodite), they are filled with oncospheres( eggs) up to 150 pieces in each segment. Features of the chain - 4 suckers on the head, the ability of the segments to creep independently on the grass, the presence of each segment of its own reproductive system.

About the conclusive host of is a human. In the human body parasitic sexually mature bull tadpole, respectively, the person allocates eggs with feces into the environment. Segments of the chain can independently crawl out and move on the body of the patient after the act of defecation. The segments are identified on the 80th day after the moment of invasion( infection).

Sexually mature bull tartar

Intermediate host - cattle, deer, zebra, yak, buffalo and others. The intermediate host is infected by eating oncospheres during nutrition( with grass, soil).Muscular tissue develops cysticerca or Finns( larvae of the chainworm), which becomes dangerous for human infection on average in 4-5 months.

Intermediate host of bovine tapeworm and source of infection by shteyearhinz for human

The mechanism of infection is alimentary, and the pathway is food. Human infection occurs through raw or poorly processed meat containing Finns( invasive larvae). The sick person for the surrounding people is not infectious, the oncosphere must go the way of development to the larvae in the body of the intermediate host, which are dangerous for human infection.

Susceptibility to shtayearhinosis is universal, adults are more likely to get sick.

Oncographs of bovine chain

Development cycle of bovine tapeworm:

Eggs with feces enter the external environment( they are located in the strobilae-segments, actively move), from the oncosphere( on grass, soil, hay).Onkosfery sufficiently stable in the external environment - can withstand low temperatures( practically can withstand wintering in the soil), die at high temperatures( up to 29-37º), with the action of ultraviolet rays. Animals become infected by eating grass contaminated with feces of a sick person. In the gastrointestinal tract of the intermediate host, larvae emerge, which penetrate through the intestinal wall into the blood vessels and are carried throughout the body. They settle in muscle tissue or intermuscular connective tissue elements( heart, tongue, chewing, skeletal), where they become a cysticerc( finnus) in about 4-5 months.
The life span of Finns in the host organism is approximately 8-9 months, after which they die. If during this time the Finn gets into the human body( eating the finnish meat), the cysticercus turns out the scolex, attaches to the mucous membrane more often than the duodenum and forms a sexually mature specimen. The duration of parasitizing bovine tapeworm in humans is about 20 years.

Development cycle of bovine chain

Immunity after the transferred shadowarhinosis is non-sterile, unstable.

Pathogenic action of bovine tapeworm in the human body:

1) mechanical action( suckers, joint activity), violation of secretory and motor functions of the gastrointestinal tract( catarrhal inflammation of the intestinal mucosa);
2) provocation of pain syndrome during passage of the segments through the buginium valve( as with appendicitis);
3) the accumulation of chains in the intestine leads to intestinal obstruction or inflammation;
4) deficiency of valuable nutrients because of their intensive consumption by chain;
5) sensitization of the body( development of an allergic reaction).

Symptoms of arthrosis

Allocate an early and late( chronic) stage of teniarinchosis. The early stage has been poorly studied due to unexplained or absent symptoms, therefore the course of the early stage is considered to be erased and malosymptomatic.

Four main syndromes are allocated to the chronic stage of shteyearhinosis:

1) asthenovegetative( general weakness, malaise, fatigue, poor sleep, dizziness, headache, increased irritability);
2) dyspeptic( nausea, sometimes vomiting, heartburn, unsteadiness of the stool - often loosening, but sometimes a tendency to constipation, hypersalivation - increased salivation);
3) abdominal pain in the abdominal area without a specific place of localization: it can be pain in the stomach - epigastrium, pain in the iliac region - in the lower abdomen on the left or on the right);
4) a special change in appetite( a decrease in appetite is sharply replaced by its increase).

Sometimes, the only evidence of the presence of the disease is the departure of the helminth and its segments from the intestine without presenting any complaints by the patient.

In a general blood test: rarely a small eosinophilia( increased eosinophils), leukopenia( decrease in leukocytes), anemia( decrease in red blood cells, hemoglobin).

In the study of gastric juice - a decrease in acidity in 70% of cases.

When X-ray examination of the intestine - there is a smoothed relief of the mucous membrane of the small intestine.

Complications of arthrosis

- Intestinal obstruction due to the accumulation of a tartar and overlapping of the intestinal lumen;
- Perforation( opening) of the intestinal wall by the chain and the development of peritonitis;
- Inflammatory phenomena( pancreatitis, appendicitis, cholangitis, DZHVP);
- Atypical location of the parasite( gall bladder, appendix, nasal cavity).

The prognosis of the disease is favorable in most cases.

Diagnosis of arthrodesis

The diagnosis is complicated due to the asymptomatic course of parasitosis. The main methods in diagnosing:

1) Gathering of an epidemiological history( the fact of using crude or thermally malo-processed meat of the intermediate host);
2) The fact of the exit from the intestine of moving segments of the parasite during the act of defecation and outside it;
3) Ovoscopy of feces and perianal scrapings followed by differential diagnosis between shadowarhinchosis and shadowsiosis( microscopy of the revealed segments with detection of the uterus with lateral branches - a sign of the ovocyst of bovine tapeworm);
4) General blood test( eosinophilia, leukopenia, anemia);
5) X-ray detection of the parasite in the intestine.

Differential diagnosis is performed with teniosis and diphyllobothriasis.

Treatment of arthrosis

Deworming is performed with antiparasitic agents.

1) On the eve and during the days of treatment - slagless diet.
The slag-free diet includes the following principles:
- to exclude from food fried, fatty, smoked, salty and sweet;
- low-fat soups, broth, rice, buckwheat, dairy products, lean fish, wholemeal bread, compotes, tea, jelly should be present in the diet;
- categorically prohibited: beets, cabbage, garlic, radish, sorrel, spinach, beans, apricots, grapes, peaches, gooseberries and raspberries, millet grains, pearl barley, milk, carbonated drinks, coffee, chocolate, alcoholic beverages;
- to eat in small portions, 5-6 times a day.

2) The main drug for the treatment of teniarinchosis is fenasal according to one of two schemes.
- in the evening a light supper, then ½ tsp.sodium bicarbonate in ¼ cup boiled water, after 10-
15 minutes diluted in 1/2 cup of sweetened water suspension of fenasal( a dose prescribed by a doctor, an average for an adult is 2-3 grams);
- in the morning on an empty stomach the same procedures in the same sequence.

After receiving fenasal, the parasite dies and comes out naturally in the act of defecation, no additional measures are needed.

The patient must change clothes daily. Treatment is performed on an outpatient basis. The effectiveness of treatment is assessed by the absence of segments of bovine tapeworm in feces during the next 3 months.

3) Alternative drug - biltricid( prazikvantel) once in a dose, which will prescribe
the attending physician.

4) Phytotherapy( masculine extract dry in capsules, pumpkin seeds).
On the eve of dehelminthization put a cleansing enema, an enema is also done on the morning of de-worming, after taking the drug( after 1.5 hours) give a salt laxative. The patient drinks the entire dose within 30 minutes( more often it is gelatin capsules).If there was no stool for 3 hours, then again put a cleansing enema, this will help the parasite out of the intestine.

Control of the effectiveness of treatment is carried out after 3-4 months. The patient is observed 2 years 2 times a year.

Prevention of arthritis

• Eliminate the possibility of eating raw or semi-raw meat( beef).
• Thoroughly inspect the meat before processing for the presence of a Finn( larvae of bovine tapeworm), the larvae in the meat are not always visible, but if you look closely, you can notice.

Bullfinch Finns in meat

• Thorough meat heat treatment to avoid helminth invasion: temperature not less than 80 degrees inside the piece and duration of at least 1 hour;Finnose meat does not withstand prolonged freezing( at -15 degrees for 5 days).
• A careful attitude towards one's own health( when there are symptoms of sickness or discomfort in the anus area, contacting the doctor for examination and possible de-worming).
• Survey on the epidemic.indications of persons of certain professions: shepherds, milkmaids, calves, cattle breeders.
• Study of carcasses for the presence of Finns in meat processing plants.

Doctor infectious diseases Bykova N.I.