• Teniosis( pig tsepen) - Causes, symptoms and treatment. MF.

    Teniosis has a predominant distribution in areas where pigs are widely used. It is in these countries that a high level of infection of pigs is registered, which sometimes reaches 35% in their total population. One such example is Taiwan, China, South Korea, Africa, Latin America.

    Teniosis( porcine tapeworm, armed tapeworm) is a parasitic disease of humans and animals caused by a helminth pork chain, characterized by a predominant lesion of the digestive system, namely, the small intestine, the main site of the parasite's localization.

    Teniosis, a mature adult pig of the pork chain

    Geographic spread of the shadow.

    Endemic foci of teniosis are determined primarily by the frequency of occurrence of infected pigs - the intermediate host of the shadow. These foci are combined into several endemic zones according to the shadeosis:

    1) The African zone( Nigeria, Cameroon, Zaire and others), in which, in addition to the presence of animal invasions, the social level of the population is low.

    2) Asian zone of the shadow( South Korea, China, Taiwan, Indonesia, India, Philippines), where the invasiveness of animals is high - 25-35%.Up to 20% of people in some areas suffer from shadows.
    3) The Latin American zone( Colombia, Mexico, Nicaragua and others), where up to 20% of pigs are infected, up to 300 thousand people are infected with a parasite.

    In the countries of the former USSR, the shadow occurs at a certain frequency in Ukraine( its western part), in Belarus. In Russia, the Krasnoyarsk Territory remains alarmed by the shadow.

    Causes of infection with the shadyosis

    The causative agent of the shadowosis is the helminth worm Taenia solium( pork tapeworm, armed tapeworm), having a flat( ribbon-shaped) body 3-4 meters long, consisting of a scolex with 4 muscular suckers, cervix, strobila( up to 1000 segments).

    There are a number of differences between the pork chain and the bull:

    1) Unlike the bull chain in the pig head( scolex) with 2 rows of hooks up to 32 pieces( hence the name "armed").
    2) The terminal( hermaphroditic) segments of the pork chain, in contrast to the bovine elongated segment, have an ovary with an additional third lobule( this is a differential diagnostic laboratory test).
    3) The terminal segments are immovable, therefore they can not move independently and reach the perianal area of ​​the patient.
    4) Eggs of pork tapeworm are contagious for humans( unlike eggs of bovine tapeworms).Each segment can contain up to 50,000 pieces. Eggs( oncospheres) of pork tapeworm are almost indistinguishable from bovine - within 6-tiny embryos, therefore, differentiation is carried out only when examining the terminal segments.

    Teniosis, scolex of the pork chain

    It is important to distinguish these chains because there are special features in the treatment of shinosis.

    The source of infection with the shadyosis

    The ultimate host of the pork chain is a person whose parasitic parasite is parasitized in the body( in the small intestine) and, respectively, the separation of segments with oncospheres along with feces occurs. A sexually mature individual parasitizes in the human body for dozens of years.

    Intermediate host - pig home, wild boar wild. Rare intermediate hosts - cats, dogs, monkeys, sometimes people. In their organism, oncospheres form the Finn( larvae of pork tapeworm) and the disease is caused by parasitism of the larvae. In humans, this disease, caused by the larvae of the chain, is called cysticercosis .

    Teniosis, Oncospheres of Pork Chain

    The mechanism of infection is alimentary, the way is food. A person can become infected with a shadyosis by using raw or insufficiently thermally processed meat containing Finns( larvae of the chainworm).

    At the same time, the patient himself is contagious to others and himself, since it secretes the eggs of the parasite. The difference is that he will infect people and himself not with a shadow, but with cysticercosis( the larval stage of the tapeworm), which is even more difficult to treat.

    Pork Chain Development Cycle:

    Adult matured pork chopsties parasitize in the small intestine of the final host - a human. With feces the terminal segments are allocated to the external environment. In the external environment, from the segments, oncospheres are distinguished, which enter the body of pigs when they eat contaminated by oncospheres. When the shell of eggs is destroyed in the stomach or intestine of the intermediate host, the oncospheres can freely penetrate into the blood vessels and spread throughout the body. Most of them in 2-3 days settles in the muscle tissue. Finns or cysticerci( larvae of pork tapeworm), which have a bubble appearance, are formed 60-70 days after infection. The main location of the localization of the Finn is the intermuscular connective tissue, but they can form in other organs and tissues( with cysticercosis).Cysticerci are vesicles up to 10 mm in diameter with a transparent liquid inside, and also attached to the inner wall of the bubble of the head of the chain.

    Teniosis, development cycle

    Finns are not resistant to high and low temperatures. At a temperature inside the piece of 80 ° Finns are reliably detoxified. The exposure time is not less than 1 hour. To neutralize carcasses of pigs with Finns, a prolonged freezing of meat to minus 12-15 ° is required for 10 days.

    Finns get into the body of the final host when eating meat, either raw or semi-moist, infected with cysticerci. It is in the intestine from the cysticerca that produces a matured pig of the pork chain .Two months after infection, the sexually mature segments with eggs appear in the small intestine in the tartar.

    Symptoms of man's shadowosis

    Pathogenic effect of pork chopsticks on the human body with shadyose( parasitizing a sexually mature pork tartar in the intestine):

    1) Toxico-allergic effect of the chain on the patient's body( development of an allergic reaction or allergic mood of the body).
    2) Mechanical action of the chain( due to the attachment of hooks to the wall of the intestine, its mechanical irritation occurs with the development of inflammation of the intestinal mucosa).
    3) Competitive absorption of host nutrients for its own vital activity.

    Clinical symptoms are mainly associated with parasitological effects on the patient's digestive system and are combined into several syndromes:

    1) astheno-neurotic syndrome( dizziness, headaches, syncope, sleep disturbance, irritability);
    2) dyspeptic syndrome( a violation of appetite - often its decrease, discomfort in the intestines after eating, belching);
    3) abdominal syndrome( the appearance of pain in the abdomen from malovyashennyh aching character of the pain to cramping and intense).

    In the general analysis of blood, there are often no serious disorders, in some patients an increase in the number of eosinophils( eosinophilia), as well as iron deficiency anemia.

    If a person is an intermediate host, cysticercosis develops( cysticerci - invasive larvae accumulate in the muscular and connective tissues), in which the course of the disease is extremely difficult( for details see the article "Cysticercosis").

    Immunity after the transferred shadow is not stable, it is possible to re-infection.

    Diagnosis of Shadowosis

    Preliminary diagnosis of shadows is made on the basis of clinical and epidemiological data. Clinical symptoms are not specific, therefore, careful differential diagnosis( exclude diseases of the gastrointestinal tract - gastroenteritis of bacterial and viral etiology, cholecystitis, rectal disease, Crohn's disease, etc.) should be performed. In support of a preliminary diagnosis, an epidemiological anamnesis is collected( eating suspicious, raw or insufficiently thermally processed meat, and meat without prior veterinary examination).

    The final diagnosis is made after a thorough laboratory examination:

    1) Examination of feces to detect scrapings of strobila - terminal segments that do not creep out. The terminal( hermaphroditic) segments of the pork chain, in contrast to the bovine elongated segment, have an ovary with an additional third lobe( this is a differential diagnostic laboratory test).
    2) Ovoscopy of perianal scrapings in order to detect terminal segments( they are immovable).The differential sign is the same.
    3) Serological methods - a blood test for the detection of specific antibodies to pork chain antigen( more relevant for cysticercosis, in which the diagnosis of stool is difficult).
    4) Additional methods: general blood test( eosinophilia, hypochromic anemia), coprogram, instrumental methods( radiography and scopies).

    Treatment of Shadowosis

    All patients should receive treatment in a hospital because of the danger of developing cysticercosis when the shells of eggs are destroyed and the oncosphere drifts into the total bloodstream.

    Compliance diet regime: diet( Table) № 13, which is indicated for acute infectious diseases, with parasitosis. The diet is 4-5 times a day in small portions. There should not be long "hungry" intervals between meals. A diet with an energy value that is lowered to a large extent due to fats and carbohydrates, with an increased content of vitamins
    Daily ration: proteins - 75-80 g( 60-70% animals);fats - 60-70 g;carbohydrates - 300-350 g;energy value - 2200-2300 kcal

    Recommended products and dishes:
    wheat dried bread;
    skimmed meat and fish broths, soups on vegetable broth, mucus broths from cereals;
    low-fat meat, poultry, fish;
    lactic acid drinks, cottage cheese;
    rubbed porridge of rice, semolina and buckwheat groats;
    potatoes, carrots, beets, cauliflower, ripe tomatoes;
    ripe soft fruits and berries, broth of wild rose;sugar, honey, jam, jam, marmalade.

    Excluded foods and dishes:
    rye and any fresh bread, baking;
    fat broths, cabbage soup, borsch;
    fatty grades of meat, poultry, fish, sausage, smoked meat, salted fish, canned food;
    whole milk and cream, fatty sour cream, cheeses;
    millet, barley and barley cereals, pasta;
    cabbage, radish, radish, onion, garlic, cucumber, legumes;
    fruits rich in fiber;
    chocolate, cakes, cocoa

    Medical treatment of shinose

    Treatment rules:

    a) Drugs that cause strobilus decay and the possible development of cysticercosis are contraindicated( fenasal and others).

    In intestinal shadows, a single appointment of prazikvantel( biltricide) is possible, the dosage prescribed by the doctor. The drug paralyzes the parasite, the latter ceases to hold onto the intestinal wall and leaves with feces.

    The extract of the male fern also causes paralysis of the helminth muscles and its rapid death. Two days in the patient diet regime, at night saline laxative( magnesia sulfate).The third day: cleansing enema, then within half an hour to drink the entire dose of fern( an average of 4-7 grams for an adult), washing down with water, after 40-50 minutes again a salt laxative. Breakfast only after 1-1.5 hours. In the absence of stool for the next 3 hours put cleansing enema.

    Pumpkin Seeds: 500g seeds pour boiling water so that they are covered with water and a water bath for 1.5-2 hours. Then in the morning on an empty stomach take all the brewed seeds with the decoction for 30-40 minutes. After 2 hours, a saline laxative.

    b) The presence of stools is mandatory for 2-2.5 hours after therapy, since in the future the paralyzing effect of fern and pumpkin seeds ends.

    c) Avoid vomiting in order to avoid drifting the parasite segments into the stomach and re-infection. E) After the release of the helminth, examine it for integrity in avoiding the preservation of terminal segments in the intestine.

    Clinical follow-up after the transferred shadows is established for a period of 4 months with the control of therapy - a 4-fold study of feces with an interval of 1 month.

    Prevention of Shadowosis

    • Purchase of meat products only in specialized large food establishments.
    • Visual examination of purchased meat for the presence in it of Finn( cysticerci) of pork chain and any suspicious inclusions.

    Teniosis, finnish Finns in raw meat

    • Eating only well-processed meat. Recall: reaching the temperature inside the piece above 80 ° for an hour. Prolonged freezing of meat for 10 days also leads to the death of the Finn.
    • Do not sample raw minced meat during cooking.
    • To monitor your own health and the health of your loved ones, and when symptoms of the disease appear, consult a doctor in a timely manner.
    • Sanitary-veterinary control over the state of pig meat at meat-packing plants.
    • Survey of decreed persons for invasiveness( workers in pig complexes, meat processing enterprises).

    The doctor infektsionist Bykova N.I.