Taenia Eggs Research Articles

Reply to “To Differentiate Taenia Eggs”

We appreciate the interest in this photo quiz, which showed a Taenia egg with an intact primary membrane ([4][1]). It would be useful to distinguish between eggs of Taenia solium and Taenia saginata, because T. solium can cause both cysticercosis and gastrointestinal infection in humans, while T.

Neurocysticercosis in Europe

Joob and Wiwanitkit [1] raised two points regarding our paper on neurocysticercosis in Western Europe [2]. First, they considered that there should be comparative data to support our suggestions that the prevalence of neurocysticercosis in Western Europe may be on the rise. This was based on the comparison of reported cases over the past four decades. As clearly stated on our paper, the number of publications and patients with neurocysticercosis steadily increased from 1970 to 2011. Of the 779 patients captured in our review, only 28 were published from 1970 to 1985, and the remaining 751 were reported from 1996 to date. Such an increase goes far beyond an enhanced interest of physicians for publishing neurocysticercosis cases, and clearly reflects an increase in its prevalence. Regarding the second topic raised by Joob and Wiwanitkit, the authors must have been confused. Taeniasis is a food-borne disease acquired by eating undercooked pork meat infested by cysticerci. In contrast, cysticercosis is mostly transmitted from person-to-person [3, 4]. It would be wise to review the life cycle of Taenia solium—clearly described more than one century ago—before commenting on this point, as it may create confusion among readers who are not familiar with the disease complex taeniasis/ cysticercosis. Humans become infected by cysticerci after ingesting Taenia eggs from a Taenia carrier.

A Review of Cases of Human Cysticercosis in Canada

Review of human cysticercosis in Canada, to estimate the magnitude of the disease and to describe the pattern of disease expression in this country. MEDLINE and manual search of case reports and case series of patients with cysticercosis diagnosed in Canada. Abstracted data included year of diagnosis, citizenship status, clinical manifestations, and form of cysticercosis. A total of 21 articles reporting 60 patients were found. Forty (67%) of these patients were diagnosed in the past two decades. Most cases came from Ontario (n=43) and Quebec (n=14). Immigrants accounted for 96% of the 28 cases in whom citizenship information was available. Neurocysticercosis was observed in 55 patients, and isolated compromise of striated muscles in the remaining five. Seizures was the primary or sole manifestation of the disease in 72% of patients, and most of them had parenchymal brain cysticerci (either viable cysts or calcifications). Two of seven patients were positive for Taenia eggs. In no case were household contacts of the patients investigated for taeniasis. An increasing number of patients with cysticercosis have been reported from Canada in the past two decades, suggesting that the prevalence of this parasitic disease may be on the rise. While most cases occur in immigrants, it is possible that at least some of these patients had acquired the disease in Canada.

Answer to April 2012 Photo Quiz

Answer: Taenia species. The spherical egg shown had a diameter of 40 μm. The thick, radially striated shell and hooked embryo inside the egg are characteristic of a Taenia egg. This egg is surrounded by a thin primary membrane. It is unusual to see the primary membrane of Taenia eggs, because this

Differentiating Taenia eggs found in human stools: does Ziehl-Neelsen staining help?

To determine whether Ziehl-Neelsen staining can differentiate Taenia solium from Taenia saginata eggs. Tapeworm proglottids (33 specimens, 23 T. solium and 10 T. saginata) and eggs (31 specimens, 13 T. solium and 18 T. saginata) were stained. Four eggs from each sample were measured and average diameters were recorded. Taenia saginata eggs stained entirely magenta in seven of 13 cases. Taenia solium eggs stained entirely blue/purple in 4/18 cases and entirely magenta in one. Eggs of T. saginata were slightly larger and always ovoid, while T. solium eggs were smaller and mostly spheric. Ziehl-Neelsen staining can occasionally distinguish fully mature T. solium from T. saginata eggs, but this distinction is neither very sensitive nor completely specific. Differential staining suggests differences in embryophore components between species which become evident with egg maturation. In this small series, egg morphology (shape, maximal diameter) provided appropriate differentiation between T. solium and T. saginata eggs.

Gastrointestinal: Beef tapeworm (Taenia saginata)

A 50-year-old Lebanese woman living in Australia was admitted to hospital with epigastric pain and melena. She had been taking warfarin for atrial fibrillation. Upper gastrointestinal endoscopy revealed a shallow ulcer, 6 mm in diameter, at the pylorus with no evidence of recent bleeding. She also had an unusual vascular lesion, 8 mm in diameter, in the second part of the duodenum that showed active bleeding, a fresh clot and a visible vessel (Figure 1). Hemostasis was achieved by the use of adrenaline injections and electrocautery. She also received an eradication regimen for Helicobacter pylori. Four weeks later, she was readmitted to hospital with melena and anemia (hemoglobin 96 g/l). Repeat upper gastrointestinal endoscopy was normal apart from scarring in the second part of the duodenum. Colonoscopy was also normal. Capsule endoscopy revealed a long, segmented tapeworm that extended from the mid-jejunum to the mid-ileum (Figure 2). Small erosions were seen near the proximal end of the tapeworm but there was no active bleeding. Fecal microscopy revealed Taenia eggs as well as cysts and trophozoites of Entameba hartmanni and Iodameba buschlii. She was treated with praziquantel, 600 mg bd for 2 days. She recalled having eaten raw beef in Lebanon in 2002. Approximately 50 million people are thought to be infected with Taenia saginata, largely in Africa, the Middle East and some parts of Europe. Infections are rare in countries such as the United States, Canada and Australia. Human infections are acquired by eating raw or semi-raw beef that contains the larval stage (cysticercus) of the parasite. The cysticercus is an oval bladder, approximately 8 mm × 5 mm, that is filled with fluid and contains the invaginated scolex of the tapeworm. In the human, the scolex attaches to jejunal mucosa and develops into an adult tapeworm, 4-10 meters in length, after 3-4 months. The majority of people have only a single tapeworm but these parasites can survive for up to 30 years. Symptoms include abdominal discomfort and nausea as well as perianal symptoms associated with the discharge of proglottids. On fecal microscopy, it is not possible to distinguish eggs from T. saginata from those of T. solium. However, differentiation may be possible with a careful examination of fecal proglottids. Effective drugs include praziquantel (as above) and niclosamide.

Population-based survey of taeniasis along the United States–Mexico border

Taenia solium and T. saginata are zoonotic tapeworms of substantial medical and economic importance. Although human taeniasis is widely recognised as an endemic problem in Mexico, its presence in the United States is poorly understood. The first population-based study to estimate the prevalence of human infection with Taenia tapeworms along the Texas-Mexico border has recently been conducted. Households were interviewed in the Texan city of El Paso and in the neighbouring Ciudad Juárez, in Mexico. Faecal samples from household members were then checked for Taenia eggs by flotation and/or for Taenia copro-antigens in an ELISA. The overall prevalence of taeniasis in this border region was found to be 3% but, compared with the residents of Juárez, El Paso residents were 8.6-fold more likely to be tapeworm carriers. The interviews revealed some important differences between the two study sites, particularly the more frequent use of anthelminthic drugs on the Mexican side of the border. These findings have implications in terms of the planning of effective health-education campaigns to decrease the prevalence of taeniasis in the human populations along the Texas-Mexico border.

Prevalence and associated risk factors of Taenia solium taeniasis in a rural pig farming community of north India

There is a lack of information on the disease burden due to Taenia solium taeniasis and its associated risk factors in pig farming communities throughout the world. The present study was conducted in a rural pig farming community of north India to estimate the prevalence of T. solium taeniasis and associated factors. Demographic, clinical and epidemiological data were collected from 1181 subjects in 210 households in 30 villages. Stool specimens from 924 subjects were examined for eggs of Taenia and other parasites. Identification of T. solium was confirmed by morphological features of segments and species-specific DNA detection from segments and stool. The prevalence of T. solium taeniasis was 18.6% (172/924); factors associated with taeniasis on multivariate analysis were age above 15 years, history of passage of Taenia segments in stool, undercooked pork consumption and poor hand hygiene (hand-washing with clay/water after defecation). Seventy-eight subjects (6.6%) with epilepsy were identified. The study showed alarmingly high rates of epilepsy and T. solium taeniasis in the study community; it highlights the need for large-scale imaging-based surveys to identify the factors associated with epilepsy including neurocysticercosis. Health education, mass anthelminthic therapy and other preventive measures are required to control the menace of the disease.

Soil contamination with ascarid eggs in playgrounds in Kirikkale, Turkey

Contamination of soil with feline and canine ascarid eggs in eight playgrounds in Kirikkale, Turkey was investigated monthly from February 2003 to January 2004. Dog faeces were also collected and all samples were examined using the zinc sulphate centrifugal flotation method. Eggs of Toxocara were observed in 5 of 8 (62.5%) of playgrounds examined and in 15.6% of 480 soil samples. The number of eggs varied from 1 to 11. Eggs were observed in soil samples collected in February, March to June, August and November, with embryonated eggs appearing in June and August. Eggs of Toxascaris leonina and Taenia spp. and oocysts of Isospora spp. were also found in 1.5%, 1.0% and 0.2% of soil samples, respectively. Of 26 samples of dog faeces collected, 7.7% were contaminated with Toxocara spp. and 11.5% with Taenia spp. The presence of Toxocara eggs in the city playgrounds and dog populations suggests a potential human health hazard due to toxocariasis.

Taeniasis/cysticercosis in Papua (Irian Jaya), Indonesia

Reports showed that an important parasitic zoonotic disease caused by Taenia solium, Taenia saginata and Taenia asiatica is found endemic in several areas of Indonesia including Papua, Bali and North Sumatra. At present it is known that the highest prevalence of taeniasis/cysticercosis in Indonesia, caused by T. solium is among the indigenous communities in Papua (formerly Irian Jaya). In the early 1970s, 8–9% of stool samples from the Enarotali hospital, Paniai District (Irian Jaya) were found positive with Taenia eggs. The samples were from members of the Ekari (Kapauku) ethnic group. Stool samples from the Moni ethnic group, living east of surrounding lakes, were egg negative. Cysticerci of T. solium were discovered in pigs. During the years 1973–1976 cases of burns increased and were ultimately found to be primarily associated with epileptic seizures induced by neurocysticercosis cases. Among 257 cases of burns, 88 cases (62.8%) were suffering from epileptic seizures before or during hospitalization. In the year 1981 T. solium seropositive persons were mostly (16%) found in the endemic Obano village. In 1997 the parasite was discovered in Jayawijaya District, which is located approximately 250 km east of Paniai District. During 1991–1995, a local health center in Assologaima, Jayawijaya District reported 1120 new cases with burns and a further 293 new cases of epileptic seizures among 15,939 inhabitants. The histopathologic appearance and mitochondrial DNA analysis found the cysts to be similar to those of T. solium from other regions of the world. Sensitive and specific serological diagnostic methods were used and improved. Cysticerci were detected in dogs, as well as in pigs. A coproantigen test for detection of adult tapeworms in patients was carried out. Medical treatment with praziquantel for taeniasis and albendazole for cysticercosis (with prednisone and sodium phenytoin treatment in cases with neurocysticercosis) was undertaken. Lifestyle, religion, and socioeconomic aspects are important issues in the perpetuation and enhancing the endemicity of T. solium taeniasis and cysticercosis in Papua, Indonesia.

Prevalence of intestinal parasitic infections in northern Vietnam.

We surveyed the prevalence of parasitic infections in the mountainous province of Hoa Binh, north-west Vietnam, involving 526 households of six ethnic groups: Muong, Kinh, Dao, Thai, Tay and Hmong. Eggs or cysts of at least one parasite species were detected in 88% of stool samples (n = 2522). Prevalences of nematodes were high among all ethnic groups: hookworm (52%), Trichuris trichiura (50%) and Ascaris lumbricoides (45%). Ascaris infection appeared to be lower in households owning a latrine, was highest among children and decreased with age. Prevalence of hookworm rose during childhood, remained high until old age, was highest among adult women, but was not linked to anaemia. Eggs of Chlonorchis spp. were found in 126 (5%) individuals (of the Muong, Kinh or Thai groups only). Chlonorchiasis increased with age and was highest among adult men. Taenia eggs were found in three individuals (0.1%). Giardia lamblia was found in all districts and among all groups and the prevalence of infection was estimated at 3%.

Epidemiological study of Taenia solium taeniasis/cysticercosis in a rural village in Yucatan state, Mexico.

A survey to detect human taeniasis and cysticercosis was conducted in a community in Yucatan state, Mexico, an area endemic for Taenia solium. Information on the environmental, demographic and risk factors associated with transmission of T. solium within the community was recorded on questionnaires. Although no Taenia eggs or proglottides were found in the initial faecal samples collected from each of the 475 subjects, the results of a capture-ELISA for T. solium coproantigen were positive for 10 of the subjects (of both genders and various ages). After treatment with niclosamide, proglottides were detected in purge samples from seven of these 10 subjects. The prevalence of parasitologically confirmed taeniasis was therefore 1.5% (seven in 475). The other three ELISA-positive cases delayed supplying faecal material post-treatment, and it is nuclear whether they had expelled proglottides before providing the samples. All 10 ELISA-positive subjects became ELISA-negative after treatment. Seroprevalence of human cysticercosis, based on the detection in immunoblots of antibodies to antigens of 8- and 26-kDa from a crude saline extract of T. solium metacestodes, was 3.7% (i.e. five positives out of 134 subjects). None of the seropositive cases demonstrated clinical symptoms of infection. Again, the positive cases were of both genders and various ages. Although tongue palpation indicated that 17 (23%) of 75 pigs kept within the community had T. solium cysticercosis, the results of immunoblotting demonstrated antibodies to the 8- and/or 26-kDa antigens of T. solium in 26 (35%). The pigs allowed to roam throughout the community were far more likely to have cysticercosis than those kept in pens (odds ratio = 42, with a 95% confidence interval of 5.05-920.2; P < 0.00001). Not surprisingly, the risk factors associated with human taeniasis and cysticercosis included the eating of infected pork and close proximity to a carrier of T. solium. The main risk factor identified for porcine cysticercosis was free-range husbandry, permitting access to human faeces. This is the first comprehensive report of taeniasis and cysticercosis in a rural population from the Yucatan peninsula of Mexico.

Basic and applied immunology in cestode infections: from hymenolepis to Taenia and Echinococcus

In larval cestode infections, it is well established that the intermediate mammalian host infected with egg-derived metacestodes in the tissue becomes completely immune to reinfection with eggs, whereas autoinfection has been conceived to occur in Hymenolepis nana/mouse (and human) and Taenia solium/human systems when these hosts are initially infected with metacestode-derived adult tapeworms in the lumen. In this review paper, the first topic is immunobiology of H. nana/mouse system on the reinfection immunity in order to get critical information as to how the initially ingested parasite (eggs or metacestodes) can develop into adult worms and how autoinfection does or does not occur in immunocompetent mice, since H. nana can complete its whole life cycle in the mouse intestinal tissue and lumen. When mice are infected with eggs (=oncospheres) of H. nana, they become immune to challenge infections with eggs within a few days (early response) and with cysticercoids within two weeks (late response). The initially established adult worms are expelled later (worm expulsion response). When mice are infected with cysticercoids, either derived from beetles or mice, they become immune to challenge infection with cysticercoids but not with eggs. Therefore, autoinfection occurs in the intestinal tissue for the establishment of cysticercoids in the tissue but never occurs in the intestinal lumen for the establishment of adult worms in immunocompetent mice. The second topic is vaccination trial against challenge infection with eggs of Asian Taenia in pigs. Pigs vaccinated with frozen oncospheres of Asian Taenia from Taiwan or Korea or T. saginata showed very strong resistance, whereas pigs vaccinated with those of T. solium showed partial resistance only. It is suggested that Asian Taenia is much closer to T. saginata than T. solium from the immunobiological viewpoint. The third topic is immunodiagnosis of echinococcosis and cysticercosis. Immunoblot analysis has revealed that Em18 (18kDa component of crude antigens of Echinococcus multilocularis protoscolex) and glycoproteins of T. solium cysticerci are highly specific or unique to alveolar echinococcosis and cysticercosis, respectively. The fourth topic is discussion on miscellaneous prospects including laboratory animal models for echinococcosis and cysticercosis.

Echinococcosis.

Echinococcosis is a human disease caused by the larval form of Taenia echinococcus, which lives in the gut of the dog, wild canides and other carnivorous animals which represent the definitive hosts and involves as intermediate hosts both domestic and wild animals. Humans become accidental intermediate hosts by ingesting Taenia eggs. The main species pathogenic for man are E granulosus causing cystic echinococcosis with worldwide distribution and endemic in sheep and cattle breeding countries, and E multilocularis causing alveolar echinococcosis, with preferential distribution in the northern hemisphere. After ingestion of contaminated food, hexacanth embryos migrate by the portal system to liver and later lung, brain and other tissues. Symptoms are related to both cyst location and size. E granulosus infection of the central nervous system (CNS) may be primary or secondary and has been estimated to be low (2%). Sharply demarcated, spherical and intraparenchymal, cysts may reach a large size causing neurological symptoms. Spilling of cyst fluid due to trauma or surgery may trigger anaphylaxis as well as disseminated infection. Host reaction is minimal in the brain but a foreign giant cell reaction may develop. E multilocularis develops within the liver as a rapid invasive pseudomalignant growth and may metastasize to the CNS, where estimated incidence reaches 5%. Hydatid antigens induce an immune reaction in the host which is helpful for the diagnosis. DNA probes and PCR may be applied to differentiate between Echinococcus spp. Although the host develops an immunological protection from reinfection, the parasite evades host immune attack. A wide range of evasion mechanisms have been advanced, including a barrier for host cells due to hydatid cyst laminated cuticle, polyclonal activation of lymphocytes by parasite soluble antigens, and depression of host cell immune responses. Chronic stimulation of the host by cyst fluid antigens leads to increased specific IgG4 production, which might act as blocking antibodies against anaphlaxis suggestive of host response immunomodulation.

Pathogenic agents in freshwater resources

Numerous pathogenic agents have been found in freshwaters used as sources for water supplies, recreational bathing and irrigation. These agents include bacterial pathogens, enteric viruses, several protozoans and parasitic worms more common to tropical waters. Although infected humans are a major source of pathogens, farm animals (cattle, sheep, pigs), animal pets (dogs, cats) and wildlife serve as significant reservoirs and should not be ignored. The range of infected individuals within a given warm-blooded animal group (humans included) may range from 1 to 25%. Survival times for pathogens in the water environment may range from a few days to as much as a year (Ascaris, Taenia eggs), with infective dose levels varying from one viable cell for several primary pathogenic agents to many thousands of cells for a given opportunistic pathogen. As pathogen detection in water is complex and not readily incorporated into routine monitoring, a surrogate is necessary. In general, indicators of faecal contamination provide a positive correlation with intestinal pathogen occurrences only when appropriate sample volumes are examined by sensitive methodology. Pathways by which pathogens reach susceptible water users include ingestion of contaminated water, body contact with polluted recreational waters and consumption of salad crops irrigated by polluted freshwaters. Major contributors to the spread of various water-borne pathogens are sewage, polluted surface waters and stormwater runoff. All of these contributions are intensified during periods of major floods. Several water-borne case histories are cited as examples of breakdowns in public health protection related to water supply, recreational waters and the consumption of contaminated salad crops. In the long term, water resource management must focus on pollution prevention from point sources of waste discharges and the spread of pathogens in watershed stormwater runoff.

Comparison of single and trickle infections of pigs with eggs of the Asian Taenia

Two groups of seven Belgian Landrace piglets each were either infected with a single dose of 3000 or with five consecutive doses of 600 Asian Taenia eggs at weekly intervals. Nine weeks after the first infection all pigs were autopsied and the number of metacestodes was obtained by slicing the liver. There were no significant differences between the mean number of viable or dead cysts present in both groups of animals. Only very low numbers of living metacestodes were foundd: 0.4% (3/779) of the total number of cysts present in the single infection group and 1.8% (13/707) in the trickle infection group. Circulating antigens could be detected in only four out of 13 animals and no differences in antibody kinetics were present between the two groups of pigs. The presence of high numbers of degenerated cysts in experimental as well as in field conditions seems to indicate that the biotic potential of the Asian Taenia is rather low.

Failure of experimental infection of baboons (Papio hamadryas) with the eggs of Asian Taenia

The infectivity of the eggs of Asian Taenia sp. for humans is not known. Using baboons (Papio hamadryas) as a model to extrapolate the findings, three animals were exposed per os with 1000, 10,000 and 50,000 infective eggs of the Asian Taenia sp. The serological, biochemical, haematological and parasitological (based on necropsy) results show that baboons are refractory to the infection. It is concluded that the Asian taeniid eggs may fail to develop in man.

Immunization of pigs against Taenia solium cysticercosis: factors related to effective protection

Fifty-six (56) pigs were immunized against Taenia solium cysticercosis with antigens from Taenia crassiceps metacestodes, in a variety of protocols, and then challenged orally with Taenia solium proglottids or eggs. Results of immunization (expressed as individual parasite loads) ranged from significant reduction of parasite loads (host protection) to clear increase (parasite facilitation) in apparent relation to the immunogen dose, adjuvant employed and genetic background of the pigs. In all trials, however, immunized pigs harboured more damaged cysticerci than controls, indicating that immunization does induce some restrictions to parasite survival even if these are eventually overwhelmed by other parasite-promoting factors. Western blots in immunized-protected pigs indicated antigens of 242, 234, 118, 77, 55 and 45 kDa as possibly being involved in immunological protection.

Neurocysticercosis in an Orthodox Jewish community in New York City.

From June 1990 through July 1991, intracerebral infection with the larval stage of the pork tapeworm Taenia solium was diagnosed in four unrelated persons in an Orthodox Jewish community in New York City. None of the patients had eaten pork, and only one had traveled to a country in which T. solium infection was endemic. We investigated this outbreak, screened serum samples from family members and household contacts for antibodies to cysticercosis, and examined stool specimens from household employees for eggs of taenia species. The four patients had recurrent seizures and brain lesions that were radiologically consistent with the presence of cysticerci. The diagnosis was confirmed in two patients by a brain biopsy, and in two by immunoblot assays for cysticercus antibodies. Of 17 immediate family members screened serologically, 7 from two families had cysticercus antibodies. Magnetic resonance imaging of the brain showed cystic lesions in two of the seropositive family members, one of whom had had a seizure. Examinations of six domestic employees from all four households revealed an active infection with taenia species in one and a positive serologic test in another. Since these women had recently emigrated from Latin American countries where T. solium infection is endemic, they were the most likely sources of infection in the members of these households. A diagnosis of neurocysticercosis should be considered in patients with seizures and radiologic evidence of cystic brain lesions, even in those who do not eat pork and who have not traveled to a country in which T. solium infection is endemic. Recent emigrants from countries in which T. solium infection is endemic should be screened for tapeworm infection in their stools before they are employed as housekeepers or food handlers.

Cysticercosis surveillance: locally acquired and travel-related infections and detection of intestinal tapeworm carriers in Los Angeles County.

A surveillance system for cysticercosis was initiated in January 1988 in Los Angeles County to measure the incidence of the disease, to more accurately assess the level of locally acquired and travel-related infection, and to evaluate household contacts for intestinal tapeworm infection. In three years of surveillance (1988-1990), 138 incident cases were reported for an average crude annual incidence rate of 0.6 per 100,000 population. The highest rates were among Hispanics (1.6/100,000), most of whom were Mexican immigrants. Eight (5.8%) cases were fatal. Nine (6.5%) probable travel-associated cases occurred among persons born in the United States who had traveled to Mexico. Ten (7.2%) autochthonous cases of cysticercosis were documented. Taenia eggs were recovered more commonly in specimens from contacts with cysticercosis cases (1.1%) than in specimens from noncontact patients (0.2%). At least one Taenia tapeworm carrier was found among contacts of five (6.9%) of 72 cysticercosis patients. Carriers were more likely to be found among contacts of patients born in the United States (22.2%) than among those of foreign-born (4.8%) patients (odds ratio = 5.4) Cysticercosis causes appreciable morbidity and mortality in Los Angeles County, principally among Hispanic immigrants. However, these results indicate that both travel-acquired and locally acquired cysticercosis may be more common than previously recognized. Public health followup of cysticercosis cases, including screening of household contacts, can identify tapeworm carriers, who can be treated and removed as potential sources of further infection.