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Fish tapeworm infection

Diphyllobothriasis

 

Fish tapeworm infection is an intestinal infection with the tapeworm parasite found in fish.

Causes

 

The fish tapeworm ( Diphyllobothrium latum ) is the largest parasite that infects humans. Humans become infected when they eat raw or undercooked freshwater fish that contain fish tapeworm cysts.

The infection is seen in many areas where humans eat uncooked or undercooked fish from rivers or lakes, including:

  • African countries in which freshwater fish are eaten
  • Eastern Europe
  • North and South America
  • Scandinavia
  • Some Asian countries

After a person has eaten infected fish, the larva begin to grow in the intestine. Larvae are fully grown in 3 to 6 weeks. The adult worm, which is segmented, attaches to the wall of the intestine. The tapeworm may reach a length of 30 feet (9 meters). Eggs are formed in each segment of the worm and are passed in the stool. Sometimes, parts of the worm may also be passed in the stool.

The tapeworm absorbs the nutrition from food that the infected person eats. This may lead to vitamin B12 deficiency and anemia.

 

Symptoms

 

Most people who are infected have no symptoms. If symptoms do occur, they may include:

  • Abdominal discomfort or pain
  • Diarrhea
  • Weakness
  • Weight loss

 

Exams and Tests

 

People who are infected sometimes pass segments of worm in their stools. These segments can be seen in the stool.

Tests may include:

  • Complete blood count , including differential
  • Blood tests to determine the cause of anemia
  • Vitamin B12 level
  • Stool exam for eggs and parasites

 

Treatment

 

You will receive medicines to fight the parasites. You take these medicines by mouth, usually in a single dose.

The drug of choice for tapeworm infections is praziquantel. Niclosamide can also be used. If needed, your health care provider will prescribe vitamin B12 injections or supplements to treat vitamin B12 deficiency and anemia.

 

Outlook (Prognosis)

 

Fish tapeworms can be removed with a single treatment dose. There are no lasting effects.

 

Possible Complications

 

Untreated, fish tapeworm infection may cause the following:

  • Megaloblastic anemia (anemia caused by vitamin B12 deficiency)
  • Intestinal blockage (rare)

 

When to Contact a Medical Professional

 

Call your provider if:

  • You have noticed a worm or segments of a worm in your stool
  • Any family members have symptoms of anemia

 

Prevention

 

Measures you can take to prevent tapeworm infection include:

  • Do not eat raw or undercooked fish.
  • Cook fish at 145°F (63°C) for at least 4 minutes. Use a food thermometer to measure the thickest part of the fish.
  • Freeze fish at -4°F (-20°C) or below for 7 days, or at -35°F (-31°C) or below for 15 hours.

 

 

References

King CH, Fairley JK. Tapeworms (cestodes). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 291.

White Jr AC, Brunetti E. Cestodes. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 354.

 
  • Antibodies - illustration

    Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

    Antibodies

    illustration

    • Antibodies - illustration

      Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

      Antibodies

      illustration

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          Tests for Fish tapeworm infection

           

             

            Review Date: 9/10/2015

            Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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