Main Campus: Chesterfield, MO 63017 | 
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.
Vitamin B12
Vitamin B12 is a water-soluble vitamin. Water-soluble vitamins dissolve in water. After the body uses these vitamins, leftover amounts leave the bo...
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
Complete blood count
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
ImageRead Article Now Book Mark ArticleDifferential
The blood differential test measures the percentage of each type of white blood cell (WBC) that you have in your blood. It also reveals if there are...
ImageRead Article Now Book Mark Article - Blood tests to determine the cause of anemia
- Vitamin B12 level
-
Stool exam
for eggs and parasites
Stool exam
Stool ova and parasites exam is a lab test to look for parasites or eggs (ova) in a stool sample. The parasites are associated with intestinal infec...
ImageRead Article Now Book Mark Article
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
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.
