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Echinococcosis (tapeworm)

Echinococcosis is widely distributed in hot climates, or in regions traditionally involved in animal husbandry. Density of patients with echinococcosis in Russia – 1-4 recorded cases per 100 thousand people. The peculiarity of the disease – is scarce symptoms at the beginning of the development of helminthiasis and as a result, late diagnosis of the disease.

Echinococcosis – helminthiasis with chronic, which is caused by the tapeworm Echinococcus granulosis. The parasite is introduced into the internal organs of humans and animals (usually lungs and liver). Their functions have been seriously violated, in the tissues of hydatid cysts are formed. The area of the disease takes the southern European countries (Italy, Cyprus, Greece, Bulgaria, Spain), South America (Brazil, Argentina). Echinococcosis is common in the southern United States, India, Japan, and Australia.

In Russia, most often exposed to the infection of residents of the territories and regions with a wide development of animal husbandry: Khabarovsk, Krasnoyarsk, Stavropol, Krasnodar, Altai Krai, Omsk, Tomsk region, Bashkiria, Tatarstan.

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Causes of echinococcosis

Final host:

  • Dogs
  • Coyotes
  • Fox
  • Lions,
  • Wolves
  • Jackals,
  • Lynx.

Intermediate host:

  • Sheep
  • Proteins
  • Buffalo,
  • Hares,
  • Horse
  • Pigs
  • People.

The placental barrier is not an obstacle for the transmission of helminth infections from mother to fetus.

The scheme of circulation of parasitic infestation:

  • The final master.
  • Environment as a place of excrement pecker and oncospheres.
  • Intermediate host or final host of healthy.

People not allocated with a feces or eggs or segments of worms, so it may not be the source of echinococcosis.

Mechanisms of infection by echinococcosis

A person infected with hydatid disease in two ways: nutritional and contact-household. The introduction of parasites in the human body occurs while eating contaminated vegetables and fruit, contaminated water, gathering herbs and berries, and feces of infected animals, contact with wool main and intermediate hosts (mainly dogs).

Short development cycle of Echinococcus in animals:

  • The final host (Fox, dog) eats the inside of an intermediate host (pig, hare, squirrel).
  • The mucous membrane of the small intestine of the definitive host develops adult worms that produce eggs.
  • Faeces movable segments with the eggs larvae are released into the environment.
  • Eggs larvae remain in the internal environment before entering to a new host.

Short development cycle of Echinococcus in humans:

  • Eggs of Echinococcus oral route into the human gut.
  • From oncosphere embryo goes into the blood, via the portal vein enters the internal organs.
  • In the lungs or in the liver forms a single-chamber bladder with a liquid, consisting of chitin and of the embryonic shell. The bubble comes the stage of larval development, additional bubbles are formed subsidiaries.
  • Cysts are formed inside the capsule for the formation of scolexes, sometimes separated fromthe walls and floating in the liquid.
  • The total weight of the bubbles one person can reach several tens of kilograms and contain up to 6-10 liters of fluid.

The pathological effects of Echinococcus in the human body

The main feature of the Echinococcus – cyst in any organ. Most often it is light (20%), liver (80%). The cyst can be singular or plural.

The consequences of the introduction Echinococcus in the body:

  • Sensitization of the organism (immediate or deferred at the time of allergic reaction, anaphylactic shock if cyst rupture).

  • The mechanical effects of enlarged hydatid cysts (atrophy and dysfunction of organs). Consequences – fibrosis, tissue fibrosis of the lungs. The deadline for the formation of vesicular structures from the time of contact with the larvae in the body on average is 2 weeks. After 4-5 months, the size of the cyst can reach 5 mm. volume of several liters a cyst reaches a period of 10-20 years.
  • A reduction in General and local immunity, re-infection owing to weak immune response of the body.

The symptoms of echinococcosis

Stages of echinococcosis:

  • Asymptomatic stage (from beginning of infection until the primary cyst).
  • The appearance of slight symptoms of introduction of infection in a specific organ.
  • The appearance of pronounced clinical picture of hydatid disease.
  • Complications of helminthiasis.

Stage selected conditionally, because the disease has a slow rate of development of symptoms, and the cysts are formed very slowly.

Symptoms of liver echinococcosis

Common symptoms:

  • Nausea and vomiting;
  • Weakness;
  • Loss of appetite;
  • Pain in the epigastric and right hypochondrium;
  • Skin rash and itching;
  • Diarrhea;
  • Hepatosplenomegaly (enlarged spleen and liver);
  • The allocation of cysts in polerowanie;
  • Inflammation of the cyst when joining a bacterial infection (pyrexia, chills, pain);
  • Abscess of the liver;
  • Obstructive jaundice in a case of squeezing a cyst of the bile ducts (dark urine, light stools, yellowing of sclera of eyes and skin, itching, increase in the number of leukocytes and eosinophils).

At the opening of the cyst the patient experiences a sharp pain, Allergy, symptoms of anaphylactic shock. Severe consequence of a breach of integrity of the cyst contamination with Echinococcus of the whole organism, secondary echinococcosis.

Learn more: Causes and symptoms of liver echinococcosis

The symptoms of echinococcosis of the lungs

Common symptoms:

  • Chest pain in the projection of light;
  • Shortness of breath;
  • Hemoptysis;
  • The weakening of breath;
  • Shortening of percussion;
  • Deformity of the chest with shift of the mediastinum;
  • The development of exudative pleurisy with effusion pleural fluid.

In violation of the integrity of the cyst located in the bronchi, the patient experiences dyspnea, coughing, suffering from acute allergic reactions, it is observed cyanosis of the skin. At the break of the cyst into the cavity of the pericardium and pleural cavity comes death due to anaphylactic shock.

Common blood test detects leukocytosis with a shift to band neutrophils and eosinophils.

Learn more: Causes and symptoms of echinococcosis of the lungs

The symptoms of hydatid disease of the spleen, kidneys, Central nervous system

Occurs very rarely in contact with Echinococcus in the systemic circulation. The symptoms of allergic rash, signs of lesions of a particular organ.


Diagnosis of echinococcosis

During examination of the patient doctor-helminthologia or infectious disease going epidemiological history. The doctor analyzes whetherpatient close contact with animals, whether it's associated with farming, how often do happen in nature.

Methods of instrumental and laboratory diagnosis:

  • Abdominal ultrasound, chest x-ray, CT scan for diagnosing cysts with one or more cameras. It is not allowed to take the puncture of the cyst, so as not to spread the infection to other organs.
  • Serology blood by IF, ELISA, Phragmites to the detection of antibodies to Echinococcus. A similar analysis has high sensitivity (98%). The study is based on such features of the organism of patients with echinococcosis, as the selection in the blood of specific antibodies.
  • The study of biological fluids (urine, sputum, contents of duodenum 12) for detection of segments and scolexes of the parasite.
  • Clinical tests – blood biochemistry (AST, ALT, bilirubin, GGTP), total blood (leucocytes and eosinophils).

The treatment of echinococcosis

Methods of treatment of echinococcosis:

  • Surgical removal of cysts from the tapeworm and the restoration of organ function previously affected by parasites. Worms removed in two ways: radically remove the cyst along with its shell, or reveal it with the removal of the fluid, disinfect the cavity, drain it, and sew shut. During surgery need extreme caution to avoid re-infection. The affected tissue is isolated, to prevent the migration of larvae in the abdominal and thoracic cavity.
  • Antiparasitic treatment (performed when mass destruction and the impossibility of carrying out operations). The main drug is Albendazole, it is assigned to courses from 3 weeks to several months. The intervals between courses, the number of which can reach twenty - 3-4 weeks. In 25% of patients relapse, 41-75% treatment effectively. Alternative – Mebendazole taken over 15-24 months. Drugs are prescribed after surgery to prevent undetected contamination with larvae of worms, as well as patients with antibodies to the parasite, but without the formation of cysts.
  • Symptomatic therapy aimed at relief of complications and other symptoms. It's an antihistamine, antitussive drugs, hepatoprotectors.

Prevention of echinococcosis

To prevent the spread of helminthiasis, the following activities:

  • Survey on hydatid cyst of the persons in the risk group: pastoralists, employees in meat processing plants and slaughterhouses, breeders, and hunters.
  • Veterinary measures for the prevention of infection of animals: compliance with sanitary norms of the slaughter and butchering of cattle, prevention of helminthiasis in dogs.
  • Observance of rules of personal hygiene: thorough washing of vegetables and fruits, drinking purified water, treatment of your hands with soap and disinfectants after contact with dogs, care for animals, and before eating.