Showing posts with label tapeworms. Show all posts
Showing posts with label tapeworms. Show all posts

Saturday, March 21, 2015

Taenia solium and the leaky brain cyst

For my other blog (warning: not a scientific blog), I wrote a little thing about why Spring is one of my favorite seasons (I mean, second to Autumn of course!) because it brings an abundance of cute baby animals to the world. One of my absolute favorites is the pig! Domesticated, wild, big, small, it doesn't matter.

Image from Daily Mail.
So, in honor of all the piglets being born this season, let's talk about a classic parasite with some new research twists. Taenia solium is a type of tapeworm that is specifically linked to pigs. T. solium is related to the "beef tapeworm of man" (Taenia saginatum, tapeworm associated with cows), but can cause some much more severe symptoms.

T. saginatum scolex imaged using electron microscopy. Image taken from the internet.
T. saginatum, the beef worm, is what everyone thinks of when they think "tapeworm": adult worms have a head, neck, and proglottids, and causes intestinal obstruction and discomfort. Oh, and it can live inside of you for up to 25 years!

In order to get your own tapeworm infection, all you have to do is consume poorly cooked beef which contains T. saginatum eggs. When the eggs "hatch", oncospheres (infective larva) migrate to the small intestine, where they will take 3 months to mature into an adult worm. Adult worms are typically 2 to 10 meters in length. Usually only one worm is found, unless you've consumed a heavily contaminated piece of meat or ate fecal matter that's full of gravid proglottids (the end pieces of the tapeworm). Fun fact: eggs can survive for months once they've left the body. Beware of old poop!

Taeniasis life cycle for T. saginatum and T. solium, via the CDC

Patients infected with a beef tapeworm (clinically described as "Taeniasis") may complain of non-specific abdominal symptoms, such as nausea, general pain and discomfort, or weight fluctuations. I say weight fluctuations because most people experience extreme weight loss (often misdiagnosed as anorexia), especially those affected in developing countries (where these parasites are most prevalent), but there have been a number of people who have infected themselves, by choice, and have reported it being "no big deal" or that they gained weight (see my favorite example: Michael Mosley of the BBC News). So, while most people experience weight loss, I suppose you could say that depends on your socioeconomic status, and whether or not you've had a choice to become infected.

T. solium life cycle from the Food and Agriculture Organization of the United Nations (fao.org)
T. solium can also cause all the same intestinal symptoms, and can live out a life cycle similar to that of T. saginatum. But, in some cases, T. solium can cause something called Neurocysticercosis (cue scary music). T. solium's life cycle and pathophysiology usually looks very similar to that of T. saginatum, only with smaller worms (4-7 meters in length). Neurocysticercosis occurs when you've ingested the eggs directly, such as ingesting contaminated feces. This happens to pigs when their food is contaminated with human feces (pretty ironic, right?).

T. solium scolex. Image from UNAM.
The consumed eggs hatch in the small intestines and the oncospheres are released. Oncospheres penetrate the intestinal mucosa and make their way to the blood. Once in the blood, they travel throughout the body and migrate to different tissues, where they will mature into cysticeri. The cysticeri really like skeletal and cardiac muscle, subcutaneous tissue, and lungs, but they can also get lodged in the central nervous system (CNS), including the brain and the cerebral ventricles. Once the cysticeri have chosen a tissue which to lodge themselves, they become calcified granulomas.


T. solium adhering to the epithelial cells of the intestine. Image from UNAM.
The most common location for cysticercosis to occur is the cerebral hemispheres, at the gray-white matter junction, but they can also be found in the cerebellum, the brainstem, the subarachnoid space, the basal cisterns, and the spine.

T. solium cysts in a human brain. Image from Discover Magazine.
 Obviously, having a 1-2 cm cyst calcifying in your brain will cause some damage. Neurocysticercosis is one of the leading causes of epilepsy in developing countries. It can also cause severe headaches, hydrocephaly and eosinophilic meningitis.

The National Institute of Allergy and Infectious Disease (NIAID) just released an article about the treatment-induced inflammatory response in pigs with neurocysticercosis. The current treatment of Praziquantel is apparently causing inflammation, blood vessel leakage, and damage to the blood-brain barrier. This means that new drugs need to be developed that can reduce inflammation at the site of the cyst(s) while maintaining the integrity and functionality of the blood-brain barrier and blood vessels.

Photo of the surface of the brain of a pig treated with the antiparasitic drug praziquantel showing blue-dyed (blue arrows) and clear (white arrows) cysts. The blue dye indicates disruptions in the blood-brain barrier. Image from NIAID/
Dr. Cristina Guerra-Giraldez.
This research only focuses on pig subjects, and has not yet been performed on humans infected with neurocysticercosis.


Want to avoid tapeworms and neurocysticercosis? The best way to do that is either to avoid eating meat, or to make sure your meat is cooked properly. Cooking meat properly is the best way to inactivate or kill most infectious diseases associated with meat consumption.

One of the major reasons diseases are so rampant in livestock is because a lot of treatments (mainly antibiotics) are used as prophylactics instead of at the onset of infection and symptom presentation. Animals that are raised in small, confined areas are more likely to be exposed to illnesses. When you are raising animals on a large scale and rely on them for income (whether through livestock trade, meat or dairy production), it can be really scary when one of your animals gets an infection, because you risk losing some of your income. It's obviously unethical to sell/trade sick animals, but it happens all the time, and is one of the main causes for the spread of disease to other regions. When prophylactic treatments are used, resistant infections are more likely to occur, which is an even larger problem (as I'm sure you can imagine).

Even if the meat you consume came from a healthy cow/pig/lamb/goat/chicken/turkey/etc., it might have been slaughtered in the same environment as a sick animal, which still puts you at risk. So, if you have a tendency to order your meat "rare", be sure you know the risks associated with that choice.

Edited to add:
I want to be clear that, even though I'm vegan, I believe choosing to be vegan is a very personal choice and no one should ever be bullied in to it. But, I also feel the need to add some information about the environmental impacts of eating meat to this post, since we are talking about risks associated with consuming meat. Considering the risks to yourself is very important, so you can actively minimize your risk of getting an infection or other serious health disparity (mostly through the long-term, excessive meat consumption),  but considering the long-term risks for the environment (ie- everyone on earth) is also really important. Here are some articles that you might want to consider reading before making a definitive decision about your dietary habits:

The Triple Whopper Environmental Impact of Global Meat Production: TIME

How does meat in the diet take an environmental toll?: Scientific American

Giving up beef will reduce carbon footprint more than cars, says expert: The Guardian

2500 gallons all wet?: EarthSave


Saturday, November 13, 2010

Tis the season for Parasitic Infections!

Ah, the holiday season. It seems that this time of year has become synonymous with meat-laden tables. Meat buffets. Meat, meat and more meat. Each culture seems to have their meat of choice for holiday celebrations, too. Some people won't celebrate Thanksgiving unless there is a 5800 lb turkey in the middle of the table. For some, it's ham, lamb or even fish.

Meat is also one of the most expensive food items you can buy, so for some families, the holidays are a time to splurge. Sure, it's reasonable to get the biggest cut of lamb you've ever seen to feed your family of 6. For this post, let's focus on the up-and-coming Thanksgiving turkey.

Nearly 50 million turkeys are raised and slaughtered for Thanksgiving every year in the United States. Think about the magnitude of such an endeavor.


Depending on the size, socioeconomic status and number of workers employed, the average turkey farm can house 7,000 turkeys at once. It takes a ridiculous amount of farms to produce enough turkeys for slaughter in time for Thanksgiving!

Why am I telling you this? I know, this sounds like advocacy for animals (I could write for daaaaays about animal cruelty, trust me), but this is strictly a science blog, so I'm telling you this as a back story. Statistical purposes.

Once again, think of the magnitude of such an operation. Now, here is the important part: try to imagine the odds for contamination in such a magnitude. Who's to say you didn't buy the turkey carcass that was accidentally dropped on the kill-room floor, and quickly swooped up before anyone else would notice? Who's to say the person plucking the feathers out of your turkey had a hole in their glove and didn't wash their hands thoroughly enough before coming to work or after using the restroom? Who's to say accuracy isn't as accurate as efficiency to the slaughterhouse that your turkey is coming from? Who's to say that every bird has been checked for health? Is the farm your turkey is from relying on mass quantities of antibiotics and treatments to keep them safe?



When you finally get your bird home, how sure are you about the quality? What quality? No, I'm not talking about the tenderness of the flesh or the overall freshness. No, I'm not talking about the growth hormone-induced size of the thighs, wings and breast. 

We've all heard about Escherichia coli and other fun bacterial contamination agents that rampantly infect our food, but let's talk about some other of the fun things that could be living on, and in, your prized dinner selection:

Poultry:
Poultry are susceptible to many parasitic infections, internally and externally. 

External parasites, such as lice and mites, spread quickly in impacted battery farms, yet most of them are removed during the plucking and washing processes of slaughter. External parasites are more of an issue if you are raising, slaughtering and preparing your own birds in-house.


Internal Parasites:

Ascarids (Large Intestinal Roundworms) 

One of the most common parasitic roundworms of poultry, Ascaridia galli, occurs in chickens and turkeys. Adult worms are about one and a half to three inches long and can be seen easily with the naked eye. Heavily infected birds may show droopiness, emaciation and diarrhea. Yet, when you have thousands of birds to take care of...would you notice one droopy bird? I wonder, how easy would it be to identify a bird with diarrhea in a factory farm setting?



Chickens of three to four months of age show resistance to infection. Specimens of this parasite are found occasionally in eggs. The worm apparently wanders from the intestine up the oviduct and is included in the egg contents as the egg in being formed.

The parasitic females lay thick heavy-shelled eggs in the intestine that pass in the feces. Embryonated eggs are very hardy and under laboratory conditions may live for two years. Under ordinary conditions, however, few probably live more than one year. Disinfectants and other cleaning agents do not kill eggs under farm conditions. Birds become infected by eating eggs that have reached the infective stage. The parasite can be controlled by strict sanitation.

 I don't know about you, but the words "strict sanitation" always make me think of poultry farms.


Ascaridia can infect other species of animals as well, including humans. Affectionately called "giant intestinal roundworms", A. lumbricoides is the most common infection of roundworm in humans. The intestinal phase causes malnourishment, intestinal blockage, verminous intoxication. It will also move around in the body in response to chemotherapy or fever. A worm with climate sensitivity, how posh!



They can also live in your lungs, which I would imagine would be... fun. In the lung it causes hemorrhage, inflammation, bacterial infection and allergy in areas with seasonal transmission. I can only imagine having seasonal transmission being a common thing in your area. "Hey boss, I can't come into work today because I've got that pesky lungworm thing that's going around now. I'm sure I'll feel better tomorrow."

I feel like this photo should be submitted to awkwardfamilyphotos.com.


Heterakis gallinae (Cecal Worms)
Heterakis gallinae is found in the ceca of chickens, turkeys and other birds. This parasite apparently does not seriously affect the health of the bird. At least no marked symptoms or pathology can be blamed on its presence. Its main importance is that it has been incriminated as a vector of Histomonas meleagridis, the agent that causes blackhead. This protozoan parasite apparently is carried in the cecal worm egg and is transmitted from bird to bird through this egg. The eggs of the parasite are very resistant to environmental conditions and will remain viable for long periods.


Capillaria (Capillary or Thread Worms)
There are several species of Capillaria that occur in poultry. Capillaria annulata and Capillaria contorta occur in the crop and esophagus. These may cause thickening and inflammation of the mucosa.

Capillaria obsignata is the most prevalent in the lower intestinal tract. The life cycle of this parasite is direct: The adult worms may be embedded in the lining of the intestine. The eggs are laid and passed in the droppings. The eggs are infective to any other poultry that may eat them. The parasites frequently produce severe inflammation and sometimes cause hemorrhage. Brutal erosion of the intestinal lining may result in death. If present in large numbers, these parasites are usually easy to find at necropsy. 

Capillaria are pretty easy to spread to humans, especially in the farm environment. Once again, sanitation is the key factor...




Tapeworms
Tapeworms or cestodes are flattened, ribbon-shaped worms composed of numerous segments or division.  The head or anterior end is much smaller than the rest of the body to assist with anchoring.

All poultry tapeworms spend part of their lives in intermediate hosts, and birds become infected by eating the intermediate hosts. These hosts include snails, slugs, beetles, ants, grasshoppers, earthworms, houseflies and others. The intermediate host becomes infected by eating the eggs of tapeworms that are passed in the bird feces.


Tapeworms can definitely infect humans. Some people live for years without knowing that they have a giant worm housed in their intestines, whereas others have an allergic reaction within about a week. Most infections are specific to mammals or poultry. It is more common to get a tapeworm infection from consuming or working around cows, sheep, pigs or dogs than it is from poultry, but a lot of family farms contain multiple types of animals in one small area. Think about it.

 Yes, this is obviously a good idea.

For mammalian-infecting tapeworms, the scolex (or "head") of the worm is adorned with a series of hooks and suckers to effectively anchor itself into the intestinal wall. Poultry tapeworms work in a similar fashion, but have a different scolex shape and pattern.




Syngamus trachea (Gapeworms)
The gapeworm is a round red worm that attach to the trachea (windpipe) of birds and causes the disease referred to as "gapes". The term describes the open-mouth breathing characteristic of gapeworm-infected birds. Heavily infected birds usually emit a grunting sound because of the difficulty in breathing and many die from suffocation. The life cycle of the gapeworm is similar to that of the cecal worm. Gapeworms infect chickens, turkeys, guinea fowl, pheasants, chukar partridge, and other birds.



The worms can easily block the trachea, so they are particularly harmful to young birds. The gapeworm is sometimes designated as the "red-worm"; or "forked-worm" because of its red color and because the male and female are joined in permanent copulation. They appear like the letter Y. The female is the larger of the two, as is pretty normal for a lot of insecta and helminth species. Both sexes attach to the lining of the trachea with their mouthparts. Sufficient numbers may accumulate in the trachea to hinder air passage. Choked to death by a worm orgy...





So, let's recap:
  • Poultry are raised and slaughtered typically in unsanitary conditions, causing unnecessary spread of many fun infective agents, most of which can be transferred to humans. 
  •  Since the holidays are nearing, millions of turkeys and other poultry will be slaughtered in mass quantities. Supply and demand means that time and efficiency is the highest priority for the industry. 
  • I'm sure many of the above photos grossed you out.
 If you're an avid reader of Under the Microscope, you know its not typically my M.O. to throw a disease or health problem in your face without presenting a solution. Here are some ways you can effectively avoid zoonotic transmission of infection:
  • Pay attention to the source of your dinner. Has your bird been raised "free-range" (*cough* yeah, right  *cough*) or in a battery farm? Has your bird been pumped full of antibiotics, growth hormones or other dietary treatments? All of that will be transferred to your body during consumption, to some degree.
  • Learn about the origin of your family's traditional meat consumption. Is it really a tradition, or just a habit at this point? Is it really that important for you to uphold the years of excess meat consumption, or is it time for a healthier, safer change?
  • Think about starting a new tradition. Sure, everything you get from a mass-produced source, like the grocery store, has a higher likelihood of having contamination of some sort, whether its meat, dairy or vegetables. But! The probability of contamination through vegetable and grain sources is much lower than that of meat preparation. 
 Some of my favorite recipes have come from vegetarian and vegan blogs. A few of my favorites are:
Try something new, healthy (and cruelty free) this year!