TENIARINKHOZ (taeniarhynchosis; synonym taeniasis saginata) — the helminthosis from group of tsestodoz caused by a bull (unaided) tapeworm and proceeding preferential with the dispeptic phenomena and an active exit of joints of the activator from an anal orifice.
T. meets everywhere. It is especially eurysynusic in the countries of Africa, East Mediterranean, South America, the Indochina peninsula and the Southern Asia, and also in Japan, on the Philippine islands. In the USSR the ASSR is registered in the republics of Transcaucasia, the Uzbek and Tajik SSR, nek-ry districts Yakut and Buryat. The invasion is observed by a bull tapeworm in a larval stage at cattle worldwide; so, in Europe it is found in 0,3 — 0,4% of the slaughtered animals, and in the nek-ry countries of East Africa — in 30 — 80%.
The activator — bull, or unaided, a tapeworm of Taeniarhynchus saginatus (Goeze, 1782); treats tape-worms (see. Flat worms ). Reaches in length of 4 — 10 m, his body consists of a head — a scolex and strobiles, divided into a set (more than one thousand) of joints (fig. 1); on a head the powerful, sometimes pigmented suckers are located. In final mature joints of a bull tapeworm the uterus is located, the median trunk and 18 — 35 side branches (fig. 2) has edges; the uterus is filled with the eggs having a thin transparent cover with two threadlike appendages (filaments). In each egg there is a germ (oncosphere) with three couples kryuchyev, put in thick double-circuit yellowish-brown radially ischerchenny cover; the size of an oncosphere is 0,03 — 0,04 X 0,02 — 0,03 mm.
In a stage of puberty helminth parasitizes only in a small bowel at the person — the definitivny (final) owner. Mature joints separate from a body, they are mobile, actively creep out of an anal orifice or are allocated with excrements to the environment; the size of joints is 20 — 30 X 12 mm.
The intermediate owner of a bull tapeworm — cattle, in muscles to-rogo larvae (Finns) of helminth develop. The cattle catches through the forage contaminated by excrements of the person, patient T., to-rye contain joints of a tapeworm or eggs allocated from them therefore the cattle gets sick with a cysticercosis. Though the majority of larvae of a bull tapeworm within 9 — 12 months after an invasion is exposed in an organism of the intermediate owner of a degeneration and calcification, a nek-swarm the quantity keeps them viability within several years. The person catches T. at consumption of the crude or insufficiently thermally processed measly meat of cattle. In a small bowel of the person from Finns in 3 months adult helminth develops. In the absence of treatment adult helminths can exist at the infested person for many years. The invasion is usually observed by a single parasite. However also the multiple invasion meets. The mixed invasions caused bull and pork by tapeworms are occasionally noted (see the Teniosis).
Patol. the processes arising at T., are caused by the mechanical irritation caused infringement of a mucous membrane of intestines suckers of a parasite, the movements of his body, active movement and an exit of mature joints, toxic impact of allocations of a tapeworm, absorption by a parasite of nutrients from intestinal contents, and also a sensitization of an organism products of exchange of helminths. Vypolzaniye of joints from an anal orifice and movement them on skin makes the irritating and oppressing impact on mentality of the patient. In a wall of a small bowel the catarrh is noted. Immunity to a reinfestation, apparently, it is not developed; the person can catch T. repeatedly.
Clinically it is expressed to T. more often at the weakened faces and at children. Periodic is characteristic, the constant otkhozhdeniye of joints of a tapeworm together with excrements and their active vypolzaniye out of the act of defecation in number of 6 — 11 in day is more rare. Patients often complain of dizziness, the general weakness, raised or a hyporexia, nausea, vomiting, abdominal pains of various intensity. In some cases the weight loss is observed. Note disturbances of gastric secretion and motor function went. - kish. path. At separate sick T. there are appendicular gripes caused probably by penetration of joints into an appendix or irritation them the bauginiyevy gate. Cases of a gastroduodenit, hepatic colic are known, teniarinkhoz-ache impassability of intestines, perforation by a tapeworm of a wall of a gut, his penetration into a pancreas with development of acute pancreatitis, emergence of a syndrome of Meunier-ra and epileptiform spasms in children. Sometimes moderate anemia develops (see). Cases of unusual localization of a parasite were observed: in a nasal cavity with an otkhozhdeniye of joints through a nose, a zapolzaniye of joints in a vagina. The negative impact of T is established. on the course of pregnancy, childbirth and a fruit.
An important diagnostic character is an active exit of joints of a bull tapeworm from an anal orifice. At an invasion other tape helminths of it usually does not happen. During the squeezing of a joint between two slide plates numerous dark branches of ovaries and a loop of a uterus of a gelkhmint are visible. Auxiliary value has microscopic examination of excrements and perianal scraping on oncospheres of a tapeworm (oncospheres of a pork and bull tapeworm are indistinguishable). In blood soon after infection of T. the eosinophilia is noted.
Treatment carry out in a hospital or at home. Apply phenasal (yomezan, niklozamid), quinacrine, bitionol. Most often appoint phenasal in a dose of 2 g to adults and children 9 years or 3 g adult on an empty stomach in two steps on a half dose in an hour are more senior; to children under 3 years — 0,5 g, 3 — 6 years — 1 g, 6 — 9 years — 1,5 g; usually for the second day at defecation fragments of a body of helminth with the changed half-ruined joints depart. The conclusion about efficiency of treatment is based on data of poll of the patient, and also a research of perianal scraping and a calla 3 — 4 months later (see. Helmintologic methods of a research). Efficiency of treatment by phenasal makes, according to various researchers, 60 — 96%. By-effects in the form of nausea, vomitings, abdominal pains are sometimes noted.
Prevention T. includes identification and deworming of patients. The maintenance of the cattle shall exclude pollution of a forage excrements of people. Meat (hulks) of cattle is investigated on existence the Finn on meat-processing plants and the meat-and-milk and food control stations. For personal prevention it is necessary to eat only well boiled thoroughly and fried thoroughly meat, not to taste some crude mincemeat. In the USSR since 1960 the complex of events directed to elimination of T is according to plan held. Mass inspections of the population for identification of sick T will for this purpose be organized., their treatment, sanitary improvement of the inhabited places (see) and livestock farms, upgrading of sanitary and veterinary examination for the purpose of identification of a cysticercosis at animals.
Bibliography: Karnaukhov V. K., etc., Studying of efficiency and portability of the tableted phenasal at intestinal tsestodoza, Medical parazitol., t. 48, No. 6, page 32, 1979; The Multivolume guide to microbiology, clinic and epidemiology of infectious diseases, under the editorship of, H. N. Zhukova-Verezhnikov, t. 9, page 460, M., 1968; Parasitic zoonoza, the lane with English, page 64, Geneva, WHO, 1980; Prokopenko L. I., etc. About social and economic value of helminthoses on materials of studying of a teniarinkhoz and diphyllobotriasis, in book: Nauch. and prikladn. probl. gelmintol., under the editorship of V. S. Yershov, page 141, M., 1978.
V. K. Karnaukhov.