What is the cure for enterobiasis

That's where the worm is

In contrast to pinworms, tapeworms need one or two intermediate hosts for their larvae to develop. In the case of beef tapeworm, humans are the ultimate hosts. There the adult worm attaches its head (Scolex) to the intestinal wall and can grow up to 10 meters long. The adult worm repeatedly sheds limbs (proglottids) that can move, contain mature eggs and are excreted with the stool. The diagnosis is made by detecting tapeworm segments or eggs in the stool. The infection gets back to the cattle when human feces are fertilized or pastures and hay meadows are used as toilets. In cattle, the eggs develop into larvae in the intestine, migrate to various organs and establish themselves there as fins - for example in muscle meat.

If a person ingests pork tapeworm eggs (Taenia solium), cysticercosis can develop. The eggs develop into larvae (Finns) in humans and migrate from the intestine to various organs, where they often calcify. The muscles, subcutaneous connective tissue, eyes and brain can be particularly affected.

Treatment of Taenioses

Praziquantel and niclosamide are the agents of choice for taeniosis. Praziquantel has a broad spectrum of activity. It is not only suitable for treating tapeworms, but also liver and pair leeches (schistosomiasis). Praziquantel paralyzes the worm muscles, which thereby lose their hold in the intestinal wall and are excreted.

In the case of taenioses, adults and children from two years of age only have to take 5 to 10 mg praziquantel per kg body weight once, depending on the type of worm. In the case of neurocysticercosis caused by pork tapeworm eggs, on the other hand, the patient must take 50 mg / kg body weight daily for 15 days (Cysticide® for adults and children from two years of age). Therapy should be carried out as an inpatient. The human medicine Biltricide® is only approved for infections with flukes (trematodes).

The side effects depend on the level and duration of the medication as well as the type, extent and location of the parasite infestation. They resemble the actual symptoms. Interactions with rifampicin, dexamethasone, chloroquine and grapefruit juice are possible.

Niclosamide as an alternative

An alternative for taeniosis is the salicylic acid derivative niclosamide. It presumably inhibits the worms' glucose uptake and cell respiration in the mitochondria. Since it is hardly absorbed enterally, it only affects the worms in the intestine, but not in other organs. Therefore it is only a second choice for pork tapeworm.

Adults and children from six years of age in the case of taeniosis take four chewable tablets, each with 500 mg niclosamide, once after breakfast. The tablets must be chewed thoroughly and swallowed with a little water. Children between two and six years of age take two chewable tablets, one tablet is sufficient for younger children, which can be ground into a fine paste with a little water. In order to remove the intestinal mucus increased by the worm infection and to better reach the worms, acidic fruit juice should be drunk. No earlier than two hours after ingestion, the patient should take a laxative so that all the mature chain links of the worm with eggs can get out of the intestine.

Treatment with mebendazole or albendazole (off label) is also possible in the case of taeniosis. The dosage of mebendazole differs from that used in the treatment of pinworm infestation. The patient must take three tablets (300 mg total) mebendazole in the morning and three in the evening for three days or two tablets twice a day for four days.

Fox and dog tapeworm hazards

Fox tapeworm (Echinococcus multilocularis) and dog tapeworm (Echinococcus granulosus and subtypes) are more dangerous than beef, pork and fish tapeworms. The larvae can develop into worms a few millimeters in size in humans, but are not transmitted further because humans are false hosts. The larvae attack the liver and sometimes other organs such as the lungs and brain, which makes the infections so dangerous.

While the dog tapeworm is more common in southern and eastern Europe, the fox tapeworm is also found in Germany (Baden-Württemberg, Bavaria, Saxony, Thuringia and Brandenburg), Austria and Switzerland (3). Dogs and cats can also be definitive hosts and thus carriers. While it used to be said that people are mainly infected through forest berries, mushrooms or vegetables and windfalls that are contaminated with fox droppings, it is now assumed that transmission through infected pets is more likely (see also page 18).