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What is it about ?
Contamination by a pork tapeworm (Taenia solium) causes cysticercosis. The pork tapeworm is a tapeworm that has hooks with which it pierces the wall of the intestine to pass into the bloodstream. It can then move around the body.
As soon as a cyst or an egg enters the digestive tract, it can turn into a larva. The larva develops in the intestine to become an adult worm, or crosses the intestinal wall and passes into the blood. From there it can reach all the tissues of the body (mainly the brain (neurocysticercosis), eyes, muscles and skin). It encapsulates in the tissue and forms a cyst.
Cysts can stay there for months, or even years without causing symptoms, until the immune system suddenly attacks them. Inflammation then occurs in and around the cyst. This is often the time when symptoms appear, for example epilepsy in the case of neurocysticercosis.
Pork tapeworm contamination occurs:
- By eating raw or undercooked pork. Pork meat may contain cysts or pork tapeworm eggs; if they are not killed during cooking, they develop in the digestive tract;
- By transmission from humans to humans or from pigs to humans via faeces. This happens especially in poor hygienic conditions (for example when an infected person does not wash their hands after using the toilet);
- By eating unwashed raw vegetables. Manure is often used for growing vegetables. But manure can contain pork tapeworm eggs which stick to the vegetables and end up on the plate.
Where and how often does it occur?
Pork tapeworm is more common in some areas than it is with us. It is common in Mexico, South America, Indonesia and South Africa. In developing countries, neurocysticercosis (pig tapeworm in the brain) is one of the leading causes of acquired epilepsy. In Belgium, the infection is never or very rarely encountered. A traveler or a migrant can import the disease from these countries.
How to recognize it?
Symptoms mainly depend on where the cyst is located. If it is in the brain and causes inflammation, it can lead to epilepsy or paralysis on one side of the body, or even headaches. Sometimes neurocysticercosis is the cause of psychosis or mental breakdown.
The first symptom of a cyst in the eyes is decreased vision.
Sometimes you feel a lump under the skin or in a muscle.
Adult worms in the intestines can cause stomach pain, diarrhea, or constipation.
How is the diagnosis made?
The diagnosis is often made by chance, after an examination carried out following certain symptoms (such as epilepsy, headaches, etc.). In this case, the brain scan shows one or more small round lesions in the brain. White blood cells in the blood are increased (eosinophils). Calcified cysts in the muscles and skin are also present and can be seen on an x-ray. A cyst in the skin is removed by surgery and then sent to the lab for further analysis. In the stool, the doctor may find tapeworm eggs. The diagnosis can also be made by specific blood tests (for example, detection of antibodies) or by examining cerebrospinal fluid.
What can you do ?
The pork tapeworm is rare, almost absent in our regions. This is largely thanks to the targeted meat inspections carried out by the AFSCA (Federal Agency for the Safety of the Food Chain) in Belgian slaughterhouses. We also have a good sanitary network in Belgium, so that wastewater is not mixed with drinking water (or it is purified beforehand).
If you are going to a country where the parasite is present, always wash raw vegetables well. If this is not possible, for example in a restaurant, then avoid them. Only eat (pork) meat if it is sufficiently cooked. Always wash your hands after using the toilet.
What can the doctor do?
Treatment of a pork tapeworm infection takes place in a specialist hospital. In Belgium, you can go to the Institute of Tropical Medicine (IMT) located in Antwerp. But treatment of cysticercosis is also possible in specialized centers such as university hospitals. A treatment plan is established there. Sometimes medication is enough, sometimes an operation has to be done to remove the cysts.
Want to know more?
Are you looking for more specialized help?
- Foreign clinical practice guide ‘Cysticercosis’ (2010), updated on 02/28/2017 and adapted to the Belgian context on 12/28/2019 – ebpracticenet
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