Period of communicability Adult worms can live for as long as 30 years, their eggs
contaminating the environment and in T. solium a direct threat to any other person.
Occurrence and distribution These are the commonest and most cosmopolitan of all the tapeworms, with a worldwide distribution in beef- and pork-eating areas, especially in the tropical belt and Eastern Europe. Over 60 million people are thought to be infected.
These two worms are found in areas of beef and pork eating where there is a ready transmission cycle in operation. Finding the worm in humans means that it is probably reasonably common in that area, whereas other places where beef and pork eating are just as much part of the usual diet, they are not found. T. saginata is increasing in Europe probably because of human sewage contamination of animal drinking water. T. solium is common in Mexico, Chile, Africa, India, Indonesia and Russia.
Control and prevention The main means of control is the proper cooking of meat. The underdone steak or joint of meat where internal temperatures are not high enough to kill the cysticercus are common ways in which transmission can still take place despite cooking. Proper control of slaughter ing in official abattoirs, with meat inspection, can prevent the dissemination of infected meat. Condemned carcasses must be burnt.
Treatment for both worms is with niclosamide 2 g as a single dose. Alternatively, praziquantel as a single dose of 5-10mg/kg can be given. Praziquantel at a dose of 50 mg/kg for 15 days can be used for cerebral cysticer-cosis in conjunction with corticosteroids, as an in-patient.
Surveillance Where a localized cycle of infection is occurring, investigation may reveal a sewage leak or other source of contamination that could easily be rectified.
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