The Fish Tapeworm

Organism The large tapeworm Diphyllobo-thrium latum.

Clinical features The presence of such a large worm (10 m or more) in the intestines can consume a considerable quantity of nutrients, but the main pathology is due to its selective absorption of vitamin B12, resulting in a megaloblastic anaemia in the host.

Diagnosis is made by finding the egg in the faeces (Fig. 9.1). Sometimes, worm segments (proglotids) are also passed.

Transmission The adult worm is found in the intestines of humans, dogs, cats, foxes and bears, and a number of other mammalian hosts. Eggs are passed in the faeces, which on contact with water liberate a cor-acidium, which is ingested by a copepod (Cyclops and Diaptomus). The coracidium develops in the copepod to a larval form, a procercoid, which when eaten by a freshwater fish finds its way into the muscles and develops into a plerocercoid. When the raw or improperly cooked fish is eaten, the liberated plerocercoid attaches itself to the intestinal wall and develops into an adult tapeworm (Fig. 9.5).

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