Tapeworm

 

Species:

 

• Hymenolepis spp

• Taenia species 

 

Taenia species infection occur globally and come from consuming undercooked pork or beef, or by consuming soil or water contaminated with the eggs from the faces of pigs or cows. Whereas Hymenolepis comes from oral contact with sources contaminated with the eggs of sources such as rats and beetles [9],[10]. 

 

Tapeworms attach to the intestine and mature in 5 to 12 weeks. Adult tapeworms are flattened, elongated, and consist of segments called proglottids. Tapeworms vary in length from 2 mm to 10 metres, and may have three to several thousand segments. The adult worm can live for up to 25 years.

 

Eggs are released when matured tapeworms release a segment of themselves that is full of eggs. All eggs are embryos that develop into different larval stages, which then develop into adults in the human [11].

 

Taenia species can grow in two main places in the body, in the intestines and in the brain [12].

 

Intestinal symptoms can include:

 

• Abdominal discomfort in the absence of bloating

• Worm segments in the stool 

• Constipation

• Diarrhoea 

 

Brain + other symtoms include:

 

• Fluctuations in appetite

• Unexplained Weight loss

• Weakness or Lethargy  

• Vitamin B12 deficiency  

• Neurological problems

• Seizures [13]

 

Roundworm

 

Species:

 

• Ascaris lumbricoides

• Strongyloides spp

 

Roundworm infection is oral, and occurs when coming in contact with soil or objects contaminated by roundworm larvae (baby roundworm) from faeces [14]. After larvae are released in the small intestine, they enter the bloodstream through the enteric mucosa. They travel to the liver via the portal vein, then to the lungs within a week. In the lungs, the larvae mature and damage the alveolar membrane. 

 

They are eventually coughed up, swallowed again, and returned to the small intestine. 

There, they mature into adult worms in about 20 days and can reach up to 30cm in length. The adult female produces up to 200,000 eggs per day, many of which are passed in the feces, although in the right environmental conditions, the eggs mature into an infectious form within 2 - 8 weeks, and can remain active for up to 17 months [15]. 

 

Adult round worms live their life in the intestines, although in their migration phase they can also affect the lungs and liver in the short-term [16].

 

Intestinal symptoms can include:

 

• Abdominal discomfort in the absence of bloating

• Indigestion 

 

Migration symptoms mimic:

 

• Bronchial irritation, can resemble spasmodic asthma 

• Right upper quadrant pain

• Pancreatitis [17]

 

Pinworm 

 

Species:

 

• Enterobius vermicularis

 

Pinworm infection occurs when ingesting the eggs, which can be as simple as scratching the perianal area and transferring eggs to objects or the mouth, or by person-to-person transmission by touching contaminating surfaces, particularly wet towels, and then transferring the eggs to the mouth. This is because Pinworm eggs can survive the external environment for hours in a dry environment, or in a cool and damp environment [18]. 

 

After you swallow the eggs, it takes about 1 to 2 months for them to turn into adult worms in the small intestine, where they grow up to 13mm long. These worms usually don’t cause symptoms while in the intestines. At night, the female worms move to the anal area and lay thousands of eggs, which causes anal itching. The eggs hatch around the anus, making it itch more [19]. 

 

Intestinal Symptoms include:

 

• Anal itching

• Abdominal discomfort in the absence of bloating

 

Migration Symptoms mimic:

 

• Pain or trouble when urinating 

• Itching Vulva 

• Vaginal discharge

• Bedwetting [20][21]

 

Whipworm 

 

Species:

 

• Trichuris trichiura

 

Whipworm infection is oral, and occurs when coming in contact with soil that is contaminated with human faeces. Whipworm is named for its whip-like shape, with a thin front and thicker back and range from 3 to 5 cm long. They attach to the host's intestinal mucosa and can lay 2,000 – 10,000 eggs daily, which are predominantly passed in the feces. 

 

Whipworm eggs can also mature in the large intestine over the course of 14 – 21 days. The worms usually live at the end of the small intestine, but in some cases, they can spread through the entire colon and rectum, and can live in the body for 1 to 4 years. 

 

Whipworm may induce prolonged inflammation of the intestine that causes villous atrophy, as well as inflammation of the colon that leads to blood loss and rectal prolapse [22].

 

Intestinal Symptoms include:

 

• Abdominal discomfort in the absence of bloating

• Anal itching

• Mucus discharge in the faces 

• Diarrhoea

 

Other Symptoms include:

 

• Iron deficiency 

• Rectal bleeding or prolapse [23]

 

Hookworm : 

 

Species Tested:

 

• Necator americanus

• Anctlostoma duodenale

 

Necator can only be transmitted through penetration of the skin, often through bare feet. After entering the bloodstream, larvae (baby worms) migrate to the lungs, where they can cause various symptoms including a dry cough or wheezing. After this larvae break through the capillaries into the throat and windpipe where they become ingested and enter into the small intestine. 

 

These Hookworms can then produce thousands of eggs within the intestines [24], and when the hatched babies have matured, they attach to the lining of the intestine by using their teeth to burrow into the mucosa and submucosa. They create negative pressure by contracting their muscular esophagi, which causes blood vessels to rupture, allowing them to actively suck blood. 

 

In addition to the physical damage caused by their teeth, like a leech, they also release enzymes that break down the blood vessels and secrete anticlotting agents that lead to continuous bleeding and significant blood loss, which can lead to anemia [25].

 

The Ancylostoma species can be transmitted through the skin and orally, when individuals come into contact with soil containing fecal matter of infected host. When Ancylostoma eggs pass from the host’s stool to soil. Larvae can penetrate the skin, entering the lymphatics, which can cause inflammation in the lymphatics [26].

 

Intestinal Symptoms include:

 

• Abdominal discomfort in the absence of bloating

• Diarrhea

 

Other Symptoms include:

 

• Lymphatic inflammation

• Iron deficiency [21]