Infectious diseases occupy an important place among all human diseases. A special place among them is occupied by helminthiases - diseases caused by worms. One such disease is fish diphyllobothriasis.
What is this
Diphyllobothriasis is an infectious disease caused by a worm from the cestodosis group. The causative agent is Difilobottrium Latum, a roundworm. This disease is widespread in the territory of the Russian Federation; fish diphyllobothriasis has been registered in Karelia and the Murmansk region, such rivers as the Indigirka, Pechora, Northern Dvina and Volga. The disease is prevalent mainly in cold regions. Less common in northern European countries; imported cases predominate.
Diphyllobothriasis of fish causes a wide tapeworm. The worm parasitizes in the small intestine. The eggs of the parasite enter the environment along with faeces and feces. Under optimal conditions (temperature up to 20 degrees), a larva emerges from the egg. It is swallowed by small crustaceans - cyclops that live in the water. It is in these crustaceans that the second stage of development of the parasite takes place -coracidium. After the crustacean is eaten by fish living in the water, a plerocercoid develops from the larva - its next stage. A person is struck by it when eating infected fish.
It was mentioned above that the main product from which diphyllobothriasis can develop is fish. Which fish is most commonly infected with tapeworm? Usually affected species such as catfish, burbot, perch, ruff, pike perch. In addition to fish, the pathogen can also be found in the meat of animals such as seals and walruses.
How infection occurs
Diphyllobothriasis is a disease that does not manifest itself in the initial period. As mentioned above, a person becomes infected by eating infected fish. Outwardly, it is no different from normal, so it is impossible to visually determine the presence of the pathogen. Predominantly river fish are infected. Worm larvae are so small that they can only be seen under a microscope.
In order for infection to occur, it is enough to hit only one larva. Worms develop in the human intestine for about two weeks. Clinical manifestations are expressed after the same time. Fishermen, sailors, sushi lovers are most often affected.
Fish diphyllobothriasis can also occur in domestic animals, but human infection from them is extremely rare.
People who have nothing to do with the listed professions or hobbies can also become infected. It all depends on how well the fish is cooked. If the temperature regime is observed, the larvae die, and the fish becomes safe to eat.
Pathogenesis of disease
How does fish diphyllobothriasis affect the human body? Usually, one or more broad tapeworms can develop in the human body, but cases of parasitism in humans of 100 or more individuals of the parasite have been described. In the body, worms can live for a long time - up to 20 years or more, while parts of his body gradually come out with feces.
Tape has the following effect on the human body:
- mechanical;
- neuro-reflex;
- toxic-allergic.
As mentioned, the pathogen parasitizes in the intestines. It attaches to the mucous membrane, which is why a zone of atrophy and ulceration forms at the site of development. As a result of neuro-reflex action, irritation of the sensitive endings of adjacent organs occurs, which disrupts the function of the stomach and liver. In addition, the pathogen causes the development of megaloblastic anemia, which is based on vitamin deficiency of vitamin B12 and folic acid.
Disease clinic
The clinical picture depends on the degree of development of the process, the massiveness of the lesion and the characteristics of the patient's body. Quite often, fish diphyllobothriasis is asymptomatic. In some cases, it is possible to identify a part of the worm in the feces, which provokes the development of such complaints from the patient as abdominal pain, rumbling, belching, etc. With a significant lesion, pathological changes in the digestive tract play an important role.system.
Patients complain of loss of appetite, vomiting, impaired stool, decreased activity, weakness. Allergic phenomena such as hives, blisters may appear on the skin.
The circulatory system in this disease also suffers, which is expressed in the form of B12-deficiency anemia.
Involvement in the pathological process of the nervous system leads to the appearance of numbness, burning, tingling, changes in the sensitivity of various parts of the body.
Diphyllobothriasis of fish: diagnosis
First of all, to make a diagnosis, it is necessary to collect an epidemic history, find out whether the patient has recently visited areas and areas endemic for this disease, whether he ate raw fish or caviar.
Particular attention should be paid to the testimony of patients. Patients may complain of excretion of parts of the worm along with feces. Particular attention should be paid to microscopic examination of feces. The diagnosis is established when the eggs of a wide tapeworm are found in it. Among additional studies, sigmoidoscopy can be performed, which will allow you to see with the naked eye changes in the intestinal mucosa, and in some cases the parasite itself.
Sometimes it is legitimate to conduct microscopy, which allows you to identify diphyllobothriasis (photos in the pathogen fish are available in the special literature).
An additional research method is a complete blood count. Diphyllobothriasis will be characterized by an increase in leukocytes, ESR, eosinophils.
To clarify the diagnosis, it is necessary to conduct a serological study.
Treatment
In order to start treatment, it is necessary to confirm the diagnosis of diphyllobothriasis. Directly to expel the worm from the body, drugs such as Fenasal, a decoction of pumpkin seeds, and male fern extract are used.
For the correction of disorders of the blood system, the use of vitamin B12 at 200-500 micrograms intramuscularly several times a week is indicated. Iron preparations are also prescribed - Ferronal, Aktiferrin, Ferroplex. To correct hemodynamic disorders, it is necessary to establish intravenous infusion of saline solutions - "Acesol", "Trisol", "Laktasol".
Enemas will also be useful, helping to cleanse the intestines and quickly remove the pathogen from the body.
If there is significant damage to the nervous system caused by fish diphyllobothriasis, treatment, in addition to the use of drug support, should also include physiotherapeutic methods.
Therapy is carried out for two weeks in a hospital. After this period, a control study of feces is carried out. The absence of helminth eggs in it indicates a successful outcome of the treatment.
Complications of the disease
With untimely treatment, fish diphyllobothriasis can be complicated by intestinal perforation. This condition requires urgent surgical intervention.
Often as a resultperforation of the intestine develops peritonitis. The presence of a worm in the intestine interferes with normal digestion. Because of this, the human body does not receive the necessary nutrients, which leads to the development of malnutrition.
Another equally important condition is immunodeficiency. Usually, when the underlying disease is treated, it disappears on its own. However, if the process is started, severe immunodeficiency may develop with the addition of an opportunistic infection.
Severe anemia can often lead to disorders in the functioning of the organs of the circulatory system, interfere with normal blood circulation and tissue metabolism, which is fraught with the development of organ dysfunction.
In children, the disease can be complicated by a febrile syndrome, which can lead to the development of epilepsy.
Prevention of diphyllobothriasis
Diphyllobothriasis is a zoonotic disease, therefore, the prevention of the development of this disease must take into account endemic characteristics and environmental features. Preventive measures should affect both the transmission of the pathogen and its natural sources. First of all, it is necessary to carefully identify all carriers of this infection, as they provoke an increase in the number of patients. Fishermen and sailors must be examined for this disease.
If there are pets in the family, be sure to examine them as well. The destruction of the natural source of infection is to clean up water bodies, as well as control the fish that enters the shops.
The main role in prevention is assigned to the sanitary service. It is the main organ that prevents fish diphyllobothriasis from spreading. The sanitary assessment of fish entering the stores and on the shelves is set by representatives of this organization. In addition, a partial role in the prevention of this disease belongs to district physicians, who are obliged to conduct educational work among the population.
Social advertising also has a good effect. Sometimes such an impact on people's minds is a stronger stimulus to action.
What should you do if you develop this condition?
Surely most people are not even aware of the existence of such a disease as diphyllobothriasis. What it is and how to treat it, only doctors know best.
The incubation period of the disease is quite long, so people cannot always associate the development of the symptoms they have with eating fish.
Most often they pay attention to the feces, in which particles of the worm are detected. This is what motivates them to seek help from a doctor.
If you have a suspicion of the development of diphyllobothriasis, in no case should you hesitate. It is best to immediately seek advice from an infectious disease specialist. It is he who can determine what disease you have developed, prescribe the appropriate research methods and draw up a competent treatment plan.
In no case should you try to cure the disease yourself. Such measures can only worsen your own condition. If, however, there is such a situation that for some reason the infectious disease specialist cannot help, it would be best to seek help from a therapist.
