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តេញ៉ាត្រី Diphylobothrim Latum: or Fish Tapeworm

  • តេញ៉ាត្រី (Diphylobothrium latum) ជាតេញ៉ាដែលធំជាងគេក្នុងខ្លួនមនុស្ស។ តេញ៉ានេះឆ្លងទៅមនុស្ស តាមរយៈ ការបរិភោគ ត្រីឆៅ រឺ ត្រីដែលមិនឆ្អិនល្អដែលផ្ទុកតេញ៉ាជំទង់។
  • វដ្តរបស់ការឆ្លងតេញ៉ាត្រីៈ
 
  • កង់តេញ៉ាត្រីមានប្រវែងប្រមាណ 3mm ទទឹងរបស់វាប្រមាណ 10mm។
  • មេតេញ៉ាត្រីអាចមានប្រវែងជាង 10mm និងអាចរស់ដល់ ២០ឆ្នាំ។
  • មេតេញ៉ាត្រី១អាចបញ្ចេញពងបាន១លានក្នុង១ថ្ងៃ។
  • កង់របស់វាមាន ប្រព័ន្ធរំលាយអាហារដោយខ្លួនឯង។ វាស្រូបចំណីអាហារពីពោះវៀន។
  • អ្នកដែលញុំាសាច់ត្រីឆៅ ប្រឈមនឹងការឆ្លងតេញ៉ាត្រីជាងគេ។ មេផ្ទះដែលជាអ្នករៀបចំម្ហូប មានឱកាសឆ្លងច្រើនជាងបុរស។
  • មានម្ហូបជាច្រើនដែលប្រើប្រាស់ត្រីឆៅដូចជា Sushi និង Sashimi របស់ជប៉ុន ។ល។
  • - ការឆ្លងតេញ៉ាត្រី Diphylobothrium latum ជាទូទៅមិនមានរោគសញ្ញាទេ
    - មិនមានការធ្វើទុក្ខអីទេ។
    - ពេលខ្លះរោគសញ្ញាមានតែការខ្វះ វីតាមីន B12 ខ្លាំងក្លាដោយសារតេញ៉ាត្រីស្រូបយក វីតាមីន B12 អស់។
    - រោគសញ្ញា តេញ៉ាត្រីមានដូចជាៈ
  • ទល់លាមក
  • រឺ រាគ
  • អស់កំលាំងល្ហិតល្ហៃ
  • ស្ទះពោះវៀន
  • ឈឺពោះ
  • ក្អួត
  • ស្រកទំងន់
  • ខ្វះវីតាមីន B12 ខ្លាំង => កើតជំងឺស្លេកស្លាំងខ្វះគ្រាប់ឈាមក្រហម
  • ដែលអាចបណ្តាលឲ្យមានជំងឺសរសៃប្រាសាទ រឺ ក្រិនខួរឆ្អឹងខ្នង
  • អាចចុកពោះខ្លាំងដោយសារវាធ្វើឲ្យស្ទះ រឺ រលាកផ្លូវទឹកប្រម៉ាត់ រឺ រលាក ប្លោកប្រម៉ាត់
  • - របៀបធ្វើរោគវិនិច្ឆ័យៈ
  • ពិនិត្យលាមក រកពង និងកង់របស់តេញ៉ា
  • - របៀបព្យាបាលៈ
  • Praziquantel រឺ Niclosamide ប៉ុន្តែថ្នាំទាំងនេះមិនធានាឲ្យធ្លាក់តេញ៉ាទាំងក្បាលទេដែលជាហេតុបណ្តាលឲ្យតេញ៉ាត្រីដុះវិញទៀត។
  • វិធីព្យាបាលល្អបំផុតគឺប្រើប្រាស់ endoscope ចាក់អាស៊ីត diatrizoic ចូលក្នុងពោះវៀនតូច (injection into the duodenal wall)។ វិធីនេះពិតជាអាចធ្វើត្រូវតេញ៉ាត្រីធ្លាក់ទាំងអស់តែម្តង។
  • - វិធីការពារៈ
  • ចំអិនត្រីឲ្យបានត្រឹមត្រូវល្អ
  • បើញុំាត្រីឆៅជប៉ុន (Sushi or Sashimi) ត្រូវបង្កកក្នុងសីតុណ្ហភាព -10oC យ៉ាងទាប ២ថ្ងៃសិន ដើម្បីសំលាប់កូនតេញ៉ាត្រីជំទង់ ដែលអាចមានក្នុងសាច់ត្រី។
  • កុំបន្ទោរបង់ក្នុងទឹក ព្រោះបើពងតេញ៉ាត្រី មិនបានចូលក្នុងពោះ បង្កង ក្តាម ខ្យង រឺ ត្រីតូចៗ និងត្រីធំៗដូច Sushi រឺ Sashimi ទេ វានឹងមិនអាចឆ្លងទៅមនុស្សបានទេ។
Parasites In Humans
Find The Nastiest Parasites In Humans

Diphyllobothrium Latum - Fish Tapeworm

Diphyllobothrium latum, the fish tapeworm, is the biggest tapeworm in humans. It causes a parasitic infection called diphyllobothriasis which is acquired by eating raw fish infected with the parasite. Diphyllobothriasis is found in Chile, Peru, Uganda and in the Northern Hemisphere (northern Asia, Europe and America) in areas of rivers and lakes.Diphyllobothrium species include: D. cordatum, D. dalliae, D. dendriticum, D. lanceolatum, D. latum, D. pacificum, D. ursi and D. yonagoensis. Diphyllobothrium latum is the most common and mostly found in Scandinavia, the Baltics and western Russia.

The life cycle of Diphyllobothrium latum starts, when immature eggs are passed in the feces of an infected human. The eggs mature in water within three weeks and form oncospheres. Larvae called coracidia hatch and get eaten by freshwater crustaceans such as copepod. After ingestion coracidia develop into procercoid larvae. If the copepod is eaten by a small fish (second intermediate host), the procercoid larvae penetrate the gut and migrate to muscle tissue where they develop into plerocercoid larvae (sparganum), the infective stage for humans. Usually a third intermediate host is needed because humans do not usually eat raw fish this small. If a trout, walleyed pike or perch eats the smaller fish, the plerocercoid larvae once again penetrate the gut and migrate to fish flesh. If a human eats the infected fish raw or undercooked the plerocercoid larvae develop into adults in the small intestine. The adults attach to the intestinal mucosa with two shallow, bilateral grooves (bothria) of their scolex. The scolex is 3 mm long and 1 mm wide. The long, flat body consists of segments, proglottids, that are produced by the neck. Full grown proglottids are about 10 mm wide and 3 mm long. The segments absorb nutrients and have their own digestive systems. As proglottids mature, they release eggs and eventually break off from the body. A Diphyllobothrium latum proglottid is characterized by a rosette-shaped uterus at its center. The eggs are ellipsoidal or oval measuring 55–75 µm by 40–50 µm. They are passed in the feces unembryonated (immature). From the start of the infection it takes about six weeks for the eggs to appear in the feces. One adult tapeworm can shed up to a million eggs per day. It can grow over 10 meters long and live up to 20 years.

Diphyllobothrium latum life cycle

People who eat raw fish are at risk of getting infected with the larvae that are sometimes present in the fish flesh. Some fishermen eat their catches raw using salt to kill parasites. Salting the fish is usually not enough to kill larval Diphyllobothrium latum. Some housewives taste fish as they are preparing it and might ingest the tiny larva. Women get infected more often than men because they usually prepare meals for the family. Raw fish is included in many regional cuisines, for example, carpaccio di persico (Italy), ceviche (Latin America), marinated herring (Scandinavia), sashimi and sushi (Japan) and tartare maison in (France).

Diphyllobothriasis is usually asymptomatic. In some cases it causes severe vitamin B12 deficiency because D. latum can absorb most of the B12 intake. In some cases it can lead to neurological symptoms. Diphyllobothriasis symptoms include:

  • constipation
  • diarrhea
  • fatigue
  • obstruction of the bowel
  • pernicious anemia (caused by vitamin B12 deficiency) which can lead to
  • subacute combined degeneration of spinal cord
  • stomach pain
  • vomiting
  • weight loss.

Migrating proglottids can cause inflammation of the bile duct or the gall bladder.

Diphyllobothriasis is diagnosed by examining a stool sample to find eggs or sometimes proglottids. Identification is restricted to genus level which actually does not matter when treating the disease since all Diphyllobothrium species respond to the same drugs. When doing research the specific worm species can be identified by performing PCR on purified eggs.

Diphyllobothriasis was previously treated with praziquantel or niclosamide. Praziquantel has some side effects that are very similar to diphyllobothriasis symptoms. Niclosamide is not absorbed in the gastrointestinal tract and has usually no side effects. However, these drugs are not reliable in cutting the scolex loose. If the head is left in the intestinal wall it will regrow. The best method is a diatrizoic acid injection into the duodenal wall. The diatrizoic acid causes all worms to detach leaving nothing behind. Niclosamide or praziquantel should only be used, if endoscopic treatment is not available.

To prevent infection:

  • Cook fish properly. If you eat sashimi or sushi, freeze it first at -10 °C (or below) for two days to kill the tapeworm larvae.
  • Do not defecate in water. If the fish tapeworm larvae cannot get in touch with the intermediate hosts, they cannot infect humans.

 



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