Cysticercosis

Cysticercosis is a tissue infection caused by the young form of the pork tapeworm. People may have little or no symptoms for years. In some cases, particularly in Asia, solid lumps of between one and two centimetres may develop under the skin. After months or years these lumps can become painful and swollen and then resolve. A specific form called neurocysticercosis which affects the brain can give neurological symptoms. In developing countries this is one of the most common causes of seizures.Cysticercosis is usually acquired by eating food or drinking water that has tapeworm eggs in it. Among foods, uncooked vegetables are the major source. The tapeworm eggs are present in the feces of a person infected with the adult worms, a condition known as taeniasis. Taeniasis, in the strict sense, is a different disease and is due to eating cysts in poorly cooked pork. People who live with someone with the tapeworm have a greater risk of getting cysticercosis. The diagnosis can be made by aspiration of a cyst. Taking pictures of the brain with computer tomography (CT) or magnetic resonance imaging (MRI) are most useful for the diagnosis of disease in the brain. An increased number of a type of white blood cell, called eosinophils, in the cerebral spinal fluid and blood is also an indicator.Infection can be effectively prevented by personal hygiene and sanitation: this includes cooking pork well, proper toilets and sanitary practices, and improved access to clean water. Treating those with taeniasis is important to prevent spread. Treating the disease when it does not involve the nervous system may not be required. Treatment of those with neurocysticercosis may be with the medications praziquantel or albendazole. These may be required for long periods of time. Steroids, for anti-inflammation during treatment, and anti-seizure medications may also be required. Surgery is sometimes done to remove the cysts.The pork tapeworm is particularly common in Asia, Sub-Saharan Africa, and Latin America. In some areas it is believed that up to 25% of people are affected. In the developed world it is very uncommon. Worldwide as of 2010 it caused about 1,200 deaths, up from 700 in 1990. Cysticercosis also affects pigs and cows but rarely causes symptoms as most do not live long enough. The disease has occurred in humans throughout history. It is one of the neglected tropical diseases.