Diphyllobothrium Latum (Fish Tapeworm)

Diphyllobothrium Latum (Fish Tapeworm) General Information

Diphyllobothrium Latum (Fish Tapeworm) is a medical condition caused by parasitic flatworms that are members of the genus Diphyllobothrium. D. latum belongs to the class of pseudophyllid cestodes. The adults of these parasites have the possibility to shed up to a million eggs a day, if not even more; it has similar characteristics to other members of the Diphyllobothrium genus, as what distinguishes them from the others is the organism that they invade. The species that leads to the appearance of Diphyllobothrium Latum (Fish Tapeworm) belongs to the genus of tapeworms and is also known as broad tapeworm or broad fish tapeworm; the larvae of these tapeworms are sometimes found in the flesh of fish or mammals. This type of tapeworm is around twelve meters long and it is considered to be the longest one that affects the human organism. The infection is also known as “Scandinavian and Jewish housewife’s disease” because it is very common around The Great Lakes. This is due to the fact that those who prepare fish balls or gefillte fish have the bad habit of tasting these dishes before they are well cooked. This is why the population more prone to develop this disorder is represented by the consumers of undercooked (under processed) or raw fish. Nowadays, Diphyllobothrium Latum (Fish Tapeworm) is rarer because the parasites are less found in the fish that swim in the Great Lakes. In the last few years, some persons suffering from this medical condition were discovered in the West Coast. It can also be observed in the western Russia and North America.  

Diphyllobothrium Latum (Fish Tapeworm) Symptoms

The parasite causing Diphyllobothrium Latum (Fish Tapeworm) lives in and around streams and fresh water lakes. What you must remember about D. latum is that in each stage of its existence, another habitat is invaded. The eggs are first found in the fecal of the definitive host. The larvae grow, in the beginning, in a copepod, and soon after this they get into the flesh of fish. Finally, the adult parasites inhabit the intestines of the mammalians. These are called plerocercoids and are always encountered inside the viscera of marine or fresh water fish. The last (final) hosts are humans and sometimes bears. Inside their organism, the parasite grows around 4-8 feet (two or three meters) and reaches its final length of 33 feet (almost 10 meters) in the last stages. Many infections caused by D. lantum are usually asymptomatic (in the case that the patient has no medical complains). After the ingestion of undercooked or raw fish has occurred, a person develops signs and symptoms, but only in a matter of ten days. The main manifestations of this medical condition (Diphyllobothrium Latum (Fish Tapeworm)) include the following: diarrhea, weight loss, abdominal distension, intermittent abdominal cramping (discomfort felt in the abdominal area), vomiting, and flatulence. Some patients may develop a deficiency of vitamin B 12 that could lead to, in very few cases, to megaloblastic anemia. Cholangitis and cholecystitis may be the result of the proglottids migrations. If the infection is really severe, intestinal obstruction may develop as a complication.

Diphyllobothrium Latum (Fish Tapeworm) Treatment

As soon as you observe signs and symptoms similar to those listed above, you should call your health care provider and establish an appointment for an emergency medical check. To determine with accuracy the disease (Diphyllobothrium Latum (Fish Tapeworm)) a series of tests need to be done. The main way to identify the parasite is by examining the stool. Under a microscope, the specialist will see if there are any eggs that present a lid, called operculate eggs; they are usually very numerous and their presence is demonstrated without concentration techniques. A very important test is the examination of proglottids that pass in the stools. To identify the exact type of tapeworm that causes the symptoms and signs is a real challenge. But this distinction does not present any medical importance because all the worms that are members of this genus are sensitive to the same category of drugs. Once the diagnosis Diphyllobothrium Latum (Fish Tapeworm) is established without any doubt, the health care provider can proceed with the adequate treatment. Any effective therapy must have the basis compound of substances that are toxic for the adult tapeworm.

Many specialists prefer to treat Diphyllobothrium Latum (Fish Tapeworm) or any other infections caused by any of the tapeworms with diatrizoic acid that is being injected only in the duodenum (the immobile part of the small intestine). After the injection is done, the worms usually detach and are passed whole. In the past, the treatments were difficult, causing many other complications; many methods of treatment were not well tolerated by the patients who also developed toxic reactions to them. The two main historical treatments are niclosamide and praziquantel. They should not be used as main therapy. They become an option only in case that an endoscopy is not possible or available. Praziquantel has proved to be effective in 90% of the patients suffering from Diphyllobothrium Latum (Fish Tapeworm). The side effects provoked by this drug are not persistent and quite mild, as they include pain in the abdomen area, muscle pain, itching or sore joints. It is always administrated as an oral medication. Niclosamide has been used before 1970 and has mild adverse effects, including skin rash, abdominal discomfort or light-headedness. The prescribed dosage is 1.5 grams for adults and only 0.75 grams for children. The tablets are usually taken with water after they were chewed. It is usually administrated on an empty stomach, particularly in the morning. Three hours after the treatment a patient is allowed to eat. In the past few years newer medications have appeared on the market and they have proved to be more efficient in helping the patient get rid of Diphyllobothrium Latum (Fish Tapeworm). These recent medicines are also easier to tolerate by the human organism and they are known to eliminate more quickly the parasite. After the treatment is over, the exams should be redone. The patient is healthy and the treatment efficient if the tests do not reveal the existence of eggs.