CESTODA

Introduction
The subclass Cestoda or tapeworm of
phylum Platyhelminthes are characterized
by the ribbon like and dorso-ventral
flattened body
Living worms are white or yellowish
There is no specialized alimentary or
digestive system, food is absorbed
through worms integument

 The excretory system is primitive; composed of

flame cell termini, capillaries and collecting
tubule
The whole body of cestodes consist of scolex,
neck and the entire chain of a few to many
segments or proglottids which is known as
strobila
The scolex is the anterior attachment organ
The neck is the growth region for strobila
throughout the life of tapeworm
The strobila is divided into immature proglottids,
mature proglottids and gravid proglottids

two lobus

Classification
Class Cestoidea
Subclass Cestoda
Ordo Cyclophillidea
Family Taeniidae
Family Hymenolepididae
Family Dilepididae
Family Davaineidae
Family Anoplocephalidae

 Ordo Pseudophyllidea
Famili Diphyllobothriidae
Scolex varies in morphology from

species to species
It is quadrate in shape with 4 muscular

cup-like suckers
In many species it has an anterior

elongate and protrusible rostellum

Rostellum situated in the center of

scolex armed with or without spines or

hooks

 The scolex of each species of

Cyclophyllidea is quite characteristic and
is sufficient for specific diagnosis
In Pseudophyllidea, the scolex is spoonshaped, bearing with dorsal and ventral
sucking groove which called bothria
The neck is constricted, the portion from
which the strobila grows by continuous
proliferation of new segments

 The cestode infection persist as long as

the scolex together with neck of the worm
remain attached to the host
The new segments arise from the neck are
called immature proglottids. They do not
yet contain fully developed internal
structure
When further developed, they are larger
and become mature proglottids. Each
contains male and female reproductive
organs

 The terminal portion of strobila which

primary genitalia of each segment are
greatly reduced or atrophy, called gravid
proglottids. The uterus filled with eggs is
remained and clearly observed
The terminal proglottids may become
detach in the intestine and pass out with
stool or detach and disintegrate in the
intestine releasing the eggs passing out
with the stool

 The reproductive organs are developed in

each mature proglottid
The male reproductive organ consist of
testes which are multiple and distributed
throughout the median plane of each
proglottid
Vasa efferentia, the small duct from each
testis, lead into a convoluted vas defferens

 When it approaches to the common atrium

on the median ventral surface in
Pseudophyllidea or on the lateral margin in
Cyclophyllidea, it is differentiated into pars
prostatica and cirrus organ
Pars prostatica and cirrus organ are
surrounded by cirrus sac
A seminal vesicle, if present, is situated at
the junction of the vassa efferentia and the
vas defferent

 The female reproductive organs

composed of a vagina which proceeded
from genital atrium to ootype
A seminal receptacle and spermatic duct
are at inner end of vagina
The ovary is bilobed, situated at the
posterior half of each proglottid
The oviduct receives the spermatic duct,
opens into the ootype

 The vitellaria, a bilobed mass in Taenia sp,

a single mass in Dipylidium or multiple
follicles in Pseudophyllidea
The vitellaria are connected into ootype by
vitelline ducts
Surrounding the ootype is the Mehlis
gland
Spermatozoa fertilize the naked ovum in
the ootype, yolk material and shell are
added by vitellaria and the egg is passed
into the uterus

 The uterus arising from the ootype runs

forward, become piled or coiled then
opens on the medians ventral aspect of
the proglottid in Pseudophyllidea
In Taenia, uterus develops branching
blindly
The shape and pattern of gravid uterus are
quite characteristic and usually the
species-diagnostic point

 Eggs are assembled in the ootype and

stored in the uterus
Eggs consist of fertilized ovum and yolk
material enveloped in an embryonic
membrane
The eggs of pseudophyllidean species are
ovoid, operculate and immature when
oviposited, yolk material is abundant

 In cyclophyllidean species, the eggs are

spherical, non operculate, contained
scanty yolk material and fully embryonated
when they are discharged from proglottids
The eggs very considerably in appearance
of the external shell as well as in the
number and thickness of the embryonic
membrane
These embryonic membrane serve as
protective covering of embryo, which is
called oncosphere

 The outer covering is delicate and usually

lost before the egg is passed in the feces
The inner embryonic covering is known as
the embryophore
In the Taeniidae, the outer covering is
frequently lost, the inner brownish
embryophore is thick and radially striated
In the Hymenolepididae, the embryophore
is thin and the outer egg shell is retained
In Dilepididae, several eggs are enveloped
in a single embryonic membrane

Egg of Taenia sp

Taenia sp, eggs

Life Cycle
Cestodes that parasitized human have
complex life cycle which involved both a
definitive and an intermediate host
Some species utilize human as the
definitive hosts, develop to adulthood in
the intestine such as Taenia saginata
For some species, human are acceptable
as definitive and intermediate hosts such
as Taenia solium

 The fully embryonated egg contains an

oncosphere, which bears six elongated
hooklets, thus it is called hexacanth
embryo
There is a pair of unicellular penetration
glands, secretion of which assist the
hooklets in penetrating the intestinal wall
of the intermediate host
In pseudophyllidean worm, the mature
embryo is called coracidium

 Coracidium is provided with a ciliated

epithelium
The hatching of ripe egg occurs in water,
two intermediate hosts are required to
complete life cycle
The cyclophyllidean worm, hatching of egg
occurs only after ingestion by the
appropriate intermediate host
Usually one intermediate host is required
and in Hymenolepis nana, no intermediate
host is needed

 The stage of cestode development within

the intermediate host is termed
metacestode
They are classified into 4 types:
Procercoid, a solid-body larva
Plerocercoid, solid, elongated worm-like body
Cysticercoid, a double-walled bladder with the
head invaginated and with a solid posterior
appendage
Cysticercus, a translucent bladder with the
head invaginated into the proximal portion of
the bladder

Order Cyclophyllidea
Family Taeniidae
1. Taenia saginata
2. Taenia solium

3.
4.
5.
6.
7.
8.

Hymenolepis nana
Hymenolepis diminuta
Dipylidium caninum
Echinococcus granulosus
Echinococcus multilocularis
Multiceps multiceps

Taenia saginata
Common name: The beef tapeworm
Diseases: Taeniosis saginata, beef
tapeworm infection
Geographical distribution: It is
cosmopolitan in distribution. The
prevalence is high in countries or areas
which people consume raw or
inadequately heated beef

Morphology:
The mature worm measures 4-12 meters
long and contain 1000-2000 proglottids
Under favorable conditions, they expand
to 25 m in length
The scolex is quadrate shape from top
view, measures 1.5-2 mm in maximum
diameter, bears four muscular
hemispherical suckers

 The proglottids of Taenia saginata are in

general like the corresponded proglottids
of Taenia solium
The genital organs of mature proglottids
differ in having twice in number of testes
(300-400) and lacking of accessory lobe of
ovary
The length of gravid proglottids, are longer
and there are 15-20 main lateral branches
on each side of the central stem of uterus
The eggs are indistinguishable from
Taenia solium eggs

Taenia saginata, proglottid

Scolex

T. saginata

Scolex Taenia saginata

Life Cycle
The adult worm is in the jejunum of small
intestine of man
The gravid proglottids are separated from
strobila in single segment and evacuated
out with feces of migrate freely out from
anus
The gravid proglottids may disintegrate
within the bowel and release eggs passed
with feces

 The embryonated eggs are ingested by

many species of herbivorus mammals
including domesticated cattle and reindeer
The oncospheres hatch in the duodenum,
penetrates intestinal wall, reach mesentric
venules or lymphatics then goes to
circulation
They are carried to any organ, with
particularly in striated muscles and cardiac
muscles

 Oncospheres develop in 60-75 days into

an infective Cysticercus bovis which
contained unarmed scolex invaginated in
the cyst
Man acquires infection through the
ingestion of raw or inadequately cooked
beef
The prepatent period is 10-12 weeks
Cysticercosis bovis is not proved in man

Pathology and Symptomatology

The adult parasite probably causes no
symptom in most patients
Some patients has abdominal discomfort,
nausea, weakness, diarrhea, lost of
weight, hunger pain and chronic
indigestion
It may causes intestinal obstruction or
produces acute appendicitis

 The detach gravid proglottids may

crawling actively out from the anus,
usually during the day when the host is
active, causing discomfort and
embarrassment of the host

Diagnosis
Recovery of eggs in stool is a generic
diagnosis
The specific diagnosis based on the
identification of the evacuated gravid
proglottids
They were pressed under two glass slides
and examined the main lateral branches of
uterus which vary from 15-20 branches
with 18 in average

 In Asia, T. saginata infection is more

prevalent than T. solium infection
Although Cysticercus cellulosae is
frequently found and many people are
more often consume raw or undercooked
pork and viscera than that of cattle
It may possible that a species other than
T.saginata and T. solium is the causative
agent of taeniosis in Asia
Asian T. Saginata or T. asiatica was called
in reports from Taiwan and Korea

Morphology of T. asiatica is similar to T.

saginata, but differs in:
1. The existence of rostellum in the scolex
2. The prominence of posterior protuberance in
gravid proglottids
3. The large of uterine branches (more than
57) in gravid proglottids

Treatment
Niclosamide administered at 2 g is
effective
Praziquantel is well tolerated and highly
effective when given 10-20 mg per kg
body weight as a single dose
Bithionol 40-60 mg/kg one or two doses
was commonly used in Japan, but this
drug is not available in Indonesia

Prevention and Control

Consume the throughly cooked beef
Heating the beef with temperature above
56oC can kill the cysticerci
All beef should be inspected for cysticerci
in the slaughter house