Taeniasis
Introduction
Introduction to cattle tsutsugamushi disease Taeniasissaginate is a kind of intestinal ascariasis caused by the parasitic human small intestine of the taeniasaginata adult, also known as beef tsutsugamushi disease and obesity tsutsugamushi disease. Its cysticercosis was first discovered by Wepfer in 1675. In 1861, Leuckart infected the gestational tract with a cysticercosis. In 1869, Oliver infected the cercariae, thereby completing the entire life history, whether domestic or foreign. The disease is the earliest recorded parasitic disease. Bovine tsutsugamushi disease is distributed worldwide, and can be prevalent in areas or ethnic groups where beef is eaten, especially in the habit of eating raw beef. In general, it is mostly sporadic. basic knowledge The proportion of illness: 0.03% Susceptible people: no specific population Mode of transmission: insect vector transmission Complications: intestinal obstruction, acute appendicitis, shock
Cause
Causes of bovine tsutsugamushi disease
(1) Causes of the disease
Bovine locust
The cattle tapeworm is also known as beef aphid, obese aphid, and no hookworm. The adult is milky white, flat as a band, segmented, and about 4m to 8m long. The front end of the worm body is thinner and gradually widens backwards. There are about 1000 to 2000 segments, and the worm body is thick and opaque. The whole body consists of three parts: the head section, the neck section and the chain body. Each section has a set of male and female reproductive organs. The number of gestational segments in the worm is about 10% of the total number of segments, and the uterus has 15 to 30 branches, which are arranged in a branch shape on both sides of the segment, neatly, and there are a large number of eggs in the uterus. Due to its telescopic creep, the eggs can be spread in the feces as well as around the anus and even on the underwear. There are about 80,000 eggs in the gestational section. 50% of the eggs are mature. Only 40% of them must mature in the body for half a month. Therefore, a tassel is close to the ovulation. 720,000. The eggs found in the feces generally have egg shells that have fallen off, and only the round or nearly round six-hooks coated with the embryo membrane have a diameter of 36 to 42 m and are yellowish brown. The embryonic membrane is 3 to 3.8 m and has a hexagonal mesh texture on the surface. The inner side of the embryonic membrane is a thin and transparent outer membrane of the young embryo, which surrounds the six hooks. The eggs of the cattle mites have strong adaptability to the outside world and can survive for dozens of days in the feces. Usually, the method of treating sewage can not completely kill the eggs, and at least 168 days in the environment of -4 °C.
Source of infection
The cattle tapeworms are distributed worldwide, and they are widely spread in areas and ethnic groups that like to eat beef, especially those with raw or semi-raw beef. In general, only scattered infections occur. There are scattered cases of cattle tapeworms in more than 20 provinces in China, but in several ethnic minority areas, such as Xinjiang, Inner Mongolia, Tibet, Yunnan, Ningxia, Sichuan, Guizhou, Miao, Guangxi, Miao and Dong of Guizhou, There is also a local popularity in the Yami and Atayal regions of Taiwan. The infection rate can reach more than 70%, the patients are mostly young adults, and the average male is slightly more than the female. The pathogen of bovine tsutsugamushi disease is the bovine cysticercosis, a cow infected with cysticercosis, which is the main source of infection of bovine tsutsugamushi.
way for spreading
Mainly related to the lifestyle and eating habits of the local population. In the endemic areas, farmers and herdsmen often defecate in the pastures and in the wild, causing manure to contaminate pastures, water sources and the ground. Ox-bearing eggs can survive for 8 weeks or longer in the outside world, so when grazing, cattle are easily infected with eggs or gestational age. Some groups like to eat raw or half-lived beef are also susceptible to infection.
The only terminal host of the locust is the human, and the intermediate host has wild boar, reindeer, llama, wildebeest, bovine, wild goat, fox, and sheep. Humans are the ultimate host of aphids, but they cannot be intermediate hosts. Bovine mites eggs are generally considered to be unable to develop or produce bovine cysticercosis (bovine cysticercosis) after being swallowed, so this is different from the anthropogenic host and human intermediate host. Because the eggs of the aphid and the gestational section are discharged with the feces, it is usually parasitic on the upper part of the human small intestine. The general evolution process is as follows: after the intermediate host ingests the contaminated feed, the six hooks are hatched in the duodenum and the mucus is punctured by the small hook and the puncture gland to penetrate the intestinal wall and reach the body with the blood flow. In each part of the muscle, especially in the head masticatory muscles, the lingual muscles, the myocardium and other skeletal muscles, it develops into an infectious cysticercosis after about 10 weeks. The mature Cysticercus cellulosae is oval in shape and has a volume of about (7-10) mm×(4-6) mm. It is a translucent cystic milky white capsule. The white small dot-shaped cephalic section is visible to the naked eye. The capsule is filled with liquid. . When a person swallows an infectious cysticercosis, the bile is digested by the bile in the small intestine, and the anterior segment is turned out and fixed on the intestinal mucosa, and the segment is formed into a chain, which develops into an adult in about 3 months. Cysticercus can also survive for about 3 years in beef. Adults have a long life span of 30 to 60 years.
Susceptible population
Any age can cause tsutsugamushi disease in cattle. After infection with cattle with aphids, the human body can produce immunity with insects, can not eliminate infection, but has certain immunity to reinfection. The minimum age is 10 months, and the highest age is 86 years old, but the majority of young adults are 21 to 40 years old, and more men than women.
(two) pathogenesis
If the segment excreted outside the human body is swallowed by the cow, the eggs in the segment develop into larvae in the bovine body, and spread to the body of the cow with blood flow, especially the more moving strands, shoulders, heart, tongue and neck. In the muscles of the ministry, it develops into the cysticercosis after 60 to 70 days. In addition to cattle, sheep, llamas, giraffes, antelopes, etc. can also be parasitic by the sac. If people eat such raw beef, or during the cooking process, the larvae in the beef are not killed, they will enter the digestive tract of the human body through the mouth, and gradually grow up in the small intestine of the human body and develop into a tapeworm. When a small amount of aphid is parasitic in the small intestine, the worm can descend from the jejunum to the ileum and then stick to the intestinal mucosa. In this case, no lesion will occur. When a large number of parasites appear, the mites can suck and damage the intestinal mucosa, and mild subacute inflammation will occur locally. If the number of parasites reaches a certain amount, it will also cause partial intestinal obstruction due to agglomeration of the worm. When there is a detachment of the segmental motion in the intestinal wall, when the ileocecal valve is blocked, the activity is enhanced, causing paralysis and causing abdominal pain and the like.
The worm's metabolites may have some toxic effects on the host. Bovine aphids absorb nutrients from the host's intestines, causing symptoms of hunger, anemia, and vitamin deficiency. Due to the action of the metabolites of the worm, the patient may also develop abnormal symptoms such as increased eosinophils, urticaria, itching and asthma. After infection with Taenia solium, specific antibodies will appear in the patient's serum.
Prevention
Bovine tsutsugamushi prevention
1. Control the source of infection in the epidemic area should be carried out census, treatment of patients and insects.
2. Strengthen the management of manure and pay attention to the cleaning of pastures. Do not let human waste contaminate the water source of the pasture to avoid infection of cattle. To strengthen the management of cattle breeding, in order to prevent cattle infection, the toilet should be separated from the cow house to prevent cattle from eating people's stool.
3. Strengthen health education, pay attention to personal hygiene, improve diet and hygiene habits, meat must be cooked and cooked thoroughly, cut knives and chopping boards of lettuce and cooked vegetables should be separated, and should be cleaned after use to prevent pollution.
4. Strengthen meat inspection and prohibit the sale of beef containing cysticercosis. Strengthen the work of slaughterhouses and strictly prohibit the sale of beef with larvae of cattle.
Complication
Bovine tsutsugamushi complications Complications, intestinal obstruction, acute appendicitis shock
The important complications of bovine tsutsugamushi disease are intestinal obstruction and acute appendicitis, which are caused by blockage of the chain or segment.
Intestinal obstruction refers to the obstruction of intestinal contents in the intestine. For common acute abdomen, it can be caused by many factors. At the onset of the disease, the obstructed intestines have anatomical and functional changes, followed by loss of body fluids and electrolytes, intestinal wall dysfunction, necrosis and secondary infections, which can lead to toxemia, shock, and death.
Symptom
Symptoms of bovine tsutsugamushi common symptoms anal itching abdominal pain nausea insomnia loss of appetite dull pain diarrhea
It can occur at any age, and the incubation period is from the swallowing of the cysticercosis to the appearance of worm fragments or eggs in the feces, which takes about 3 months. The minimum age is 10 months, and the highest age is 86 years old, but the majority of young adults are 21 to 40 years old, and more men than women. There are more than one adult mites in the parasitic body, and there are as many as eight, and the largest number is 31.
Symptoms: The severity of the disease is related to the number of parasites in the body.
Lighter: It can be asymptomatic, and white patches are the most common symptoms found in stools or underwear. Most patients see this. The gestational section is more than the stool, accompanied by the feces excreted, and often automatically single or two or three sections connected from the anus to climb out, short-term peristal around the anus, and slipped to the perineum or thigh, the patient felt anal itching Discomfort. Almost 100% of patients have symptoms of anal itching.
In severe cases, the symptoms are obvious and can even die due to complications.
Gastrointestinal symptoms: The most common form of abdominal pain is found in about half of the cases. Abdominal pain can be in the upper abdomen, umbilical or non-fixed position, can be dull pain, dull pain, tingling, biting or burning sensation, a small number of patients may have colic. In addition, there may be nausea (15.7% to 46%), vomiting (11%), and diarrhea (10% to 50%). Loss of appetite or hyperactivity and indigestion are more common.
Systemic symptoms: fatigue, weight loss, nighttime molars, anemia, malnutrition, etc.
A few patients may have:
Neurological symptoms: dizziness, nervousness, insomnia, epileptic seizures and syncope.
Skin symptoms: allergic pruritus, urticaria, nodular pruritus, etc.
Examine
Inspection of cattle with tsutsugamushi
Blood picture
The blood picture changes little, generally no anemia, eosinophils can be slightly increased, and more often in the early stages of the disease.
2. Egg inspection
In most patients, the eggs can be found in the feces, but because the aphids have no uterine pores, the eggs cannot be directly discharged into the intestines. Only when the segments of the pregnancy are squirming or rupturing, the eggs are spread into the feces, so not every In one case, the eggs can be found. The eggs can be examined by direct smear or thick smear method, sedimentation method and floating concentration method. The Hein thick smear method can detect 97 times in three times. The sub-method is an anal smear test, which can detect the eggs. The method is simple and the positive rate is almost equal to the sedimentation method. It can be used for census, sputum or swab smear to detect the mites eggs, and can not identify the worms, because the cattle mites It is very similar to the pig's tapeworm, and it is difficult to distinguish between the two.
3. Pregnancy section examination
The gestational section of the cattle mites often sheds from the chain and is excreted with vomit or feces. Therefore, it is often a simple and accurate diagnosis method to ask whether there is vomiting or sputum in the stool. Observe the number and shape of uterus branches in the gestational section. It can be used to identify the type of intestinal mites, pick out the pieces mixed in the feces and wash them with water, sandwich between the two slides, and distinguish the number and shape of the uterus from the naked eye. The number of branches is 15 to 30, which is in the form of branches. The uterus branches of the porcine mites have 7 to 13 branches and are dendritic.
4. Head section check
24 hours after deworming treatment, the entire fecal examination head section can be used to help evaluate the efficacy and identify the species. The feces can be placed in a large container and rinsed repeatedly with clean water until the feces are clarified, and the sediment is transferred to a glass container lined with a black background. Carefully look for the head section. If the worm body is tangled, it should be carefully untied and searched for the chain to the thin end. The head section of the cow mites is nearly square, larger and has no apex and small hooks. It is round, small and has a apex, with two rows of small hooks on it. The head section is driven out to indicate that the treatment is thorough. If there is a worm infection, it should be noted that the number of chains is consistent with the number of heads.
5. Immunological examination
In vivo test using insect homogenate or worm protein as antigen, ring precipitation test, complement binding test or latex agglutination test can detect antibodies in vivo, the positive coincidence rate is 73.7% ~ 99.2%, using enzyme-linked immunosorbent assay It can detect specific antigens in host feces, with sensitivity up to 100%, and is highly specific, with no cross-reactivity with aphids, small membrane aphids, hookworms and whipworms.
6. Molecular biology examination
The DNA-DNA spot blotting method can be used to detect the eggs of the aphid, and in recent years, the polymerase chain reaction (PCR) is used to amplify a trace-specific DNA sequence of the outer surface of the egg or the exfoliated body of the worm. The specificity and sensitivity of cattle or aphids in the human body are high.
Diagnosis
Diagnosis and identification of bovine tsutsugamushi disease
Diagnostic criteria
1. Epidemiological data should ask the patient about the nationality, religious beliefs, whether there is a raw or semi-raw beef habit, especially from ethnic minority areas, for reference.
2. Vomiting or faecal sputum or sputum excretion of the sputum can almost make a diagnosis, but young women have a history of concealment due to shame, and the number and morphology of uterus branches from the gestational section are the main diagnostic methods. One.
3. Stool and anal swab smear to find mites eggs.
4. Immunology and molecular biology examinations can also assist in diagnosis.
Differential diagnosis
Need to be differentiated from swine tsutsugamushi disease.
Taeniasis solium is an intestinal ascariasis caused by adult taenia solium parasitic in the human small intestine, also known as pork tsutsugamushi disease and chain tsutsugamushi disease. Its morphology and life history have many similarities with the cattle tapeworm. The adult parasitic worms are parasitic in the human intestines, and the larvae are parasitic in human subcutaneous tissue, muscle, brain and other tissues and organs, which is cysticercosis (cysticercosis). Cysticercosis is one of the most important human parasitic diseases.
The aphid in Taiwan, China, has an adult form like a locust, while the larva is similar to the cysticercosis of the locust, with a stunted hook; its cysticercosis is parasitic on animals such as deer, wild goats, wild boars, and monkeys. In the liver, pigs and cattle can also be infected. Human infections are caused by raw wild animal livers and can also be affected by raw pigs, beef and internal organs.
