Taeniasis
Introduction
Introduction to swine tsutsugamushi The taeniasissolium is a kind of intestinal ascariasis caused by the adult taeniasolium 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 cattle tapeworms, but there are some important differences. Among them, human beings are both the final host and the intermediate host in the life history of the swine mites, and the adult mites are parasitic in the human intestines, which are intestines with tsutsugamushi disease. The larvae are parasitic in human subcutaneous tissues, muscles, brains and other tissues and organs. Cysticercosis (cysticercosis). Cysticercosis is one of the most important parasitic diseases in humans. The following mainly describes the tsutsugamushi disease. basic knowledge Proportion of disease: The incidence rate of most half-cooked pork eating habits is about 0.05%-0.06% Susceptible people: no specific population Mode of infection: digestive tract spread Complications: appendicitis, intestinal obstruction, cysticercosis
Cause
Causes of swine tsutsugamushi disease
(1) Causes of the disease
Pig with aphids, also known as pork aphids, chain-like aphids, hookworms, is the main human parasitic aphid in China, adult is smaller than cattle tapeworms, thin and transparent, body length 3 ~ 5m, head section nearly spherical, not included Pigment, 0.6 ~ 1mm, in addition to four suction cups in the head section, the top has a top protrusion, there are 25 ~ 50 small hooks on the top, arranged in two circles inside and outside, the neck is slender, the number of chain segments is small, the number Hundreds, the mature section is nearly square, the pregnancy section is narrow and long, the number of uterus branches is small, 7 to 13 are distributed in the shape of multiple branches, and the eggs are indistinguishable from the eggs of the cattle.
The adult mites are parasitic in the human small intestine, and the gestational section is detached from the chain and excreted with the feces. When the intermediate host pig swallows the gestational section of the feces, the eggs are ruptured by the digestive juice in the duodenum. The six hooks escape and follow the blood flow or lymph of the intestinal wall to reach various parts of the host body. The worms gradually grow, and the middle cells dissolve to form a cavity and are filled with liquid. After about 10 weeks, they develop into mature cysticercosis, and cysticercosis in pigs. The muscles are the most, of which the medial femoral muscle is the most, the mature cysticercosis is elliptical, about 20mm×11mm., milky white translucent, human ingested into the raw or half-lived cystic scorpion diseased pork, in the stomach capsule The wall of the sacral sac is digested, and the sacral sac of the duodenum is valgus, which is fixed on the small intestine wall and becomes an adult. The eggs are found in the feces after about 2 to 3 months (Fig. 1).
Adults can live for about 25 years in the human body. People can sometimes be swallowed by ingestion of food contaminated with eggs or when they are regulfed to the pharynx during deworming. Eggs are in the human body. It can also develop into cysticercosis and suffer from cysticercosis in pigs. When the cysticercosis is in the vital organs such as the brain and eyes, it can endanger life or cause serious damage.
(two) pathogenesis
People who are infected with pork containing cysticercosis may also develop cysticercosis due to accidental intake of eggs of aphids in human excreta and become intermediate hosts. In addition, if there are adults in the intestines, they may The gestational tract in the intestine is brought into the stomach and hatched six hooks, which migrate to the subcutaneous tissue, muscle, viscera and central nervous tissue.
Epidemiology
Pig tsutsugamushi disease is widely distributed in China, and there are scattered cases in various places. It is more common in the northeast and east China than in cattle mites, with a ratio of 8:1 and 7.1:1, and the infection rate is less than 1% to 15.2%. It is endemic in Yunnan, Henan, Heilongjiang, Jilin, and Guangxi Zhuang Autonomous Region.
1. The source of infection is a source of infection of the disease. At present, rural pigs in China are still mainly distributed, and pigs often eat for food outside the circle. Therefore, there is a greater chance of swallowing pigs with tapeworms or eggs. Especially in the economic backwardness or lack of toilets in remote areas, people in the wild or in the pigs as toilets, so the infection rate of pigs with cysticercosis is very high. In these areas, there are also more people suffering from tsutsugamushi disease in pigs.
2. Routes of transmission People are infected by eating raw or half-lived pork containing cysticercosis. Not cooked when cooked, or tasted raw meat or eat raw meat hot pot, or raw and cooked knives can be eaten into the live sac.
3. Susceptible people are generally susceptible to swine mites. After infection with swine mites, the human body can produce worm immunity, which has a protective effect on host reinfection. Domestic patients are only 6 months old and the longest are 85 years old. They are mostly young and middle-aged, with more men than women.
Prevention
Pig band tsutsugamushi prevention
1. Pucha Puji The only host of epidemiological significance is the only host of aphid. Therefore, thorough treatment of patients is an effective measure to control the source of infection, which not only can cure patients, but also reduce the incidence of cysticercosis in recent years. The work of removing cockroaches and killing sacs promoted in the northeastern region has achieved great results, and the incidence of tsutsugamushi disease and porcine cysticercosis has decreased significantly.
2. Strengthening health education Education The masses will change the eating habits of unhealthy raw food, half-cooked pork, strictly implement the separation of raw and cooked cooking utensils, pay attention to personal hygiene, strengthen the health quarantine of eating stalls, and those who suffer from pig mites may not work in the catering industry.
3. Strict meat quarantine slaughtering pigs must be quarantined by the state-designated health department before entering the market. It is strictly forbidden to list and sell rice pork. After the pig hair is treated with sodium hydroxide or ferric chloride coloring solution, the hair root sheath is treated. The color can be changed from white of healthy pig to brown or brown of sick pig. The accuracy rate can reach 81.2%100%. It can be promoted and applied. After slaughter, the pork should be refrigerated at -12~-13°C for 12h. Kill.
4. Change the method of raising pigs to promote captivity, and not to have the opportunity to be infected with human feces. Domestic pigs have been tested with whole cysticercosis homogenate (Q83 antigen) and Freund's adjuvant for immunization of pigs, 3 years total protection rate It is 91.39%; a single inoculation of 3ml with Q83 antigen Freund's adjuvant can achieve 100% protection rate, and the safety protection period can reach 7-8 months.
Complication
Pig with tsutsugamushi complications Complications appendicitis intestinal obstruction cysticercosis
Can be complicated by appendicitis or intestinal obstruction, as well as cysticercosis.
Symptom
Pig with tsutsugamushi symptoms Common symptoms Nausea nodules Diarrhea Abdominal pain Indigestion
The symptoms of swine tsutsugamushi disease are similar to those of bovine tsutsugamushi disease. Generally, there are no obvious symptoms. The number of parasites in human intestines is generally one, even two or more. The maximum number of domestic reports is 19, and the clinical symptoms may have abdominal pain. Nausea, indigestion, diarrhea, weight loss, and intestinal obstruction can occur when there are many insects. Similar to cattle tsutsugamushi disease, patients often see a section of the stool and see a doctor.
The importance of swine tsutsugamushi disease is that the adult worms in the intestines have the risk of causing autophagy infection of cysticercosis. In the case of reverse motility or deworming in the intestines of the intestines, the detached gestational patches have the possibility of reversing into the stomach. Incubation of the six hooks causes autologous infection with cysticercosis. This route is more important than the swallowing of eggs due to poor hygiene habits or contamination of food by eggs. Among the 450 cases of cysticercosis reported abroad, 21.6% have a history of intestinal ascariasis. Domestic, it is 28.6% to 67.3%; while pigs with aphids have 2.3% to 25% concurrent with cysticercosis, and the longer the infection period, the greater the risk of autologous infection, especially in patients with subcutaneous and epileptic cysticercosis. The history of intestinal mites accounted for 48.1% and 48.6%, respectively. Therefore, patients with mites can not ignore the early thorough treatment because the symptoms are not obvious.
Examine
Inspection of swine tsutsugamushi
Blood picture:
The number of eosinophils is slightly elevated.
2. Egg inspection
In most patients, eggs can be found in the feces, using direct smear or thick smear method, precipitation method and floating concentration method. Using the cotton swab method for anal smear examination, the eggs can be detected. The method is simple, the positive rate is approximately equal to the precipitation method, and can be used for the census. The aphid eggs found in the stool or swab smear can not be identified, because the cattle tapeworms are very similar to the pig tapeworms, and the two are difficult to distinguish.
3. Pregnancy section examination:
Asking in detail whether there is vomiting or sputum in the stool is often a simple and accurate diagnosis. Observing the number and shape of uterus branches of the gestational segment can be used to identify the intestinal mites. The segments mixed in the feces are picked out and washed with water, sandwiched between the two slides, and the number and shape of the uterus branches can be distinguished by the naked eye. The uterus branch of the pig with aphid pregnancy section is 7-13, which is dendritic.
4. Head section check
24 hours after deworming treatment, the entire fecal examination head section can be used to help assess the efficacy and identify the species. The feces can be placed in a large container and rinsed repeatedly with clean water until the faeces are clarified. The sediment is transferred to a glass container lined with a black background, and the head section is carefully searched. If the worms are tangled, they should be carefully untied and searched for the thin ends. In addition to the four suction cups, the head section has a top end with 25 to 50 small hooks arranged in two circles inside and outside. 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, ring precipitation test, complement binding test or latex agglutination test can be used to detect antibodies in vivo by using insect homogenate or worm protein as antigen. The positive coincidence rate is 73.7%-99.2%. Enzyme-linked immunosorbent assay can also detect specific antigens in host feces, with sensitivity up to 100%, and is highly specific, with no cross-reactivity with aphids, microcystis, hookworms and whipworms.
6. Molecular biology check:
Polymerase chain reaction (PCR) can amplify the species-specific DNA of the eggs or worms in the feces, and finally detect the adult mites in the human body.
7. Subcutaneous cysticercosis nodules for biopsy. Intracerebral cysticercosis can be diagnosed by CT.
Diagnosis
Diagnosis and identification of swine tsutsugamushi disease
diagnosis
There is a history of discharge of mites in the stool, especially those with subcutaneous nodules of the cysticercosis or those with epilepsy. The tsutsugamushi disease should be considered. The combination of medical history and laboratory examination can make the diagnosis of most patients clear, because the pigs carry aphids. The disease can be complicated by dangerous cysticercosis, so it should be seriously identified with the tassel tsutsugamushi disease.
1 section: pigs with small aphids, rounded, with apex and small hooks; cattle with aphids larger, nearly square, no apex and small hooks;
2 mature section: pig with aphid ovary divided into three leaves; cattle with aphids divided into two leaves;
3 pregnancy section: pigs with aphid uterus branch on each side of 7 to 13 dendritic; cattle with aphid uterus branch on each side of 15 to 30 pairs of branches.
Differential diagnosis
Pig tsutsugamushi can be associated with dangerous cysticercosis, so it should be carefully identified with cattle tsutsugamushi disease. From the section:
1 head section: pigs with small aphids, rounded shape, with apex and small hooks; cattle with aphids larger, nearly square without apex and small hooks;
2 Pregnancy section: 7 to 13 branches on each side of the uterus branch of the aphid; 15 to 30 pairs of branches on each side of the uterus branch of the aphid
3 mature section: pig with aphid ovary lobes; cattle with mites divided into two leaves
