How Would I Know if I Had a Tapeworm?

Flatworms that can live in the digestive tract are called tapeworms. You would know if you had a tapeworm if you had nausea, diarrhea, weight loss, abdominal pain, and other symptoms.

Flatworms that can live in the digestive tract are called tapeworms. They're rare in the U.S., where the number of annual cases reported is less than 1,000. Most of the time, people don’t know they have a tapeworm infection because they have either mild symptoms or none at all.

So, how do you get rid of tapeworms? Read on to find out.

Tapeworms are flatworms that live in the GI tract. They're an infection commonly caused by the parasite Taeniasis. Different varieties of tapeworms can be found in several types of food, including Taenia solium (pork tapeworm), Taenia saginata (beef tapeworm), or Taenia asiatica (Asian tapeworm).

People get infected by tapeworms worldwide. Infection can occur anywhere with contaminated beef, but it's especially common in Russia, Latin America, Eastern Europe, and Eastern Africa. It's rare in the U.S., except in areas where cattle and people are in close contact and sanitation is poor. Tapeworm infections from pork happen in communities with poor sanitation where people eat undercooked pork. There are higher rates of infection in Eastern Europe, sub-Saharan Africa, India, and Asia. 

Tapeworms can get into the body when you eat or drink something infected by a worm or its eggs. Once in the body, the head of the tapeworm attaches to the inner wall of the intestine and eats your food as it's digested. Pieces of the worm and eggs break off and come out of the body in bowel movements. Then, if infected feces get into water or soil, they can affect other people or animals.

Simply put, most people get infections from eating raw or undercooked pork, beef, or fish infected with tapeworms, or by coming in contact with fecal matter that has tapeworm eggs.

Sometimes, dogs and cats may be diagnosed with a tapeworm. In general, you can't pick it up from your pets. The most common type of tapeworm that infects household animals is a flea tapeworm called <i>Dipylidium caninum</i>. If your pet has a tapeworm, they were likely infected by swallowing a parasite-contaminated flea. This seldom happens in humans. 

Most people with a tapeworm infection don't realize they have one. It can take months or years for symptoms to start. Some may complain of: 

• Abdominal pain
• Diarrhea
• Mild nausea
• Weight loss

A child with a tapeworm might feel a piece of the worm coming out during a bowel movement. It may also be visible in the feces. A tapeworm that lives in a child's intestine for a long time can grow and block the appendix or other organs, leading to appendicitis.

Certain types of tapeworms can cause anemia by using up the vitamin B12 that red blood cells need. Pork tapeworms can cause a disease called cysticercosis. This happens when the eggs of the pork tapeworm form larvae and get into the bloodstream through the intestinal wall. They can then travel to organs such as the eyes, muscles, and brain and form cysts. This can then cause: 

• Seizures
• Problems with vision
• Lumps under your skin
• Trouble walking or weakness  
• Abnormal heartbeat

Cysticercosis is rare in the U.S. but can be common in many countries with higher prevalence rates of tapeworm infection.

To diagnose a tapeworm infection, your doctor may collect stool samples from 3 separate days. They'll check these samples for tapeworm eggs or pieces of a worm. They may also order a blood test.  

If your doctor suspects cysticercosis, they might order an MRI or a CAT scan of your brain or other organs to look for cysts.

A tapeworm is divided into three main parts:

• The head, or the part that attaches to the intestine
• The neck, or the part that can regenerate
• The remainder of the body, divided into segments that may contain eggs

If treatment does not get rid of the head and neck, it's possible for the whole worm to reform.

Tapeworm infections must be treated by a doctor. Your doctor will write a prescription for anti-parasitic medication. Usually, one treatment is enough. In bad cases of cysticercosis — which can cause fluid buildup around the brain — doctors may use a shunt to drain the fluid. A surgeon may have to intervene and remove cysts that cause problems with the lungs, eyes, liver, heart, or other organs.

The drug of choice for tapeworms is praziquantel. Another option is niclosamide. Your doctor will determine which is best for you. 

Several steps can be taken to prevent tapeworm infections:

• Cook all meats until the juices run clear and the center is cooked through. 
• Freeze all meat for 24 hours before cooking to destroy any tapeworm eggs.
• Wash your hands thoroughly and often with soap and warm water. This is especially important after using the bathroom and before you touch your food.   
• Cook all fish until it flakes when pressed with a fork and no parts remain translucent.

If you live in or are traveling to an area where tapeworm infections are common:

• Only drink water that's been boiled for at least 60 seconds. Otherwise, stick to bottled water or bottled or canned beverages.
• At local restaurants, verify that the water and ice are filtered.
• Avoid undercooked or raw meat and fish, raw vegetables and fruit that you didn't peel yourself, and some foods from street vendors.
• Wash and cook your fruits and vegetables with clean water.

Whole pieces of meat and fish should be cooked to a temperature of more than 145°F (63°C) for at least 3 minutes. Ground meat should be cooked to at least 160°F (71°C). Freshwater fish shouldn't be consumed as sushi unless it's frozen first. This will kill any tapeworms and their eggs in the fish. Safe freezing times for fish are:

• 7 days at −4°F (−20°C) or below  
• 15 hours at −31°F (−35°C) or below until solid, store at −31°F (−35°C) or below
• 24 hours at −31°F (−35°C) or below until solid, store at −4°F (−20°C) or below 

Cysts may be visible in contaminated fish and meat. Drying and smoking will not kill tapeworm cysts.