Diphyllobothriasis of fish. Diphyllobothriasis - what is this disease?

Infectious diseases occupy an important place among all human diseases. A special place among them is occupied by helminthiases - ailments caused by worms. One of these diseases is fish diphyllobothriosis.

What it is

Diphyllobothriasis is an infectious disease caused by a worm from a group of cestodiasis. The causative agent is Difilobottrium Latum, a round worm. This disease is widespread in the territory of the Russian Federation; Diphyllobothriosis of fish is registered in Karelia and the Murmansk region, rivers such as Indigirka, Pechora, Severnaya Dvina and Volga. The disease is prevalent mainly in cold areas. In northern European countries is less common; Prevailing imported cases.

Diphyllobothriosis of fish causes a wide ribbon. The worm parasitizes in the small intestine. The eggs of the parasite enter the environment together with faeces and feces. Under optimum conditions (temperature up to 20 degrees) the larva leaves the egg. It is swallowed by small crustaceans - cyclops, living in water. It is in these crustaceans that the second stage of development of the parasite - coracidia - passes. After the crustacean is eaten by the fish dwelling in water, the plerocercoid develops from the larva - its next stage. A person is amazed by them when eating contaminated fish for food.

It was mentioned above that the main product from which diphyllobothriasis can develop is fish. Which fish is most often infected with lentets? Usually, such species as catfish, burbot, perch, ruff, pikeperch are affected. In addition to fish, the pathogen can be contained in meat of animals such as a seal and walrus.

How does the infection occur?

Diphyllobothriasis is a disease that does not manifest itself in the initial period. As stated above, a person becomes infected by eating contaminated fish. Outwardly, it is no different from normal, so it is impossible to visually determine the presence of the pathogen. Primarily, river fish are infected. The worm's larvae are so small that they can only be seen under a microscope.

To get infected, it is enough to get only one larva. In the human intestine, worms develop about two weeks. Clinical manifestations are expressed through the same time. Most often affected by fishermen, sailors, lovers of land.

Diphyllobothriosis of fish can manifest itself in domestic animals, but human infection from them occurs extremely rarely.

People who are not related to the listed professions or hobbies can also get infected. It all depends on how well the fish is cooked. If the temperature conditions are met, the larvae die, and the fish becomes safe for consumption.

Pathogenesis of the disease

How does the fish's diphyllobothriosis affect the human body? Usually one or more wide ribbonworms can develop in the human body, but cases of parasitizing 100 or more individuals of the parasite are described. In the body, worms can live long enough - up to 20 years or more, with parts of his body gradually coming out with feces.

On the human body, the Lentian has the following effects:

• Mechanical;
• Nervously-reflex;
• Toxic and allergic.

As it was said, the causative agent parasitizes in the intestine. It is attached to the mucosa, because of which a zone of atrophy and ulceration is formed at the site of development. As a result of the neural-reflex action, the sensitive endings of the adjacent organs are irritated, because of which the function of the stomach and liver is disturbed. In addition, the causative agent causes the development of megaloblastic anemia, which is based on vitamin B12 vitamin deficiency and folic acid.

Clinic of the disease

The clinical picture depends on the degree of development of the process, the severity of the lesion and the characteristics of the patient's body. Quite often, fish diphyllobothriosis is asymptomatic. In some cases, it is possible to detect a part of the worm in the stool, which triggers the development of such complaints from the patient, like abdominal pain, rumbling, belching, etc. If the lesion is important, pathological changes on the part of the digestive system play an important role.

Patients complain of a decrease in appetite, vomiting, stool, decreased activity, weakness. On the skin may manifest allergic phenomena, such as urticaria, blisters.

The circulatory system with this disease also suffers, which is expressed as B12-deficiency anemia.

Involvement in the pathological process of the nervous system leads to the appearance of numbness, burning, tingling, changes in the sensitivity of various parts of the body.

Diphyllobothriasis of fish: diagnosis

First of all, for the diagnosis it is necessary to collect an epidemic history, to find out whether the patient recently visited endemic for this disease areas and areas, whether he used to eat raw fish or caviar.

Particular attention should be given to the indications of patients. Patients may complain about the allocation of parts of the worm, along with feces. Particular attention should be given to microscopic examination of stool. The diagnosis is established when a wide ribbon is found in it. Among additional studies, you can perform a sigmoidoscopy that will allow you to see with the naked eye changes in the intestinal mucosa, and in some cases even the parasite itself.

Sometimes it is lawful to conduct a microscopy, which allows to detect diphyllobothriasis (photos in the fish of the pathogen are available in the special literature).

An additional method of investigation is a general blood test. Diphyllobothriasis will be characterized by an increase in leukocytes, ESR, eosinophils.

To clarify the diagnosis it is necessary to conduct a serological study.

Treatment

In order to begin treatment, it is necessary to confirm the diagnosis of diphyllobothriasis. Directly to drive the worm out of the body use such drugs as "Fenasal", a decoction of pumpkin seeds, an extract of a male fern.

To correct the violations of the blood system is shown the use of vitamin B12 for 200-500 micrograms intramuscularly several times a week. Also , iron preparations are prescribed - Ferronal, Aktiferrin, Ferroplex. To correct hemodynamic disorders it is necessary to adjust intravenous infusion of saline solutions - "Acesol", "Trisol", "Lactasol".

Useful and will be enemas that help to cleanse the intestines and remove the pathogen from the body as soon as possible.

If there are significant lesions of the nervous system, to which led fish diphyllobothriosis, treatment, in addition to the use of drug support, should include physiotherapy methods.

Therapy is carried out for two weeks in a hospital. After this period, a control study of feces is carried out. The absence of helminth eggs in it indicates a successful outcome of treatment.

Complications of the disease

With untimely begun treatment, diphyllobothriosis of fish can be complicated by intestinal perforation. This condition requires urgent surgical intervention.

Often as a result of perforation of the intestine develops peritonitis. The presence of a worm in the intestine prevents normal digestion. Because of this, the human body does not receive the necessary nutrients, which leads to the development of exhaustion.

Another no less important condition is immunodeficiency. Usually, when treating the underlying disease, it disappears by itself. However, if the process is started, it is possible to develop severe immunodeficiency with the attachment of an opportunistic infection.

Severe anemia can often lead to abnormalities in the functioning of the organs of the circulatory system, impede normal blood circulation and tissue metabolism, which is fraught with the development of violations of organ function.

In children, the disease can be complicated by a febrile syndrome, which can lead to the development of epilepsy.

Prevention of diphyllobothriasis

Diphyllobothriasis is a disease of the type of zoonosis, therefore the prevention of the development of this disease must take into account the endemic characteristics and characteristics of the environment. Preventative measures should influence both the transmission of the pathogen of the disease, and its natural sources. First of all, it is necessary to carefully identify all carriers of this infection, as they provoke an increase in the number of patients. Fishermen and seamen are necessarily inspected for this disease.

If there are pets in the family, you should also examine them. Destruction of the natural source of infection consists in cleaning the reservoirs, as well as controlling the fish that enters the stores.

The main role in prevention is assigned to the health service. It is the main organ that prevents the spread of diphyllobothriasis of fish. Sanitary evaluation of fish arriving at stores and on the shelves is exhibited by representatives of this organization. In addition, a partial role in the prevention of this disease belongs to the district therapists, who are obliged to conduct educational work among the population.

A good effect and has a social advertising. Sometimes such an impact on people's consciousness is a stronger stimulant to action.

What should you do if you develop this disease?

Surely most people do not even know about the existence of such a disease as diphyllobothriasis. What is this and how to treat it, doctors know best only.

The incubation period of the disease is quite long, so people can not always connect the development of those symptoms that they have, with eating fish.

Most often they pay attention to the feces in which the worm particles are detected. This is what motivates them to seek help from a doctor.

If you have a suspicion of developing diphyllobothriasis, in no case should you hesitate. It is best to immediately seek advice from an infectious disease specialist. It is he who can determine what disease you have developed, assign appropriate methods of research and make up a competent treatment plan.

In no case should you try to cure the disease yourself. Such measures can only worsen your own condition. If there is such a situation that for any reason an infectious disease specialist can not help, it is best to seek help from a therapist.