Tapeworm in children may not cause signs and symptoms for a long time after entering the body. This is also known as taeniasis and is found in humans all around the globe. However, children living in Latin America, Asia, Sub-Saharan Africa, and Eastern Europe have a higher incidence (1). Abdominal pain and weight loss are seen in some children. These worms can form cysts anywhere in the body and are called cysticercosis, and in the brain, it is called neurocysticercosis. Brain infection with tapeworm larvae can cause epilepsy. This accounts for 30% of seizure cases in endemic zones (2).
Read on to know the types, signs, causes, treatment, and prevention of taeniasis or tapeworm infection in children.
What Is A Tapeworm And How Does It Grow?
Tapeworms are parasitic intestinal worms. They are flatworms that look like a long tape, and they live in the intestines of humans or animals. They are not capable of surviving outside the host.
Tapeworms can live for several years and grow more than 30 meters long. They grow by feeding on the nutrition from the hosts, thus causing nutritional deficiencies.
Kids can get tapeworm infection from food or water contaminated with a worm or its eggs. The parasite attaches itself to the lining of the intestine and feeds on blood that contains digested nutrients.
Tapeworms are made up of numerous segments, and each segmant can produce eggs. As the tapeworm grows, the lower segments break off and appear in feces.
Types Of Tapeworms
The species of tapeworms that cause infection in humans are (4):
- Taenia solium (pork tapeworm)
- Taenia saginata (beef tapeworm)
- Taenia asiatica (Asian tapeworm)
- Hymenolepis nana (dwarf tapeworm)
- Diphyllobothrium latum (fish tapeworm)
How Do Tapeworms Infect Kids?
Kids become infected with tapeworm from the following:
- Consuming food or water contaminated with infected feces
- From an infected person, if they have not washed hands after using the toilet
- From contaminated objects for example, doorknobs
- Eating undercooked or uncooked fish or meat from an infected animal (5)
- Eating without washing their hands after playing in contaminated soil or water
Signs And Symptoms Of Tapeworms In Children
Most kids with tapeworms can be asymptomatic for months or years. However, some may develop signs and symptoms of tapeworm infection such as (6):
- Abdominal pain
- Loss of appetite
- Weight loss
- Worms in feces or around the anus
- Anemia Cysts in the skin or in internal organs
Complications due to tapeworm infection may include (7):
- Cysticercosis: Eggs of Tenia solium (pork tapeworm) can reach the bloodstream from the intestines. These can move to other parts of the body and form cysts in muscles, brain, eyes, or other organs. Cysticercosis is prevalent in places with poor sanitation and hygiene practices.
Cysts may cause symptoms depending on its location, including (7):
- Muscles: Lumps under the skin
- Heart: Abnormal heartbeat
- Brain: Seizures, confusion, vision problems, headaches, meningitis, hydrocephalus, stroke
- Spine: Weakness and difficulty in walking
- Cysts may cause anaphylaxis (allergic reaction) if they are broken or damaged.
Other possible complications of tapeworm infections are (8):
- Pancreatitis (inflammation of the pancreas)
- Cholecystitis (inflammation of the gall bladder)
- Bowel obstruction
Brain infection caused by pork tapeworm eggs is known as neurocysticercosis. This can be fatal if left untreated. Echinococcus tapeworm causes hydatid disease (echinococcosis), which most commonly affects the liver. A large hydatid cyst can damage the liver and cause other problems.
Note: You do not get cysticercosis from eating pork since the eggs are not found in meat. It generally happens after consuming food or water contaminated with feces that contain the tapeworm eggs.
When To See The Doctor
Although tapeworm infections usually do not cause any problems, you may need to see a doctor if your child shows signs and symptoms that are concerning.
Diagnosis Of Tapeworms In Children
The following are used to diagnose tapeworm infection (9):
- Stool sample analysis to check for eggs and worm segments
- CT or MRI scan for cysts
- Blood tests to identify antibodies
- Ultrasound of the liver
The doctor may also ask for samples after the treatment to ensure that the stool is free of eggs and segments.
Treatment For Intestinal Tapeworm In Children
Treatment is with antihelminthic agents that kill or paralyze the worms. Some of the effective drugs include (10):
- Biltricide (Praziquantel)
- Albenza (Albendazole)
- Alinia (Nitazoxanide)
These drugs are effective against adult worms but not the eggs. To prevent reinfection it is important that your child washes their hands thoroughly before eating and after using the toilet. Over-the-counter treatments may not be effective and a prescription medication may be required.
Infections that occur in other organs, outside the intestine, may need other treatments in addition to antihelminthic therapy. The doctor may administer the following medications depending on the site and complications of the infections (11) (12):
- Albendazole (Albenza) (antihelminthic medication) helps reduce the size of cysts. Ultrasound or radiographic imaging is done to evaluate the effectiveness of treatment.
- Niclosamide blocks glucose intake and could damage the metabolism in the tapeworm.
- Prescription corticosteroid medications such as prednisone and dexamethasone may help to decrease inflammation of the tissue.
- Anti-epileptic medication are given if neurocysticercosis causes seizures.
- Hydrocephalus (excess fluid in the brain) caused by tapeworms may require shunting of fluid from the head using tubes to avoid complications.
- Surgical removal of the cysts may be done to remove cysts from the organs, the cavity is washed with anti-parasitic solutions to prevent reinfection.
It is important to follow the recommended treatment regime to avoid complications of the disease. Untreated infections may increase the risk of developing complications
How To Prevent Tapeworms In Children?
The following tips will help to prevent tapeworms in kids (13):
- Wash hands with soap and water before eating and after using the toilet
- Cook meat until well done
- Freeze meat for 24 hours before cooking
- Do not consume undercooked or uncooked fish or meat
- Wash fruit and vegetables before eating
- Avoid buying meat from vendors that lack strict regulations and farming practices.
- Pet dogs may also get tapeworm infections. Deworm your dogs as recommended by the vet to reduce the risk
The following tips can be helpful if you are traveling to endemic areas:
- Drink boiled or bottled water.
- Avoid water fountains and ice cubes.
- Do not consume fruits and vegetables peeled by others.
Frequently Asked Questions
1. Can worms affect a child’s behavior?
Infected children may be less active and appear dull or slow, physically and emotionally. Contact your doctor if you notice these symptoms and get your child tested (14).
2. Can my child go to school with worms?
Yes, children with tapeworms can go to school, nurseries, or daycares without worrying about infecting other children (15). However, if they are sick, it is better to keep them rested at home.
3. How often should a child be dewormed?
According to WHO, the frequency of deworming depends on the number of children believed to be infected in a particular geographical area. WHO recommends deworming at least once a year in endemic areas and twice a year for areas with more people with the infection (16).
Tapeworms in children can cause signs and symptoms such as abdominal pain, nausea, diarrhea, and loss of appetite. The worms may often be visible around the anus or in feces, and cysts can be seen under the skin. Cysts can be formed in various body parts, and the symptoms may vary depending on the location, as a brain cyst can cause seizures, confusion, and headaches. They can also trigger allergic reactions if broken. It is recommended to treat tapeworm infections with the bactericide Albenza or mebendazole.
2. Awa Ba-Diop, et al.; Epidemiology, causes, and treatment of epilepsy in sub-Saharan Africa; The Lancet Neurology (2017).
3. Digestive System – Tapeworm; Rady Childrens Hospital San Diego
4. Taeniasis/cysticercosis; transmission and burden; The World Health Organization
5. Fish tapeworm infection; United States National Library of Medicine
6. Taeniasis FAQs; Centers for Disease Control and Prevention
7. Parasites-Cysticercosis; Centers for Disease Control and Prevention
8. Ellen J. Lesh and Mark F. Brady; Tapeworm (Taenia Solium, Taenia Saginata, Diphyllobothrium, Cysticercosis, Neurocysticercosis); StatPearls Publishing (2020).
9. Taeniasis and Cysticercosis; Investigative Guidelines; PUBLIC HEALTH DIVISION; Acute and Communicable Disease Prevention
10. Ann E. Lloyd, et al.; Treatment Options and Considerations for Intestinal Helminthic Infections; Journal of Pharmacy Technology (2014).
11. Hector H. García, et al.; Current Consensus Guidelines for Treatment of Neurocysticercosis; Clinical Microbiology Reviews (2002).
12. Parasites-Cysticercosis; Resources for Health Professionals; Centers for Disease Control and Prevention
13. Tapeworm; healthdirect; Australian Government Department of Health
14. Anisha Jasti, et al.; Mental and behavioral effects of parasitic infections: a review; National Library of Medicine (2007)
15. Threadworms; NHS
16. School Deworming; WHO
17. Tapeworms; American Academy of Pediatrics