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How to manage worms in the brain?

Dr Shirish Kumar
Haematologist,
WHO,
Geneva

Q: I am a 29-year-old female. I have a worm inside my brain. Did the worm enter my brain through food, such as pork or uncooked root, or unhealthy food practices, or is it that I have a weak immune system? Please inform me about a dietary course. I have already started its medication as recommended for future prevention. The prevalent unhygienic conditions in India, particularly in Orissa, cannot be fully avoided.

A:The pork tapeworm, Taenia solium is responsible for neurocysticercosis or infection of the human brain.Ingestion of undercooked pork containing cysticerci (eggs) of T. solium leads to the disease. It spreads to the skeletal muscle and brain and may also involve the spinal cord. The eggs are able to survive in the human brain and overcome the defence by secreting chemicals that inhibit humans to mount an inflammatory response. Over a period of years, the parasite loses this ability and then inflammation occurs that leads to degeneration of the eggs. Due to this inflammatory response the brain, patients may develop seizures. As the inflammation continues, the parasite becomes enclosed a collection of cells and fibrous tissue (granuloma), which can either heal or lead to scarring and calcification. The eggs may be found in the eye (ocular cysticercosis), in the skeletal muscle or under the skin (subcutaneous cysticercosis). In endemic areas avoid undercooked pork to reduce the risk of intestinal infection, eat only fruits and vegetables that have been peeled well, thoroughly wash with clean water all food prior to eating and wash hands carefully and often. Freezing meat at minus five degrees centigrade for four days or thoroughly cooking it kills any living larvae.There is good evidence that once infected, patients are immune to re-infection.