View source for Cysticercosis

{{about|infection by the young form of the worms|the organism|Taenia solium}}
{{short description|Tissue infection caused by the young form of the pork tapeworm}}
{{Infobox medical condition (new)
| name            = Cysticercosis
| image           = Neurocysticercosis.gif
| caption         = Magnetic resonance image in a person with [[neurocysticercosis]] showing many cysts within the brain.
| field           = [[Infectious disease (medical specialty)|Infectious disease]]
| symptoms        = 1–2 cm lumps under the skin<ref name=WHO2013/>
| complications   = [[Neurocysticercosis]]<ref name=Garcia03/>
| onset           =
| duration        = Long term<ref name=Gar2002/>
| causes          = Eating tapeworm eggs ([[fecal oral transmission]])<ref name=WHO2013/>
| risks           =
| diagnosis       = [[Fine needle aspiration|aspiration]] of a cyst<ref name=Garcia03/>
| differential    =
| prevention      = Improved [[sanitation]], treating those with [[taeniasis]], cooking pork well<ref name=WHO2013/>
| treatment       = None, medications<ref name=Garcia03/>
| medication      = [[Praziquantel]], [[albendazole]], [[corticosteroids]], [[anti seizure medications]]<ref name=WHO2013/>
| prognosis       =
| frequency       = 1.9 million<ref name=GBD2015Pre>{{cite journal|last1=GBD 2015 Disease and Injury Incidence and Prevalence|first1=Collaborators.|title=Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.|journal=Lancet|date=8 October 2016|volume=388|issue=10053|pages=1545–1602|pmid=27733282|doi=10.1016/S0140-6736(16)31678-6|pmc=5055577}}</ref>
| deaths          = 400<ref name=GBD2015De/>
}}
<!-- Definition and symptoms -->
'''Cysticercosis''' is a tissue [[infection]] caused by the [[cysticercus|young form]] of the [[Taenia solium|pork tapeworm]].<ref>{{cite book|last1=Roberts|first1=Larry S.|last2=Janovy Jr.|first2=John|title=Gerald D. Schmidt & Larry S. Roberts' Foundations of Parasitology|date=2009|publisher=McGraw-Hill Higher Education|location=Boston|isbn=978-0-07-302827-9|pages=348–351|edition=8th}}</ref><ref name=WHO2013>{{cite web|title=Taeniasis/Cysticercosis Fact sheet N°376|url=https://www.who.int/mediacentre/factsheets/fs376/en/|work=World Health Organization|access-date=18 March 2014|date=February 2013|url-status=live|archive-url=https://web.archive.org/web/20140315052600/http://www.who.int/mediacentre/factsheets/fs376/en/|archive-date=15 March 2014}}</ref> People may have few or no symptoms for years.<ref name=Gar2002/><ref name=Garcia03/> In some cases, particularly in Asia, solid lumps of between one and two centimetres may develop under the skin.<ref name=WHO2013/> After months or years these lumps can become painful and swollen and then resolve.<ref name=Gar2002>{{cite journal |vauthors=García HH, Evans CA, Nash TE, et al. |title=Current consensus guidelines for treatment of neurocysticercosis |journal=Clin. Microbiol. Rev. |volume=15 |issue=4 |pages=747–56 |date=October 2002 |pmid=12364377 |pmc=126865 |doi= 10.1128/CMR.15.4.747-756.2002}}</ref><ref name=Garcia03/> A specific form called [[neurocysticercosis]], which affects the [[human brain|brain]], can cause [[neurological]] symptoms.<ref name=Garcia03/> In [[developing country|developing countries]] this is one of the most common causes of [[seizure]]s.<ref name=Garcia03/>

<!-- Cause and Diagnosis -->
Cysticercosis is usually acquired by eating food or drinking water contaminated by tapeworm eggs from human [[feces]].<ref name=WHO2013/> Among foods, uncooked vegetables are the major source.<ref name=WHO2013/> The tapeworm eggs are present in the [[feces]] of a person infected with the adult worms, a condition known as [[taeniasis]].<ref name=Garcia03/><ref name=CDC>{{cite web |url=https://www.cdc.gov/parasites/cysticercosis/ |title=CDC - Cysticercosis |url-status=live |archive-url=https://web.archive.org/web/20140710171827/http://www.cdc.gov/parasites/cysticercosis/ |archive-date=2014-07-10 }}</ref> Taeniasis, in the strict sense, is a different disease and is due to eating [[microbial cyst|cyst]]s in poorly cooked pork.<ref name=WHO2013/> People who live with someone with the pork tapeworm have a greater risk of getting cysticercosis.<ref name=CDC/> The diagnosis can be made by [[fine needle aspiration|aspiration]] of a cyst.<ref name=Garcia03/> Taking pictures of the brain with [[computer tomography]] (CT) or [[magnetic resonance imaging]] (MRI) are most useful for the diagnosis of disease in the brain.<ref name=Garcia03/> An increased number of a type of [[white blood cell]], called [[eosinophils]], in the [[cerebral spinal fluid]] and blood is also an indicator.<ref name=Garcia03/>

<!-- Prevention and Treatment -->
Infection can be effectively prevented by personal hygiene and [[sanitation]]:<ref name=WHO2013/> this includes cooking pork well, proper [[toilet]]s and sanitary practices, and improved access to clean water.<ref name=WHO2013/> Treating those with taeniasis is important to prevent spread.<ref name=WHO2013/> Treating the disease when it does not involve the nervous system may not be required.<ref name=Garcia03/> Treatment of those with neurocysticercosis may be with the medications [[praziquantel]] or [[albendazole]].<ref name=WHO2013/> These may be required for long periods.<ref name=WHO2013/> [[Steroid]]s, for anti-inflammation during treatment, and [[anti-seizure medications]] may also be required.<ref name=WHO2013/> Surgery is sometimes done to remove the cysts.<ref name=WHO2013/>

<!-- Epidemiology -->
The pork tapeworm is particularly common in Asia, Sub-Saharan Africa, and Latin America.<ref name=Garcia03>{{cite journal |vauthors=García HH, Gonzalez AE, Evans CA, Gilman RH |title=''Taenia solium'' cysticercosis |journal=Lancet |volume=362 |issue=9383 |pages=547–56 |date=August 2003 |pmid=12932389 |pmc=3103219 |doi=10.1016/S0140-6736(03)14117-7 }}</ref> In some areas it is believed that up to 25% of people are affected.<ref name=Garcia03/> In the developed world it is very uncommon.<ref name=Bob2014/> Worldwide in 2015 it caused about 400 deaths.<ref name=GBD2015De>{{cite journal|last1=GBD 2015 Mortality and Causes of Death|first1=Collaborators.|title=Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.|journal=Lancet|date=8 October 2016|volume=388|issue=10053|pages=1459–1544|pmid=27733281|doi=10.1016/s0140-6736(16)31012-1|pmc=5388903}}</ref> Cysticercosis also affects pigs and cows but rarely causes symptoms as most are slaughtered before symptoms arise.<ref name=WHO2013/> The disease has occurred in humans throughout history.<ref name=Bob2014>{{cite journal |vauthors=Bobes RJ, Fragoso G, Fleury A, et al. |title=Evolution, molecular epidemiology and perspectives on the research of taeniid parasites with special emphasis on ''Taenia solium'' |journal=Infect. Genet. Evol. |volume=23 |pages=150–60 |date=April 2014 |pmid=24560729 |doi=10.1016/j.meegid.2014.02.005 }}</ref> It is one of the [[neglected tropical diseases]].<ref>{{cite web|title=Neglected Tropical Diseases|url=https://www.cdc.gov/globalhealth/ntd/diseases/index.html|website=cdc.gov|access-date=28 November 2014|date=June 6, 2011|url-status=live|archive-url=https://web.archive.org/web/20141204084219/http://www.cdc.gov/globalhealth/ntd/diseases/index.html|archive-date=4 December 2014}}</ref>
{{TOC limit|3}}

==Signs and symptoms==

===Muscles===
Cysticerci can develop in any [[voluntary muscle]]. Invasion of muscle can cause [[myositis|inflammation of the muscle]], with [[fever]], [[eosinophilia]], and [[Muscle hypertrophy|increased size]], which initiates with muscle swelling and later progress to [[atrophy]] and [[fibrosis|scarring]]. In most cases, it is asymptomatic since the cysticerci die and become [[calcification|calcified]].<ref name="test">{{cite book |first1=E.K. |last1=Markell |first2=D.T. |last2=John |first3=W.A. |last3=Krotoski |title=Markell and Voge's medical parasitology |url=https://archive.org/details/markellvogesmedi0000mark_8thed |url-access=registration |year=1999 |publisher=Saunders |isbn=978-0-7216-7634-0 |edition=8th }}</ref>

===Nervous system===

The term [[neurocysticercosis]] is generally accepted to refer to cysts in the [[parenchyma]] of the brain. It presents with seizures and, less commonly, headaches.<ref name="pmid19836788">{{cite journal |vauthors=Kerstein AH, Massey AD |title=Neurocysticercosis |journal=Kansas Journal of Medicine |year=2010 |volume=3 |issue=4 |pages=52–4 |url=http://archie.kumc.edu/handle/2271/867 |url-status=live |archive-url=https://web.archive.org/web/20110719225826/http://archie.kumc.edu/handle/2271/867 |archive-date=2011-07-19 |doi=10.17161/kjm.v3i4.11320 |doi-access=free }}</ref> Cysticerca in brain parenchyma are usually 5–20&nbsp;mm in diameter. In subarachnoid space and fissures, lesions may be as large as 6&nbsp;cm in diameter and lobulated. They may be numerous and life-threatening.<ref>{{cite journal|last1=Fleury|first1=A|last2=Dessein|first2=A|last3=Preux|first3=PM|last4=Dumas|first4=M|last5=Tapia|first5=G|last6=Larralde|first6=C|last7=Sciutto|first7=E|s2cid=30854700|title=Symptomatic human neurocysticercosis--age, sex and exposure factors relating with disease heterogeneity.|journal=Journal of Neurology|date=July 2004|volume=251|issue=7|pages=830–7|pmid=15258785|url= http://www.thelancet.com/article/S0140-6736%2813%2960691-1/abstract|doi=10.1007/s00415-004-0437-9}}</ref>

Cysts located within the ventricles of the brain can block the outflow of [[cerebrospinal fluid]] and present with symptoms of increased [[intracranial pressure]].<ref>{{cite journal |vauthors=Suri A, Goel RK, Ahmad FU, Vellimana AK, Sharma BS, Mahapatra AK |s2cid=207604470 |title=Transventricular, transaqueductal scope-in-scope endoscopic excision of fourth ventricular neurocysticercosis: a series of 13 cases and a review |journal=J Neurosurg Pediatr |volume=1 |issue=1 |pages=35–9 |date=January 2008 |pmid=18352801 |doi=10.3171/PED-08/01/035 }}</ref>

Racemose neurocysticercosis refers to cysts in the [[subarachnoid space]]. These can occasionally grow into large lobulated masses causing pressure on surrounding structures.<ref>{{cite journal |vauthors=Hauptman JS, Hinrichs C, Mele C, Lee HJ |s2cid=21535283 |title=Radiologic manifestations of intraventricular and subarachnoid racemose neurocysticercosis |journal=Emerg Radiol |volume=11 |issue=3 |pages=153–7 |date=April 2005 |pmid=16028320 |doi=10.1007/s10140-004-0383-y}}</ref>

Spinal cord neurocysticercosis most commonly presents symptoms such as back pain and [[radiculopathy]].<ref>{{cite journal|vauthors=Jang JW, Lee JK, Lee JH, Seo BR, Kim SH | s2cid=1951568 | title=Recurrent primary spinal subarachnoid neurocysticercosis. | journal=Spine | date=Mar 2010 | volume=35 | issue=5 | pages=E172–5|doi=10.1097/BRS.0b013e3181b9d8b6| pmid=20118838 }}</ref>

===Eyes===
In some cases, cysticerci may be found in the [[globe (human eye)|eyeball]], [[extraocular muscles]], and under the [[conjunctiva]] (''subconjunctiva''). Depending on the location, they may cause visual difficulties that fluctuate with eye position, retinal edema, hemorrhage, a decreased vision or even a visual loss.<ref name="test" />

===Skin===
{{main|Cysticercosis cutis}}

Subcutaneous cysts are in the form of firm, mobile nodules, occurring mainly on the trunk and extremities.<ref name="eight">{{cite journal |author=Wortman PD |title=Subcutaneous cysticercosis |journal=J. Am. Acad. Dermatol. |volume=25 |issue=2 Pt 2 |pages=409–14 |date=August 1991 |pmid=1894783 | doi=10.1016/0190-9622(91)70217-p }}</ref> Subcutaneous nodules are sometimes painful.{{cn|date=May 2021}}

==Cause==
[[File:Life cycle.gif|thumb|right|Life cycle of ''Taenia solium'']]
The cause of human cysticercosis is the egg form of ''[[Taenia solium]]'' (often abbreviated as ''T. solium'' and also called pork tapeworm), which is transmitted through the oral-fecal route. Eggs are accidentally ingested from contaminated water or vegetables. The eggs enter the intestine where they develop into [[larva]]e. The larvae enter the bloodstream and invade host tissues, where they further develop into larvae called cysticerci. The cysticercus larva completes development in about 2 months. It is semitransparent, opalescent white, and elongate oval in shape and may reach a length of 0.6 to 1.8&nbsp;cm.<ref name="test" />

==Diagnosis==
The traditional method of demonstrating either tapeworm eggs or [[proglottid]]s in stool samples diagnoses only taeniasis, carriage of the tapeworm stage of the life cycle.<ref name=CDC/> Only a small minority of patients with cysticercosis will harbor a tapeworm, rendering stool studies ineffective for diagnosis.<ref name="pmid9886197">{{cite journal|author1=HH Garcia |author2=R Araoz |author3=RH Gilman |author4=J Valdez |author5=AE Gonzalez |author6=C Gavidia |author7=ML Bravo |author8=VC Tsang | title=Increased prevalence of cysticercosis and taeniasis among professional fried pork vendors and the general population of a village in the Peruvian highlands. Cysticercosis Working Group in Peru | journal=Am. J. Trop. Med. Hyg. | year=1998 | volume=59 | issue=6 | pages=902–905| pmid=9886197 |doi=10.4269/ajtmh.1998.59.902 |doi-access=free }}</ref> Ophthalmic cysticercosis can be diagnosed by visualizing parasite in eye by [[fundoscopy]].{{cn|date=November 2020}}

In cases of human cysticercosis, diagnosis is a sensitive problem and requires [[biopsy]] of the infected tissue or sophisticated instruments.<ref>{{cite journal|last=Richards F|first=Jr|author2=Schantz, PM |title=Laboratory diagnosis of cysticercosis.|journal=Clinics in Laboratory Medicine|volume=11|issue=4|pages=1011–28|pmid=1802519|year=1991|doi=10.1016/S0272-2712(18)30532-8}}</ref> ''Taenia solium'' eggs and proglottids found in feces, ELISA, or [[polyacrylamide gel electrophoresis]] diagnose only taeniasis and not cysticercosis. Radiological tests, such as [[X-ray]], [[CT scan]]s which demonstrate "ring-enhancing brain lesions", and [[MRI]]s, can also be used to detect diseases. X-rays are used to identify calcified larvae in the subcutaneous and muscle tissues, and CT scans and MRIs are used to find lesions in the brain.<ref name=gut/><ref>{{cite journal|last=Webbe|first=G.|title=Human cysticercosis: Parasitology, pathology, clinical manifestations and available treatment|journal=Pharmacology & Therapeutics|volume=64|issue=1|pages=175–200|doi=10.1016/0163-7258(94)90038-8|pmid=7846114|year=1994}}</ref>

===Serological===
Antibodies to cysticerci can be demonstrated in serum by [[enzyme linked immunoelectrotransfer blot]] (EITB) assay and in CSF by ELISA. An immunoblot assay using lentil-lectin (agglutinin from Lens culinaris) is highly sensitive and specific. However, individuals with intracranial lesions and calcifications may be seronegative. In the CDC's immunoblot assay, cysticercosis-specific antibodies can react with structural glycoprotein antigens from the larval cysts of ''Taenia solium''.<ref name=CDC/> However, this is mainly a research tool not widely available in clinical practice and nearly unobtainable in resource limited settings.{{citation needed|date=July 2020}}

===Neurocysticercosis===
The diagnosis of neurocysticercosis is mainly clinical, based on a compatible presentation of symptoms and findings of imaging studies.{{cn|date=January 2021}}

====Imaging====
Neuroimaging with CT or MRI is the most useful method of diagnosis. CT scan shows both calcified and uncalcified cysts, as well as distinguishing active and inactive cysts. Cystic lesions can show [[Ring-enhancing lesion|ring enhancement]] and focal enhancing lesions. Some cystic lesions, especially the ones in ventricles and subarachnoid space may not be visible on CT scan, since the cyst fluid is [[Radiodensity|isodense]] with [[cerebrospinal fluid]] (CSF). Thus diagnosis of extraparenchymal cysts usually relies on signs like hydrocephalus or enhanced basilar meninges. In such cases CT scan with intraventricular contrast or MRI can be used. MRI is more sensitive in detection of intraventricular cysts.<ref>{{cite journal|last1=Robbani|first1=I|last2=Razdan|first2=S|last3=Pandita|first3=KK|s2cid=15316095|title=Diagnosis of intraventricular cysticercosis by magnetic resonance imaging: improved detection with three-dimensional spoiled gradient recalled echo sequences.\|journal=Australasian Radiology|year=2004|volume=48|issue=2|pages=237–9|pmid=15230764|doi=10.1111/j.1440-1673.2004.01279.x}}</ref><ref>{{cite journal|last1=Lucato|first1=L.T.|last2=Guedes|first2=M.S.|last3=Sato|first3=J.R.|last4=Bacheschi|first4=L.A.|last5=Machado|first5=L.R.|last6=Leite|first6=C.C.|title=The Role of Conventional MR Imaging Sequences in the Evaluation of Neurocysticercosis: Impact on Characterization of the Scolex and Lesion Burden|journal=American Journal of Neuroradiology|date=1 September 2007|volume=28|issue=8|pages=1501–1504|doi=10.3174/ajnr.A0623|pmid=17846200|doi-access=free}}</ref>

====CSF====
CSF findings include [[pleocytosis]], elevated protein levels and depressed glucose levels; but these may not be always present.{{cn|date=November 2020}}

==Prevention==
Cysticercosis is considered as “tools-ready disease” according to WHO.<ref>{{cite web |title=Global Plan to Combat Neglected Tropical Diseases 2008–2015 |date=2007 |publisher=World Health Organization |url=http://whqlibdoc.who.int/hq/2007/who_cds_ntd_2007.3_eng.pdf |at=Box 1. Selected neglected tropical diseases and zoonoses to be addressed within the Global Plan. p. 2 |url-status=live |archive-url=https://web.archive.org/web/20100722225903/http://whqlibdoc.who.int/hq/2007/WHO_CDS_NTD_2007.3_eng.pdf |archive-date=2010-07-22 }}</ref> International Task Force for Disease Eradication in 1992 reported that cysticercosis is potentially eradicable.<ref name=TaskForce92>{{cite journal |title=Update: International Task Force for Disease Eradication, 1992 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=41 |issue=37 |pages=691, 697–8 |date=September 1992 |pmid=1518501 |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/00017648.htm |url-status=live |archive-url=https://web.archive.org/web/20090306044642/http://www.cdc.gov/mmwr/preview/mmwrhtml/00017648.htm |archive-date=2009-03-06 |author1=Centers for Disease Control (CDC) }}</ref> It is feasible because there are no animal reservoirs besides humans and pigs. The only source of ''Taenia solium'' infection for pigs is from humans, a definite host. Theoretically, breaking the life cycle seems easy by doing intervention strategies from various stages in the life cycle.<ref name="eleven">Schantz, P. "Eradication of ''T. solium'' Cysticercosis" International Conference on Emerging Infectious Diseases 2002. CDC.ftp://ftp.cdc.gov/pub/infectious_diseases/iceid/2002/pdf/schantz.pdf</ref>

For example,{{cn|date=May 2021}}
# Massive chemotherapy of infected individuals, improving [[sanitation]], and educating people are all major ways to discontinue the cycle, in which eggs from human feces are transmitted to other humans and/or pigs.
# Cooking of pork or freezing it and inspecting meat are effective means to cease the life cycle
# The management of pigs by treating them or vaccinating them is another possibility to intervene
# The separation of pigs from human faeces by confining them in enclosed piggeries. In Western European countries post World War 2 the pig industry developed rapidly and most pigs were housed.<ref name="Welfare">{{cite book|author=Jeremy N. Marchant-Forde|title=The Welfare of Pigs|url=https://books.google.com/books?id=zNz4-EN4RSkC&pg=PA333|date=2008-11-26|publisher=Springer Science & Business Media|isbn=978-1-4020-8909-1|pages=333–|url-status=live|archive-url=https://web.archive.org/web/20170407061756/https://books.google.com/books?id=zNz4-EN4RSkC&pg=PA333|archive-date=2017-04-07}}</ref> This was the main reason for pig cysticercosis largely being eliminated from the region. This of course is not a quick answer to the problem in developing countries.

===Pigs===
The intervention strategies to eradicate cysticercosis includes surveillance of pigs in foci of transmission and massive chemotherapy treatment of humans.<ref name=TaskForce92 /> In reality, control of ''T. solium'' by a single intervention, for instance, by treating only human population will not work because the existing infected pigs can still carry on the cycle. The proposed strategy for eradication is to do multilateral intervention by treating both human and porcine populations.<ref name=Gonzalez03>{{cite journal |vauthors=Gonzalez AE, García HH, Gilman RH, Tsang VC |title=Control of ''Taenia solium'' |journal=Acta Trop. |volume=87 |issue=1 |pages=103–9 |date=June 2003 |pmid=12781384 |doi=10.1016/S0001-706X(03)00025-1}}</ref> It is feasible because treating pigs with [[oxfendazole]] has been shown to be effective and once treated, pigs are protected from further infections for at least 3 months.<ref name="fifteen">{{cite journal |vauthors=Gonzalez AE, Gavidia C, Falcon N, et al. |title=Protection of pigs with cysticercosis from further infections after treatment with oxfendazole |journal=Am. J. Trop. Med. Hyg. |volume=65 |issue=1 |pages=15–8 |date=July 2001 |pmid=11504400 |url=http://www.ajtmh.org/cgi/pmidlookup?view=long&pmid=11504400|doi=10.4269/ajtmh.2001.65.15 |doi-access=free }}</ref>

===Limitations===
Even with the concurrent treatment of humans and pigs, complete elimination is hard to achieve. In one study conducted in 12 villages in Peru, both humans and pigs were treated with praziquantel and oxfendazole, with the coverage of more than 75% in humans and 90% in pigs<ref>Garcia, H.H., 2002. "Effectiveness of an interventional control program for human and porcine ''Taenia solium'' cysticercosis in field conditions." In: International Health. Johns Hopkins University, Baltimore, p. 250.</ref> The result shows a decrease in prevalence and incidence in the intervention area; however the effect did not completely eliminate ''T. solium''. The possible reason includes the incomplete coverage and re-infection.<ref>{{cite book |author=Gilman, R.H. |author2=Garcia, H.H. |author3=Gonzalez, A.E. |author4=Dunleavy, M. |author5=Verastegui, M. |chapter=Short cuts to development: methods to control the transmission of cysticercosis in developing countries |editor-last=García |editor-first=H.H. |editor2-last=Martínez |editor2-first=M. |title=''Taenia solium'' taeniasis/cysticercosis |publisher=Editorial Universo |location=Lima |year=1999 |isbn=978-9972910203 |pages=313–326 }}</ref> Even though ''T. solium ''could be eliminated through mass treatment of human and porcine population, it is not sustainable.<ref name=Gonzalez03 /> Moreover, both tapeworm carriers of humans and pigs tend to spread the disease from endemic to non-endemic areas resulting in periodic outbreaks of cysticercosis or outbreaks in new areas.<ref>{{cite journal |vauthors=Margono SS, Subahar R, Hamid A, et al. |title=Cysticercosis in Indonesia: epidemiological aspects |journal=Southeast Asian J. Trop. Med. Public Health |volume=32 |issue=Suppl 2|pages=79–84 |year=2001 |pmid=12041608 }}</ref><ref>{{cite journal |vauthors=Wandra T, Subahar R, Simanjuntak GM, et al. |title=Resurgence of cases of epileptic seizures and burns associated with cysticercosis in Assologaima, Jayawijaya, Irian Jaya, Indonesia, 1991–95 |journal=Trans. R. Soc. Trop. Med. Hyg. |volume=94 |issue=1 |pages=46–50 |year=2000 |pmid=10748897 |doi=10.1016/s0035-9203(00)90433-4}}</ref>

===Vaccines===
Given the fact that pigs are part of a life cycle, vaccination of pigs is another feasible intervention to eliminate cysticercosis. Research studies have been focusing on vaccine against cestode parasites, since many immune cell types are found to be capable of destroying cysticercus.<ref name="twenty">{{cite journal |vauthors=Sciutto E, Fragoso G, de Aluja AS, Hernández M, Rosas G, Larralde C |title=Vaccines against cysticercosis |journal=Curr Top Med Chem |volume=8 |issue=5 |pages=415–23 |year=2008 |pmid=18393905 |doi=10.2174/156802608783790839 }}</ref> Many vaccine candidates are extracted from antigens of different cestodes such as ''Taenia solium'', ''T. crassiceps'', ''T. saginata'', ''T. ovis'' and target oncospheres and/or cysticerci. In 1983, Molinari et al. reported the first vaccine candidate against porcine cysticercosis using antigen from cysticercus cellulosae drawn out from naturally infected.<ref>{{cite journal |vauthors=Molinari JL, Meza R, Suárez B, Palacios S, Tato P, Retana A |title=''Taenia solium'': immunity in hogs to the Cysticercus |journal=Exp. Parasitol. |volume=55 |issue=3 |pages=340–57 |date=June 1983 |pmid=6852171 |doi=10.1016/0014-4894(83)90031-0}}</ref> Recently, vaccines extracted from genetically engineered 45W-4B antigens have been successfully tested to pigs in an experimental condition.<ref>{{cite journal |vauthors=Luo X, Zheng Y, Hou J, Zhang S, Cai X |title=Protection against Asiatic ''Taenia solium'' induced by a recombinant 45W-4B protein |journal=Clin. Vaccine Immunol. |volume=16 |issue=2 |pages=230–2 |date=February 2009 |pmid=19091992 |pmc=2643551 |doi=10.1128/CVI.00367-08 }}</ref> This type of vaccine can protect against cysticercosis in both Chinese and Mexican type of ''T. solium''. However, it has not been tested in endemic field conditions, which is important because the realistic condition in the field differ greatly from experimental condition, and this can result in a great difference in the chances of infection and immune reaction.<ref name="twenty" />

Even though vaccines have been successfully generated, the feasibility of its production and usage in rural free ranging pigs still remains a challenge. If a vaccine is to be injected, the burden of work and the cost of vaccine administration to pigs will remain high and unrealistic.<ref name="twenty" /> The incentives of using vaccines by pig owners will decrease if the vaccine administration to pigs takes time by injecting every single pig in their livestock. A hypothetical oral vaccine is proposed to be more effective in this case as it can be easily delivered to the pigs by food.<ref name="twenty" />

====S3PVAC vaccine====
The vaccine constituted by 3 [[peptide]] synthetically produced (S3Pvac) has proven its efficacy in natural conditions of transmission.<ref name="Huerta M 2001">{{cite journal | vauthors = Huerta M, De Aluja AS, Fragoso G, Toledo A, Villalobos N, Hernandez M, Gevorkian G, Acero G, Diaz A et al. | year = 2001 | title = Synthetic peptide vaccine against ''Taenia solium'' pig cysticercosis: successful vaccination in a controlled field trial in rural Mexico | journal = Vaccine| volume = 20 | issue = 1–2| pages = 262–6 | doi = 10.1016/S0264-410X(01)00249-3 | pmid = 11567772 }}</ref> The S3PVAC vaccine so far, can be considered as the best vaccine candidate to be used in endemic areas such as Mexico (20). S3Pvac consists of three protective peptides: KETc12, KETc1 and GK1, whose sequences belong to native [[antigen]]s that are present in the different developmental stages of ''T. solium'' and other cestode parasites.<ref name="twenty" /><ref>http://www-lab.biomedicas.unam.mx/cistimex/s1.html#capitulo6 {{webarchive|url=https://web.archive.org/web/20090307202025/http://www-lab.biomedicas.unam.mx/cistimex/s1.html |date=2009-03-07 }}</ref>

Non-infected pigs from rural villages in Mexico were vaccinated with S3Pvac and the vaccine reduced 98% the number of cysticerci and 50% the number of prevalence.<ref name="Huerta M 2001"/><ref>{{cite journal | vauthors = Sciutto E, Morales J, Martinez JJ, Toledo A, Villalobos MN, Cruz-Revilla C, Meneses G, Hernandez M, Diaz A et al. | year = 2007 | title = Further evaluation of the synthetic peptide vaccine S3Pvac against ''Taenia solium'' cysticercosis in pigs in an endemic town of Mexico | journal = Parasitology | volume = 134 | issue = Pt 1| pages = 129–33 | doi = 10.1017/S0031182006001132 | pmid = 16948875 | s2cid = 27758572 }}</ref> The diagnostic method involves necropsy and tongue inspection of pigs. The natural challenge conditions used in the study proved the efficacy of the S3Pvac vaccine in transmission control of ''T. solium'' in Mexico.<ref name="twenty" /> The S3Pvac vaccine is owned by the National Autonomous University of Mexico and the method of high scale production of the vaccine has already been developed.<ref name="twenty" /> The validation of the vaccine in agreement with the Secretary of Animal Health in Mexico is currently in the process of completion.<ref name="twenty seven">E-mail interview with Edda Sciutto. Feb 26 2009.</ref> It is also hoped that the vaccine will be well-accepted by pig owners because they also lose their income if pigs are infected cysticercosis.<ref name="twenty seven" /> Vaccination of pigs against cysticercosis, if succeeded, can potentially have a great impact on transmission control since there is no chance of re-infection once pigs receive vaccination.{{cn|date=November 2020}}

===Other===
Cysticercosis can also be prevented by routine inspection of meat and condemnation of measly meat by the local government and by avoiding partially cooked meat products. However, in areas where food is scarce, cyst-infected meat might be considered as wasted since pork can provide high quality protein.<ref>CWGESA. 5th General Assembly of the Cysticercosis Working Group in Eastern and Southern Africa. 2007. CIRADhttp://pigtrop.cirad.fr/sp/recursos/publications/procedimientos/5th_general_assembly_of_the_cysticercosis_working_group_in_eastern_and_southern_africa</ref> At times, infected pigs are consumed within the locality or sold at low prices to traffickers who take the uninspected pigs at urban areas for sale.<ref>{{cite journal |vauthors=Morales J, Martínez JJ, Garcia-Castella J, et al. |s2cid=5707291 |title=''Taenia solium'': the complex interactions, of biological, social, geographical and commercial factors, involved in the transmission dynamics of pig cysticercosis in highly endemic areas |journal=Ann Trop Med Parasitol |volume=100 |issue=2 |pages=123–35 |date=March 2006 |pmid=16492360 |doi=10.1179/136485906x86275 }}</ref>

==Management==

===Neurocysticercosis===
<!-- Conservative -->
Asymptomatic cysts, such as those discovered incidentally on neuroimaging done for another reason, may never lead to symptomatic disease and in many cases do not require therapy. Calcified cysts have already died and [[Involution (medicine)|involuted]]. Further antiparasitic therapy will be of no benefit.{{cn|date=November 2020}}

<!-- Emergent -->
Neurocysticercosis may present as hydrocephalus and acute onset seizures, thus the immediate therapy is emergent reduction of intracranial pressure and [[anticonvulsant]] medications. Once the seizures have been brought under control, antihelminthic treatments may be undertaken. The decision to treat with antiparasitic therapy is complex and based on the stage and number of cysts present, their location, and the persons specific symptoms.<ref>{{cite journal |author=White AC |title=New developments in the management of neurocysticercosis |journal=J. Infect. Dis. |volume=199 |issue=9 |pages=1261–2 |date=May 2009 |pmid=19358667 |doi=10.1086/597758 |doi-access=free }}</ref>

<!-- Medications -->
Adult ''Taenia solium'' are easily treated with [[niclosamide]], and is most commonly used in taeniasis. However cysticercosis is a complex disease and requires careful medication. [[Praziquantel]] (PZQ) is the drug of choice. In [[neurocysticercosis]] praziquantel is widely used.<ref>{{cite journal |author=Pawlowski ZS |title=Role of chemotherapy of taeniasis in prevention of neurocysticercosis |journal=Parasitol. Int. |volume=55 |issue=Suppl|pages=S105–9 |year=2006 |pmid=16356763 |doi=10.1016/j.parint.2005.11.017 |pmc=7108384 }}</ref> [[Albendazole]] appears to be more effective and a safe drug for neurocysticercosis.<ref name=Matthaiou08>{{cite journal |doi=10.1371/journal.pntd.0000194 |vauthors=Matthaiou DK, Panos G, Adamidi ES, Falagas ME |title=Albendazole versus Praziquantel in the Treatment of Neurocysticercosis: A Meta-analysis of Comparative Trials |journal=PLOS Neglected Tropical Diseases |volume=2 |issue=3 |pages=e194 |year=2008 |pmid=18335068 |pmc=2265431 |editor1-last=Carabin |editor1-first=Hélène}}</ref><ref>{{cite journal |doi=10.1056/NEJMoa031294 |author=Garcia HH |author2=Pretell EJ |author3=Gilman RH |author4=Martinez SM |author5=Moulton LH |author6=Del Brutto OH |author7=Herrera G |author8=Evans CA |author9=Gonzalez AE |author10=Cysticercosis Working Group in Peru |title=A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis |journal=N Engl J Med |volume=350 |issue=3 |pages=249–258 |year=2004 |pmid=14724304 |url=https://researchonline.lshtm.ac.uk/5217/1/nejmoa031294.pdf }}</ref>  In complicated situation a combination of praziquantel, [[albendazole]] and [[steroid]] (such as corticosteroids to reduce the [[inflammation]]) is recommended.<ref>{{cite web|title=Taeniasis/Cysticercosis|url=https://www.who.int/zoonoses/diseases/taeniasis/en/|publisher=World Health Organization|access-date=6 February 2014|url-status=live|archive-url=https://web.archive.org/web/20140221163055/http://www.who.int/zoonoses/diseases/taeniasis/en/|archive-date=21 February 2014}}</ref> In the brain the cysts can be usually found on the surface. Most cases of brain cysts are found by accident, during diagnosis for other ailments. Surgical removals are the only option of complete removal even if treated successfully with medications.<ref name=gut>{{cite book |first=Yezid |last=Gutierrez |title=Diagnostic Pathology of Parasitic Infections with Clinical Correlations |chapter=26. Cysticercosis, Coenurosis, Sparganosis and proliferating Cestode larvae |chapter-url=https://books.google.com/books?id=oKSEhVMVrJ4C&pg=PA635 |year=2000 |publisher=Oxford University Press |isbn=978-0-19-512143-8 |pages=635–652 |edition=2nd}}</ref>

Antiparasitic treatment should be given in combination with [[corticosteroids]] and anticonvulsants to reduce inflammation surrounding the cysts and lower the risk of seizures. When corticosteroids are given in combination with praziquantel, cimetidine is also given, as corticosteroids decrease action of praziquantel by enhancing its [[first pass metabolism]]. [[Albendazole]] is generally preferable over [[praziquantel]] due to its lower cost and fewer drug interactions.<ref name=Matthaiou08/>

<!-- Surgery -->
Surgical intervention is much more likely to be needed in cases of intraventricular, racemose, or spinal neurocysticercosis. Treatments includes direct excision of ventricular cysts, shunting procedures, and removal of cysts via endoscopy.{{cn|date=November 2020}}

===Eyes===
In eye disease, surgical removal is necessary for cysts within the eye itself as treating intraocular lesions with anthelmintics will elicit an inflammatory reaction causing irreversible damage to structural components. Cysts outside the globe can be treated with anthelmintics and steroids. Treatment recommendations for subcutaneous cysticercosis includes surgery, praziquantel and albendazole.<ref name="eight" />

===Skin===
In general, subcutaneous disease does not need specific therapy. Painful or bothersome cysts can be surgically removed.{{citation needed|date=July 2020}}

==Epidemiology==

=== Regions ===
''Taenia solium'' is found worldwide, but is more common where pork is part of the diet. Cysticercosis is most prevalent where humans live in close contact with pigs. Therefore, high prevalences are reported in Mexico, Latin America, West Africa, Russia, India, Pakistan, North-East China, and Southeast Asia.<ref>{{cite book|last1=Reeder|first1=P.E.S. Palmer, M.M.|title=Imaging of Tropical Diseases : With Epidemiological, Pathological, and Clinical Correlation|year=2001|publisher=Springer-Verlag|location=Heidelberg, Germany|isbn=978-3-540-56028-9|pages=641–642|edition=2 (revised)|url=https://books.google.com/books?id=W9hMKQ2AKLEC|url-status=live|archive-url=https://web.archive.org/web/20160519014843/https://books.google.com/books?id=W9hMKQ2AKLEC&pg|archive-date=2016-05-19}}</ref> In Europe it is most widespread among [[Slavic people]].<ref name="gut" /><ref>{{cite journal|last=Hansen|first=NJ|author2=Hagelskjaer, LH |author3=Christensen, T |title=Neurocysticercosis: a short review and presentation of a Scandinavian case.|journal=Scandinavian Journal of Infectious Diseases|volume=24|issue=3|pages=255–62|pmid=1509231|year=1992|doi=10.3109/00365549209061330}}</ref> However, reviews of the epidemiological in Western and Eastern Europe shows there are still considerable gaps in our understanding of the disease also in these regions.<ref name=west_europe>{{cite journal | last1 = Laranjo-González | first1 = M| last2 =  Devleesschauwer | first2 =B| last3 =  Trevisan | first3 =C| last4 = Allepuz | first4 =A| last5 = Sotiraki | first5 =S| last6 =  Abraham | first6 =A| last7 = Afonso | first7 =MB| last8 = Blocher | first8 =J| last9 = Cardoso | first9 =L| last10 = Correia da Costa | first10 =JM| last11 = Dorny | first11 =P| last12 = Gabriël | first12 =S| last13 = Gomes | first13 =J| last14 = Gómez-Morales | first14 =MÁ| last15 = Jokelainen | first15 =P| last16 = Kaminski | first16 =M| last17 = Krt | first17 =B| last18 = Magnussen | first18 =P| last19 = Robertson | first19 =LJ| last20 = Schmidt | first20 =V| last21 = Schmutzhard | first21 =E| last22 = Smit | first22 =GSA| last23 = Šoba | first23 =B| last24 = Stensvold | first24 =CR| last25 = Starič | first25 =J| last26 = Troell | first26 =K| last27 = Rataj | first27 =AV| last28 = Vieira-Pinto | first28 =M| last29 = Vilhena | first29 =M| last30 = Wardrop | first30 =NA| last31 = Winkler | first31 =AS| last32 = Dermauw | first32 =V | title = Epidemiology of taeniosis/cysticercosis in Europe, a systematic review: Western Europe | doi =  10.1186/s13071-017-2280-8 | year = 2017 | journal = Parasit Vectors| volume = 10 | issue = 1 | pages =349 | pmid = 28732550| pmc = 5521153}}</ref><ref name=east_europe>{{cite journal | last1 = Trevisan | first1 = C. | last2 = Sotiraki| first2 = S. | last3 = Laranjo-González| first3 = M. | last4 = Dermauw | first4 = V. | last5 = Wang | first5 = Z. | last6 = Kärssin | first6 = A. | last7 =  Cvetkovikj | first7 = A. | last8 = Winkler | first8 = A.S.  | last9 = Abraham | first9 = A. | last10 = Bobić | first10 = B. | last11 = Lassen | first11 = B. | last12 = Cretu | first12 = C.M. | last13 = Vasile | first13 = C. | last14 = Arvanitis | first14 = D. | last15 =  Deksne | first15 = G. | last16 = Boro | first16 = I.  | last17 = Kucsera | first17 = I. | last18 = Karamon | first18 = J. | last19 =  Stefanovska | first19 = J. | last20 = Koudela | first20 = B.  | last21 = Pavlova | first21 = M.J. | last22 = Varady | first22 = V. | last23 = Pavlak | first23 = M. | last24 = Šarkūnas | first24 = M. | last25 = Kaminski | first25 = M. | last26 =  Djurković-Djaković | first26 = O. | last27 = Jokelainen | first27 = P.  | last28 = Jan | first28 = D.S. | last29 = Schmidt | first29 = V. | last30 =  Dakić | first30 = Z. | last31 = Gabriël | first31 = S.  | last32 =  Dorny| first32 = P. | last33 = Devleesschauwer | first33 = B. | title = Epidemiology of taeniosis/cysticercosis in Europe, a systematic review: eastern Europe | doi =  10.1186/s13071-018-3153-5 | year = 2018 | journal = Parasit Vectors | volume = 11 | issue = 1 | pages =569 | pmid = 30376899| pmc = 6208121 }}</ref>

The frequency has decreased in developed countries owing to stricter meat inspection, better hygiene and better sanitation of facilities.{{cn|date=January 2021}}

=== Infection estimates ===
In Latin America, an estimated 75 million persons live in endemic areas and 400,000 people have symptomatic disease.<ref>{{cite journal |vauthors=Bern C, Garcia HH, Evans C, et al. |title=Magnitude of the disease burden from neurocysticercosis in a developing country |journal=Clin. Infect. Dis. |volume=29 |issue=5 |pages=1203–9 |date=November 1999 |pmid=10524964 |pmc=2913118 |doi=10.1086/313470 }}</ref> Some studies suggest that the prevalence of cysticercosis in Mexico is between 3.1 and 3.9 percent. Other studies have found the [[seroprevalence]] in areas of Guatemala, Bolivia, and Peru as high as 20 percent in humans, and 37 percent in pigs.<ref>{{cite journal |vauthors=Yeh J, Sheffield JS |title=Cysticercosis: A Zebra in the Neighborhood |journal=Virtual Mentor |volume=10 |issue=4 |pages=220–3 |date=April 2008 |url=http://virtualmentor.ama-assn.org/2008/04/cprl1-0804.html |doi=10.1001/virtualmentor.2008.10.4.cprl1-0804 |pmid=23206912 |access-date=2009-02-20 |archive-url=https://web.archive.org/web/20090219234814/http://virtualmentor.ama-assn.org/2008/04/cprl1-0804.html |archive-date=2009-02-19 |url-status=dead }}</ref> In Ethiopia, Kenya and the Democratic Republic of Congo around 10% of the population is infected, in Madagascar 16%. The distribution of cysticercosis coincides with the distribution of ''T. solium''.<ref>{{cite web |title=Taeniasis/Cysticercosis |work=Zoonoses |publisher=World Health Organization |url=https://www.who.int/zoonoses/diseases/taeniasis/en/index.html |url-status=live |archive-url=https://web.archive.org/web/20081009155516/http://www.who.int/zoonoses/diseases/taeniasis/en/index.html |archive-date=2008-10-09 }}</ref> Cysticercosis is the most common cause of symptomatic [[epilepsy]] worldwide.<ref>{{cite journal |title=Relationship between epilepsy and tropical diseases. Commission on Tropical Diseases of the International League Against Epilepsy |journal=Epilepsia |volume=35 |issue=1 |pages=89–93 |year=1994 |pmid=8112262 |doi=10.1111/j.1528-1157.1994.tb02916.x|s2cid=221733822 }}</ref>

Prevalence rates in the United States have shown immigrants from Mexico, Central and South America, and Southeast Asia account for most of the domestic cases of cysticercosis.<ref>{{cite journal|author= Flisser A.|date=May 1988|title= Neurocysticercosis in Mexico|journal =Parasitology Today|volume=4|issue=5|pages= 131–137|pmid=15463066|doi=10.1016/0169-4758(88)90187-1}}</ref>

In 1990 and 1991, four unrelated members of an [[Orthodox Jewish]] community in [[New York City]] developed recurrent seizures and brain lesions, which were found to have been caused by ''T. solium''.  Their poor hygiene was the cause of infection .  <ref>{{Cite web|title=Taeniasis/Cysticercosis|url=https://www.who.int/news-room/fact-sheets/detail/taeniasis-cysticercosis|access-date=2021-03-17|website=www.who.int|language=en}}</ref><ref>{{cite book | url=https://books.google.com/books?id=cm5pTOiYEmsC&q=pork+tapeworm+orthodox+jews&pg=PA192 | title=Outbreak Investigations Around the World: Case Studies in Infectious Disease | author=Dworkin, Mark S. | pages=192–196 | year=2010 | publisher=Jones and Bartlett Publishers | access-date=August 9, 2011 | isbn=978-0-7637-5143-2 }}</ref><ref>{{cite journal | journal=[[New England Journal of Medicine]] | title=Neurocysticercosis in an Orthodox Jewish Community in New York City | last1=Schantz |first1=Peter M. | date=September 3, 1992 | volume=327 | issue=10 | pages=692–695 | doi=10.1056/NEJM199209033271004 | pmid=1495521 | last2=Moore | first2=Anne C. | last3=Muñoz | first3=José L. | last4=Hartman | first4=Barry J. | last5=Schaefer | first5=John A. | last6=Aron | first6=Alan M. | last7=Persaud | first7=Deborah | last8=Sarti | first8=Elsa | last9=Wilson | first9=Marianna |display-authors = 2}}</ref>

=== Deaths ===
Worldwide as of 2010 it caused about 1,200 deaths, up from 700 in 1990.<ref name=Loz2012>{{cite journal |vauthors=Lozano R, Naghavi M, Foreman K, et al. |s2cid=1541253 |title=Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 |journal=Lancet |volume=380 |issue=9859 |pages=2095–128 |date=December 2012 |pmid=23245604 |doi=10.1016/S0140-6736(12)61728-0 |hdl=10536/DRO/DU:30050819 |url=https://zenodo.org/record/2557786 |hdl-access=free }}</ref> Estimates from 2010 were that it contributed to at least 50,000 deaths annually.<ref>{{cite journal |last1=Román |first1=G. |last2=Sotelo |first2=J. |last3=Del Brutto |first3=O. |last4=Flisser |first4=A. |last5=Dumas |first5=M. |last6=Wadia |first6=N. |last7=Botero |first7=D. |last8=Cruz |first8=M. |last9=Garcia |first9=H. |last10=de Bittencourt |first10=P. R. |last11=Trelles |first11=L. |last12=Arriagada |first12=C. |last13=Lorenzana |first13=P. |last14=Nash |first14=T. E. |last15=Spina-França |first15=A. |title=A proposal to declare neurocysticercosis an international reportable disease |journal=Bulletin of the World Health Organization |date=2000 |volume=78 |issue=3 |pages=399–406 |pmid=10812740 |pmc=2560715 |issn=0042-9686}}</ref>

In US during 1990–2002, 221 cysticercosis deaths were identified. Mortality rates were highest for Latinos and men. The mean age at death was 40.5 years (range 2–88). Most patients, 84.6%, were foreign born, and 62% had emigrated from Mexico. The 33 US-born persons who died of cysticercosis represented 15% of all cysticercosis-related deaths. The cysticercosis mortality rate was highest in California, which accounted for 60% of all cysticercosis deaths.<ref>{{cite journal |vauthors=Sorvillo FJ, DeGiorgio C, Waterman SH |title=Deaths from cysticercosis, United States |journal=Emerging Infect. Dis. |volume=13 |issue=2 |pages=230–5 |date=February 2007 |pmid=17479884 |pmc=2725874 |doi=10.3201/eid1302.060527 }}</ref>

==History==
[[File:Taenia solium scolex.JPG|thumb|[[Scolex]] (head) of ''Taenia solium'']]
The earliest reference to tapeworms were found in the works of [[ancient Egypt]]ians that date back to almost 2000 BC.<ref name="four">{{cite book |author1=Wadia, N.H. |author2=Singh, G. |chapter=''Taenia Solium'': A Historical Note |editor1=Singh, G. |editor2=Prabhakar, S. |title=''Taenia Solium'' Cysticercosis: From Basic to Clinical Science |publisher=CABI Publishing |year=2002 |isbn=978-0851996288 |pages=157–168 }}</ref> The description of measled pork in the ''[[History of Animals]]'' written by [[Aristotle]] (384–322 BC) showed that the infection of pork with tapeworm was known to [[Ancient Greece|ancient Greeks]] at that time.<ref name="four" /> It was also known to Jewish<ref>Ancient Hebrew Medicine<{{cite web |url=http://www.healthguidance.org/entry/6309/1/Ancient-Hebrew-Medicine.html |title=Archived copy |access-date=2011-03-17 |url-status=live |archive-url=https://web.archive.org/web/20110226115042/http://www.healthguidance.org/entry/6309/1/Ancient-Hebrew-Medicine.html |archive-date=2011-02-26 }}></ref> and later to [[Medicine in medieval Islam|early Muslim physicians]] and has been proposed as one of the reasons for pork being forbidden by [[Kashrut|Jewish]] and [[Islamic dietary laws]].<ref>{{Cite book|title=Neurocysticercosis|first1=O.H. |last1=del Brutto |first2=J. |last2=Sotelo |first3=G.C. |last3=Román|publisher=[[Taylor and Francis]]|year=1998|isbn=978-90-265-1513-2|page=3}}</ref> Recent examination of evolutionary histories of hosts and parasites and DNA evidence show that over 10,000 years ago, ancestors of modern humans in Africa became exposed to tapeworm when they scavenged for food or preyed on antelopes and bovids, and later passed the infection on to domestic animals such as pigs.<ref name="seven">{{cite journal |author=Becker H |journal=Agricultural Research Magazine |volume=49 |issue=5 |title=Out of Africa: The Origins of the Tapeworms |date=May 2001 |url=http://www.ars.usda.gov/is/AR/archive/may01/worms0501.htm |url-status=live |archive-url=https://web.archive.org/web/20090310150335/http://www.ars.usda.gov/is/AR/archive/may01/worms0501.htm |archive-date=2009-03-10 }}</ref>

Cysticercosis was described by Johannes Udalric Rumler in 1555; however, the connection between tapeworms and cysticercosis had not been recognized at that time.<ref name=Cox02>{{cite journal |author=Cox FE |title=History of human parasitology |journal=Clin. Microbiol. Rev. |volume=15 |issue=4 |pages=595–612 |date=October 2002 |pmid=12364371 |pmc=126866 |doi=10.1128/CMR.15.4.595-612.2002}}</ref> Around 1850, [[Friedrich Küchenmeister]] fed pork containing cysticerci of ''T. solium'' to humans awaiting execution in a prison, and after they had been executed, he recovered the developing and adult tapeworms in their intestines.<ref name="four" /><ref name=Cox02/> By the middle of the 19th century, it was established that cysticercosis was caused by the ingestion of the eggs of ''T. solium''.<ref name="six">Küchenmeister, F. The Cysticercus cellulosus transformed within the organism of man into ''Taenia solium''. Lancet 1861 i:39.</ref>

==Society and culture==
* The first patient on the television show ''[[House (TV series)|House]]'' (in [[Pilot (House)|the pilot episode]]) had cysticercosis.{{cn|date=January 2021}}
* In the crossover of the series ''[[Grey's Anatomy]]'' ([[Grey's Anatomy (season 5)|season 5]], episode 15) and ''[[Private Practice (TV series)|Private Practice]]'' (season 2), Archer Montgomery, brother of ''[[Addison Montgomery|Addison Forbes Montgomery]]'', suffered from neurocysticercosis. He was cured via the surgical removal of the cysts by his former brother-in-law [[Derek Shepherd]].{{cn|date=January 2021}}

==See also==
* [[Coenurosis]]
* [[Coenurosis in humans]]
* [[Echinococcosis]]
* [[Trichinosis]]

==References==
{{Reflist}}

==External links==
{{offline|med}}
* {{cite web |title=''Taenia solium'' |work=NCBI Taxonomy Browser |url=https://www.ncbi.nlm.nih.gov/Taxonomy/Browser/wwwtax.cgi?mode=Info&id=6204 |id=6204}}
{{Medical resources
  | ICD10          = {{ICD10|B|69||b|65}}
  | ICD9           = {{ICD9|123.1}}
  | ICDO           =
  | OMIM           =
  | DiseasesDB     = 3341
  | MedlinePlus    = 000627
  | eMedicineSubj  = emerg
  | eMedicineTopic = 119
  | eMedicine_mult = {{eMedicine2|med|494}} {{eMedicine2|ped|537}}
  | MeshID         = D003551
  | Scholia        = Q246068
}}
{{Helminthiases}}

[[Category:Helminthiases]]
[[Category:Parasitic diseases associated with beef and pork consumption]]
[[Category:Wikipedia medicine articles ready to translate]]
[[Category:Zoonoses]]
[[Category:RTTID]]
[[Category:Rare infectious diseases]]
[[Category:Neglected tropical diseases]]
[[Category:Tropical diseases]]