Unwashed and uncooked vegetables, especially leafy ones such as spinach, may be infected with tapeworm (NYT ph... Read More

The next time you reach out to pick a piece of succulent seekh kebab or sushi , think twice. It may be infected with tapeworm - a flat, slimy and segmented parasite that killed an 18-year-old Faridabad boy, infesting his brain, right eye and even a testicle. The case was published in the New England Journal of Medicine this week.

"When we did an MRI and ultrasounds, we found more than 1,000 cysts in the teenager's body," said Dr Nishanth Dev, who co-authored the article with Dr S Zafar Abbas. They work at ESIC Medical College and Hospital, Faridabad and got this case of cysticercosis , the medical term for this infection, four years ago.

So how does it spread? "Humans become accidental hosts of tapeworm," says Dr Nishanth. Pigs pass out eggs in their feces, which then contaminate water or food. Besides under-cooked pork, unwashed, uncooked vegetables, especially leafy ones such as spinach, may also be infected with eggs as feces of infected pigs are a major source of transmission. CDC also warns about the risks of eating sushi which contains raw fish.

Once inside the human body, the cysts hatch in the intestine. The adult tapeworm then lays more eggs, which sometimes travel in the bloodstream and make their home in different parts of the body, like heart, liver and brain.

Dr PK Sethi, emeritus consultant, neurology at Sir Ganga Ram Hospital in Delhi, says that salads and minced meat preparations are best avoided. "The commonest symptoms of cysticercosis are seizures and epilepsy," says Dr Praveen Gupta, director, neurology at Fortis Memorial Hospital, Gurgaon. According to a 2016 research published in the Indian Journal of Medical Research, it is the most common cause of epilepsy in India.

Last year, Dr Gupta treated an eight-year-old girl who had more than 100 tapeworm eggs in her brain. "When she came to us, her weight had doubled because of taking anti-epilepsy drugs and steroids. She had fits and severe headache," says Dr Gupta, who put her on a regimen of anti-epileptic drugs and medicines that dissolve cysts. "Typically, the course is for 15 days but can extend to a month.

The cysts take six months to a year to die. In some cases, the cysts can leave a scar in the brain tissue, says Dr Sethi, leading to continued fits and life-long dependence on anti-epilepsy drugs. It's not rare, and thrives in unsanitary conditions

As many as 8.3 million people in Latin America, Asia and sub-Saharan Africa are estimated to be suffering from neurocysticercosis, the version of the disease that affects the brain and spinal cord, according to the World Health Organization .

Dr Nishanth adds that out of all the cases of cysticercosis, 80% do not present any symptom. Kerala and Tamil Nadu have the lowest number of cysticercosis cases because of better standards of hygiene while northern states like Punjab and Uttar Pradesh report more cases.

"If we do random CT scans, 1% to 2% people will show some calcification in the brain tissue due to tapeworm cysts," says Dr Gupta.

