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Tracking Taenia solium : A tale of pork and prisoners

Tracking Taenia solium : A tale of pork and prisoners. Ref. 11. Catherine A. Leadabrand, M.D. Taenia solium (pork tapeworm). Trichinella spiralis (pork roundworm). Taeniasis , Cysticercosis. Trichinosis. Impacts of T. solium. Leander Paes.

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Tracking Taenia solium : A tale of pork and prisoners

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  1. Tracking Taeniasolium:A tale of pork and prisoners Ref. 11 Catherine A. Leadabrand, M.D.

  2. Taeniasolium (pork tapeworm) Trichinellaspiralis (pork roundworm) Taeniasis, Cysticercosis Trichinosis

  3. Impacts of T. solium Leander Paes • Est. 50 million people with cysticercosis worldwide • #1 cause of acquired epilepsy worldwide • Caused 2% of seizures in 1,800 patients presenting to 11 different ER’s in US • Topic of pilot episode of the TV series “House” Ref. 13

  4. Ref. 13

  5. Intermediate Host, Pig

  6. Life Cycle

  7. Life Cycle, Take 2

  8. Intermediate Host, Human Ref. 14

  9. Life Cycle, Take 2 X Ref. 14

  10. A Mystery of the 1800’s “The farther backwards you look, the farther forwards you can see.” --Winston Churchill (from Ref. 10) Taeniasolium (pork tapeworm) Cysticercus cellulosae (bladder worm) ? =

  11. Friedrich Küchenmeister (1821-1890) • German Gynecologist • Parasitologist (trichinosis, tapeworms) • Devout son of Protestant minister • Cremation advocate • Early 1850’s experiments with Taeniapisiformis in rabbits/dogs • Mid 1850’s tapeworm experiments in humans Ref. 4

  12. “Experimental proof that Cysticercus cellulosae changes to Taenia solium within the Human Intestine” F. Küchenmeister, 1855 (translated from German)

  13. The Experiment • Notified that a convict was sentenced to death by guillotine nearby • Assisted by anonymous physician colleagues • 8 days to complete experiment • Only had rabbit tapeworm larvae on hand

  14. “Since it is the custom to allow the convict certain extras in the way of food following the death sentence,” Kϋchenmeister had the convict fed “good boullion soup with noodles in star-shaped or triangle form.” After the soup was cooled to “blood temperature” his colleague added 7 pieces of bladder worms that were about the size of the noodles . “Thus the convict received the bladder worms without knowing it.”

  15. A serendipitous event: “About 84 hours before the convict’s death, my wife found some bladder worms in our evening meal, which consisted of warm pork roast from a restaurant near my home.”

  16. He rushed to the restaurant and “after pleading for awhile, I discovered that the pork came from a pig that had been slaughtered in the restaurant 60 hours previously.” “Measly Pork” He convinced the owner to give him 1 lb of the raw meat . . . . . .then he rode before daybreak to the prison.

  17. At once the colleague prepared a breakfast for the convict: “Since soup at this time would have been suspicious,” blood sausage was prepared by removing some of the fat pieces and replacing with bladder worms. 12 hours later the prisoner again received soup, this time with the pork tapeworm larvae, And so on . . .

  18. Experimental Tally

  19. Post-mortem findings • 1 young Taenia solium firmly attached to duodenum (scolex also matched C. cellosae) • 3 young Taenia solium free-floating • 3 other small Taenia , species indeterminant (free-floating)

  20. Kϋchenmeister’s closing plea: “That everyone in his own field work toward the end that the surely harmless experiment of bladder worm feeding be allowed to be repeated on criminals under probable death sentence. In the case of a subsequent pardon, the tapeworms can be easily expelled. This will calm anxious souls and will serve science at the same time.”

  21. Repercussions New focus on prevention of transmission from pork to humans Published in Lancet 1861 (but only as an abstract) Self-infection by less famous colleagues Küchenmeister continued his career as an acclaimed parasitologist Some ethical outcry among scientists of the day—”debasing to our common nature”

  22. How far should we go in the name of science (or reimbursement)? How will our clinical practices appear to future generations? Should we sacrifice the good of the individual for the good of the group?

  23. REFERENCES, SCIENTIFIC 1. Davis, LE. “Neurocysticercosis” Emerging Neurological Infections edited by Power, C and Johnson RT. Taylor & Francis Group, 2005. 261-287 2. Garcia HH, Del Brutto OH. “Neurocysticercosis: updated concepts about an old disease”for The Cysticercosis Working Group in Peru. The Lancet Neurology - 1 October 2005:4(10):653-661. 3. Grove, DI. , “Taeniasolium and TAENIASIS SOLIUM and CYSTICERCOSIS” A history of human helminthology. Wallingford, Oxon, C.A.B.. International, 1990. Chapter 13, pp 356-383. 4. Kean BH, MottKE, & Russell AJ, eds. “ TaeniasisSolium—Cysticercosis” Tropical Medicine and Parasitology: Classic Investigations. Cornell University Press, Ithica, 1978. Volume II, Chapter 33, pp 627-630. 5. Küchenmeister, F. The Cysticercuscellulosus transformed within the organism of man into Taeniasolium. Lancet 1861 i:39. 6. Küchenmeister, F. On animal and vegetable parasites of the human bodya manual of their natural history, diagnosis, and treatment. Tr. from the 2d German ed., by Edwin Lankester. Printed for the Syndenham Society, London, Eng. 1857.

  24. REFERENCES, SCIENTIFIC, cont’d. 7. Küchenmeister, F. Experimentellernachweis, dassCysticercuscellulosaeinnerhalb des menschlichendarmkanalessich in Taeniasoliumumwandelt. Wiener MidizinischeWochenschrift, 5:1-4, 1855. Translated from the German. 8. Ong S, Talan DA, Moran GJ, Mower W, Newdow M, Tsang VC, Pinner RW, EMERGEncy ID NET Study Group. Neurocysticercosis in radiographically imaged seizure patients in U.S. emergency departments. Emerg Infect Dis. 2002;8(6):608-613. 9. Sorvillo F, Wilkins P, Shafir S, Eberhard M. Public health implications of cysticercosis acquired in the United States. Emerg Infect Dis [serial on the Internet]. 2011 Jan . [http://www.cdc.gov/EID/content/17/1/1.htm 10. Wadia NH, Singh, G. “TaeniaSolium: A Historical Note” TaeniaSoliumCysticercosis: From Basic to Clinical Science. Singh G., ed. CABI Publishing, 2002. 157-168

  25. REFERENCES, ARTWORK and ANIMATION 11. http://animal.discovery.com/invertebrates/monsters-inside-me/pork-tapeworm-cysticercosis/images/pork-tapeworm-cysticercosis.jpg, Taeniasoliumscolex. Electron microscopy view. 12. Cannon, Renee. 2007. Various life cycle stages. 13. Curtis BG, animator and illustrator. Miscellaneous life cycle scenes. July-Aug, 2011. 14.http://www.medscape.com/features/slideshow/neurocysticercosis. Pathologic specimen, Brain with cysticercosis infestation. 15. Shore D, creator and Singer B, producer. “House” Pilot Episode: “Everybody Lies”. Fox Broadcasting Company, Nov. 16, 2004.

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