Tracking Taenia solium: A tale of pork and prisoners

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Tracking Taenia soliumA tale of pork and
prisoners
Ref. 11
Catherine A. Leadabrand, M.D.
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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 ERs in US
• Topic of pilot episode of the TV series House

Ref. 13
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Ref. 13
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Intermediate Host, Pig
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Life Cycle
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Life Cycle, Take 2
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Intermediate Host, Human
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Life Cycle, Take 2
X
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A Mystery of the 1800s
The farther backwards you look, the farther
forwards you can see. --Winston Churchill
(from Ref. 10)
Taenia solium (pork tapeworm)
Cysticercus cellulosae (bladder worm)
?

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Friedrich Küchenmeister (1821-1890)

• German Gynecologist
• Parasitologist (trichinosis, tapeworms)
• Devout son of Protestant minister
• Cremation advocate
• Early 1850s experiments with Taenia pisiformis
  in rabbits/dogs
• Mid 1850s tapeworm experiments in humans

Ref. 4
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Experimental proof that Cysticercus cellulosae
changes to Taenia solium within the Human
Intestine
F. Küchenmeister, 1855 (translated from German)
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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

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• Since it is the custom to allow the convict
  certain extras in the way of food following the
  death sentence, K?chenmeister 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.

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A serendipitous event
About 84 hours before the convicts death, my
wife found some bladder worms in our evening
meal, which consisted of warm pork roast from a
restaurant near my home.
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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.
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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 . . .
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Experimental Tally
Species Number Hours pre-execution
C. pisiformis 6 in soup 140
C. tenuicollis ? 130
C. cellusosae 12 in sausage 72
18 in soup 60
15 in soup 36
12 in sausage 24
18 in soup 12
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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)

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K?chenmeisters 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.

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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
  daydebasing to our common nature

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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?
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• 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 diseasefor The
  Cysticercosis Working Group in Peru. The Lancet
  Neurology - 1 October 20054(10)653-661.
•  
• 3. Grove, DI. , Taenia solium 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.
  Taeniasis SoliumCysticercosis Tropical
  Medicine and Parasitology Classic
  Investigations. Cornell University Press, Ithica,
  1978. Volume II, Chapter 33, pp 627-630.
• 5. Küchenmeister, F. The Cysticercus cellulosus
  transformed within the organism of man into
  Taenia solium. Lancet 1861 i39.
• 6. Küchenmeister, F. On animal and vegetable
  parasites of the human body a 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.

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• REFERENCES, SCIENTIFIC, contd.
• 7. Küchenmeister, F. Experimenteller nachweis,
  dass Cysticercus cellulosae innerhalb des
  menschlichen darmkanales sich in Taenia solium
  umwandelt. Wiener Midizinische Wochenschrift,
  51-4, 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.
  20028(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. Taenia Solium A
  Historical Note Taenia Solium Cysticercosis
  From Basic to Clinical Science. Singh G., ed.
  CABI Publishing, 2002. 157-168

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• REFERENCES, ARTWORK and ANIMATION
• 11. http//animal.discovery.com/invertebrates/mon
  sters-inside-me/pork-tapeworm-cysticercosis/images
  /pork-tapeworm-cysticercosis.jpg, Taenia solium
  scolex. 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/ne
  urocysticercosis. 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.