What Are Crabs (Pubic Lice)? What Causes Crabs?

Pubic lice (Sing: pubic louse), also known as crab louse, crabs, or Fullers; Latin name Pthirus pubis are tiny parasitic blood-sucking wingless insects that infest the human genitals, causing itching and red spots. The only other animal known to be affected by this insect is the gorilla. Crabs may also affect other coarse hair on the body, including the eyelashes, eyebrows, beards, moustaches, as well as the hair on the back and abdomen. Pubic lice are about 2mm long and are gray-brown in color.

Pubic lice pass from person-to-person, in most cases as a result of sexual intercourse - close hugging and kissing are also possible routes. Parents can pass on the lice to their children via the sharing of towels, clothing, bedding or closets (wardrobes); however this is rare. Infested children are at risk of lice spreading to their eyelashes, resulting in possible infections.

Crabs affect sexually active adolescents and adults much more commonly than children. Pubic lice cannot survive for very long away from the warmth and humidity of a human body. Experts say that crabs are the most contagious STD (sexually transmitted disease). If an infected person has sexual intercourse with a non-infected person, the latter has a 90% risk of getting an infestation, according to The Mayo Clinic, USA.

According to the National Health Service (NHS), UK, there were 2,500 cases of pubic lice seen at sexual health clinics in the UK in 2006.

According to Medilexicon's medical dictionary:

Pthirus is "a genus of lice (family Pediculidae) formerly grouped in the genus Pediculus. The main species is Pthirus pubis (formerly Pediculus pubis), the crab or pubic louse, a parasite that infests the pubes and neighboring hairy parts of the body."

What are the signs and symptoms of crabs (pubic lice infestation)?

A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.

Signs and symptoms may not become apparent until one to three weeks after a person comes into contact with the lice. Signs and symptoms may include:

• Itching in the pubic region - this is not caused by biting from the insect, but from an allergic reaction to the louse saliva and feces (droppings, excrements, stools). The itching is usually worse at night.


• Red spots and skin lesions - small red bumps or spots may appear. Scratching by the patient may also results in marks.


• Blue spots on the skin - especially on the thighs or lower abdomen.


• Other parts of the body - the lice may spread to the stomach, upper thighs, chest, moustache, and beard. In children they may spread to the eyelashes. Wherever the lice are located, symptoms of itching are common, as well as skin irritation.


• Louse droppings - the presence of dark brown or black powder on the skin or in underwear could indicate the presence of crab droppings.


• Blood in underwear - this is usually caused by scratching by the patient which breaks the skin.


• Adult pubic lice and eggs - an adult pubic louse is smaller than a match head; it is approximately 2mm long. It has six legs and has a gray-brown color. Its back legs are very large, and look like the claws of a crab. The large back legs are used to cling onto the hair.

Eggs are very small, oval shaped, with a yellowish-white color. They stick firmly to the base of the hair.

Both the adult pubic lice and their eggs are visible to the naked eye - some people may need a magnifying glass. You may be able to detect them in coarse hair in the following parts of your body:

• Along the edge of the scalp
• In facial hair (beards, moustaches)
• In the eyebrows
• In the eyelashes
• In the hair around the anus
• In the hair of the armpits
• In the pubic hair (genital area)

The detection of empty eggshells (nits) after treatment does not mean the infestation is necessarily still present.

When should you see your doctor?

In the majority of cases OTC (over-the-counter, no prescription required) medications will successfully treat the infestation. You should see you doctor if:

• The OTC medication, usually in the form of a lotion, cream or shampoo, does not kill the lice.


• You are pregnant. Pregnant women should not use anti-lice medications without checking with their doctor.


• You have developed a skin infection due to skin lesions (from scratching).


• The patient is a child.

What are the risk factors for crabs?

A risk factor is something which increases the likelihood of developing a condition or disease. For example, obesity significantly raises the risk of developing diabetes type 2. Therefore, obesity is a risk factor for diabetes type 2. Risk factors for crabs include:

• Being sexually active, especially for adolescents.
• Having several sex partners.
• Having sexual relations with a person who has an infestation.
• Sharing towels, bedding or clothing with an infested person.

What are the causes of crabs?

An infested person needs to be in close-body contact with another person for the infestation to be passed on. The lice cannot jump, fly or swim - they crawl from one hair to another.

• Sex - the most common form of contact that results in an infestation is through sex, including sexual intercourse, anal sex and oral sex.


• Non-sexual bodily contact - such as hugging or kissing may also result in an infestation (less common).


• Sharing items - sharing towels, bedding, etc., with an infected person can raise the risk of pubic lice infestation in other people (much smaller risk).

Condoms are effective for protection against many sexually transmitted infections, but not from pubic lice infestation. It is not the penetration during the sexual act that raises the risk, but rather the close proximity of hair from one person to the hair of another person.

Pubic lice life-cycle

A pubic louse has a life expectancy of between 1 to 3 months. A female might lay up to 300 eggs during her life.

Eggs hatch within 6 to 10 days. Lice take 2 to 3 weeks to reach maturity (the age for reproduction).

A louse can survive for up to 24 hours away from the human body. They will never deliberately leave a human, unless it is to crawl onto another human, because they feed on human blood - without it they starve. The only other animal, apart from humans, known to be affected by pubic lice infestation is the gorilla.

Diagnosing pubic lice infestation

Both the doctor, as well as the patient can easily detect the presence of lice and eggs through a visual examination of the affected area - usually the pubic area. Some people may find that a magnifying glass is easier.

An infestation is confirmed if moving lice are spotted.

The presence of lice eggs (nits) does not necessarily mean there is an infestation. After successful treatment there may still be some remaining empty egg shells.

Sexually transmitted infections - doctors in the UK and many other countries will ask the patient whether the infestation was transferred through sexual contact or some other means. If they were the result of sexual contact the doctor will recommend that the patient be screened for other STIs (sexually transmitted infections) or STDs (sexually transmitted diseases) as a precaution. In this text, and virtually all medical texts, STI and STD have the same meaning.

What are the treatment options for crabs?

Pubic lice can be treated without needing to go to the doctor's. There are insecticidal creams, lotions and shampoos available at pharmacies which do not require a doctor's prescription. Ask your pharmacy for a suitable medication. If you are pregnant see your doctor first.

Most treatments are applied once, and then again seven days later.

Anybody with an infestation should also make sure that other people who came into close physical contact receive treatment; including all members of the household, not just sexual partners.

Some pubic lice may have developed resistance to some medications - i.e. the medication does not work because they have become immune to it. If this happens to you, either talk to a pharmacist or your doctor - they will recommend an alternative treatment after checking whether you have been applying the application properly.

Make sure you talk to your pharmacist or GP before using a treatment so that you know how to use it properly. Follow their instructions carefully. Sometimes the GP's or pharmacist's instructions may vary from what is written on the packet; do what the health care professional told you - if their instructions vary from what is written on the packet, do not be afraid to mention this fact to them.

The following groups of people should not be treated without first talking to your doctor or qualified pharmacist (do not be afraid to ask the person at the pharmacy whether they are fully qualified pharmacists):

• Infants
• Children under 18 years of age
• A pregnant woman

OTC lotions and creams - these are usually the first line of defense. If they do not kill the lice a doctor may prescribe a stronger lotion (or shampoo).

• Malathion (Ovide) aqueous lotion - this medication is suitable for anybody aged over six months. Malathion is flammable (can catch fire), so keep away from cigarettes, hair dryers and other heat sources. In many countries this is a prescription lotion.


• Permethrin 5% dermal cream - this medication should not be used on patients aged less than 18 years. Pregnant women and breastfeeding mothers should not take it, unless her doctor says so.

Instructions for both malathion lotion or permethrin cream, in most cases, are:

• Apply the lotion to the whole body, including the scalp, face, neck and ears (not just the affected areas).


• Make sure the lotion is applied to the eyebrows.


• Apply the lotion to your beard or moustache (if you have a beard and/or moustache).


• Apply to pubic hair, hair between your legs, and hair around the anus.


• Keep the lotion away from your eyes. If some does get in your eyes, rinse thoroughly with water.


• One total application will generally require about 100ml of lotion or 30-60g of cream.


• Malathion lotion - leave on for 12 hours or overnight.
• Permethrin 5% cream - leave on for 24 hours.


• Wash the medication off with warm water (gently and thoroughly).


• Repeat the whole process seven days later.


• Do not use medication more often than indicated. Do not repeat the application for more than three consecutive weeks.

Eyelash treatment - anybody with an eyelash infestation should treat the eyelashes and the body as well. Patients should not try to pull the nits out - there is a serious risk of eye injury. The medication for eyelashes is different from the treatments for other parts of the body - do not use them on your eyes. For eyelashes you should use:

• An eye ointment - ideal for patients under 18 years of age and pregnant or nursing mothers. The medication has a white or yellow soft paraffin base and suffocates the parasite.
  
  
  • Apply twice a day to the eyelashes, making sure every part of each eyelash is covered.
  
  
  • Wash hands thoroughly before applying, and again afterwards.
  
  
  • Each time the ointment is applied, gently wipe away any ointment that is still there from the previous application (with a tissue). Then throw away the tissue.
  
  
  • Continue like this, twice a day for eight days. If lice are still present (ignore the eggs) continue until day 10.


• An insecticide shampoo or cream rinse - for example, permethrin 1%.
  
  
  • Apply the cream to where the eyelashes start (the base), using a cotton bud.
  • Do not open your eyes during the application.
  • Leave it there for 5 to 10 minutes.
  • Wash off the cream with water.
  • If any gets into your eyes wash them straight away with water.

In the majority of cases the first treatment will be successful and all the lice will be killed off. However, the eggs may still be there, with the risk of hatching. If you re-apply the medication after seven days it makes sure that any hatched lice will be killed off before they are mature enough to reproduce.

One week after your second treatment check for lice again. If you are not sure how to check, go to your GP (general practitioner, primary care physician) or a GUM (genitor-urinary medicine) clinic.

Nits (eggs or empty egg-shells) may linger for a while even after successful treatment. Their presence does not mean the infestation is still there. However, if you find moving lice or eggs that are not empty (they can hatch), you should see your GP.

You doctor will make sure the patient fully understands how to apply the medication. In some cases the GP may ask the patient to repeat the treatment. If treatment fails a second time the doctor will recommend an alternative medication. This may mean switching from malathion to permethrin, or vice-versa. Other possible medications include phenothrin or carbaryl.

Preventing crabs

Protecting others - if you have an infestation, refrain from sexual activity until your treatment is completed successfully.

Sexual partners - the fewer sexual partners you have, the lower the risk will be of becoming infected with STIs generally, including pubic lice.

Regular check-ups - regular check-ups can reduce the risk for all STIs.

Condoms - although condoms will not protect you from pubic lice, they will help protect you from other STIs.

Sharing items - if you have an infestation, do not share your bedding, clothing, towels and closet with other members of your household.

Other members of the household - if one person has an infestation, treat everyone in that household for pubic lice as a precaution.

Possible complications

If complications to occur they tend to be minor and usually as a result of leaving the infestation untreated.

Skin - intense itching can lead to scratching, which can cause excoriation (skin flakes off) and/or infection.

Eyes - if the eyelashes have been affected there is a risk of:

• Blepharitis - swelling of the eyelids. The patient will have a foreign body or burning sensation, there may be excessive tearing (liquid tears), itching, photophobia (sensitivity to light), red and swollen eyelids, the whites of the eyes becomes reddened, blurred vision, or crusting of the eyelashes first thing in the morning.


• Conjunctivitis - there is a thin layer of cells (membrane) between the inner surface of the eyelids and the whites of the eyes, called the conjunctiva. Conjunctivitis is when the conjunctiva becomes inflamed. Another name for conjunctivitis is pink eye. Inflammation causes tiny blood vessels (capillaries) in the conjunctiva to become more prominent, giving the eye a red or pink look.


• Corneal epithelial keratitis - the cornea becomes inflamed.

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What Are Tapeworms? What Causes Tapeworm Infection?

Tapeworms, or cestodes, are intestinal parasites; they are worms that are flattened like a tape measure. A tapeworm cannot live freely on its own - it survives within the gut (intestine) of an animal, including a human.

A parasite is an animal or plant that lives in a host; another animal or plant.

Tapeworm eggs generally enter the human host from animals through ingested food, especially raw or undercooked meat. Humans can also become infected if there is contact with animal stools or contaminated water. When an infection is passed from an animal to a human it is called zoonosis.

Most people who have a tapeworm experience no symptoms and are unaware of hosting one. If signs and symptoms are present, they usually include tiredness, abdominal pain, weight loss and diarrhea.

A human who has a tapeworm will need treatment to get rid of it. Treatment is 95% effective and lasts just a few days.

The most common tapeworms to infect humans in Western Europe and USA/Canada are:

• Taenia solium - the pork tapeworm. Also known as the armed tapeworm or measly tapeworm.


• Taenia saginata - the beef tapeworm. Also called the unarmed tapeworm.


• Hemynolepis nana - the dwarf tapeworm.

Taenia solium and echinococcus granulosus (dog tapeworm) can cause other illnesses if their larvae get out of the host's intestine and settle elsewhere in the body.

According to the National Health Service (NHS), UK, in 2005 there were 71 reported incidences of beef and pork tapeworms among humans in England and Wales, and just 1 in Scotland. Authorities do not know whether the hosts became infected in the UK or while they were abroad. There were 11 cases of hydatid disease, an infection caused by the dog tapeworm in England and Wales in 2005 - two of these people had had a recurrence of the disease.

According to the CDC (Centers for Disease Control and Prevention), USA, tapeworm incidence in the USA has been rising, mainly because of increased raw fish consumption.

According to Medilexicon's medical dictionary, a tapeworm is:

"An intestinal parasitic worm, adults of which are found in the intestine of vertebrates; the term is commonly restricted to members of the class Cestoidea. Tapeworms consist of a scolex, variously equipped with spined or sucking structures by which the worm is attached to the intestinal wall of the host, and strobila having several to many proglottids that lack a digestive tract at any stage of development.

The ovum, entering the intestine of an appropriate intermediate host, hatches and the hexacanth penetrates the gut wall and develops into a specific larval form (cysticercoid, cysticercus, hydatid, strobilocercus), which develops into an adult when the intermediate host is ingested by the proper final host. A three-host cycle with a swimming coracidium, procercoid and plerocercoid (sparganum) larva, and adult intestinal worm is found in aquatic life cycles, as in Diphyllobothrium latum (broad fish tapeworm) and other pseudophyllid cestodes.

Other important species of tapeworm are Echinococcus granulosus (hydatid tapeworm), Hymenolepis nana or H. nana var. fraterna (dwarf or dwarf mouse tapeworm), Taenia saginata (beef, hookless, or unarmed tapeworm), T. solium (armed, pork, or solitary tapeworm), and Thysanosoma actinoides (fringed tapeworm of sheep)."

What are the risk factors for tapeworms?

A risk factor is something that increases the risk of developing an illness, condition or infection. For example, poor dental hygiene increases the risk of developing gum disease. Therefore, poor dental hygiene is a risk factor for gum disease. The following are considered risk factors for tapeworm infection:

• General lack of hygiene - if you wash your hands infrequently the risk of transferring infection into your mouth is greater.


• Working with or exposure too animals - this is especially the case in areas where feces are not disposed of effectively.


• Traveling to or living in certain parts of the world - countries, and parts of some countries where sanitation practices are poor, the risk of becoming infected with a tapeworm is much greater.


• Consuming raw or undercooked meats and fish - larvae and eggs present in meats and fish may infect people if eaten raw or undercooked. Experts say that sushi (raw fish) is safe if it has been frozen beforehand - the risk with fish is mainly freshwater fish.

What are the signs and symptoms of tapeworm infection?

A symptom is something the patient feels and reports, while a sign is something other people, including a doctor or nurse may detect. For example, pain may be a symptom while a rash may be a sign.

It is not uncommon for an infected person to have no apparent signs and symptoms. Even if symptoms are present, they may be so mild that many people believe they are caused by something else.

If signs or symptoms are present, they may include the following (may vary depending on the type of tapeworm):

• Eggs, larvae or segments from the tapeworm in stools. The segments will contain tapeworm eggs.


• Abdominal pain. This may include epigastric pain - pain in the abdomen, just above the stomach.


• Vomiting


• Nausea


• General weakness


• Inflammation of the intestine (enteritis), which often causes diarrhea as well.


• Diarrhea


• Weight loss


• Altered appetite - sometimes there may be a loss of appetite. Hosts with the pork tapeworm may experience a rise in appetite.


• Sleeping difficulties


• Dizziness


• Convulsions


• Malnutrition - because the tapeworm is grabbing an important proportion of essential nutrients.


• Vitamin B12 deficiency - this is very rare and only among hosts infected with Diphyllobothrium latum (fish tapeworm)

Invasive infection signs and symptoms

If the tapeworm larvae made their way out of the intestines and formed cysts in tissues elsewhere in the body, there is a risk of tissue damage. The following symptoms may be possible:

• Fever
• Abdominal pain or discomfort
• Jaundice
• Cystic lumps or masses
• An allergic reaction to larvae
• Bacterial infections
• Seizures and other neurological symptoms
• Blindness
• Intracranial pressure (pressure inside the skull

Signs and symptoms will depend on what type of tapeworm it is, how severe the infection is, and which tissues (which part of the body) are infected.

What are the causes of tapeworm infection?

In human beings, tapeworm infection is most commonly caused by:

The pork tapeworm (Taenia solium), beef tapeworm (Taenia saginata), dwarf tapeworm (Hymenolepis nana), and fish tapeworm (Diphyllobothrium latum) from raw freshwater fish.

Most people become infected after ingesting tapeworm eggs or larvae.

• Ingestion of eggs - eggs get into humans via food, water or contaminated soil (mainly contaminated with infected animal feces). If a host, such as a pig, has a tapeworm inside, proglottids (worm segments) or eggs may be present in its feces, which drop onto the soil. Each segment may have thousands of eggs. A human can become infected by drinking contaminated water, being close to the animals and contaminated soil, or consuming contaminated food. The eggs hatch into larvae (baby tapeworms) and make their way into the gut, or even outside and infect other parts of the body. This type of infection is most common with tapeworms that come from infected pigs, and much less common if the original host was cattle or fish.


• Eating infected meat/fish - if the meat or fish has larvae cysts and is undercooked or raw, they can reach the intestine where they mature into adult tapeworms. An adult tapeworm can live as long as 20 years, they can also be up to 50 feet long. Many of them attach themselves to the walls of the intestine, while others will go straight through the digestive system and end up in the toilet when the human passes a stool.
  
  Fish tapeworm infection is more common in countries where the consumption of raw fish is common practice, such as Eastern Europe, Scandinavia and Japan. Undercooked or raw freshwater fish, such as salmon, are the most common sources.


• Human-to-human transmission - the dwarf tapeworm can be transmitted from human-to-human. It is the only tapeworm that can go through its entire life cycle, eggs-larvae-mature tapeworms, in one single host. Dwarf tapeworm infection is the most common tapeworm infection globally.


• Insect-to-human transmission - fleas and some types of beetles may pick up the eggs by eating the excrements (droppings) of infected rats or mice. These insects can infect humans. The insects are called intermediate hosts - the tapeworm exists in them in between the egg and adult stages. This type of infection occurs with dwarf tapeworms, and is much more common in areas where hygiene practices are poor.


• Re-infecting yourself - during treatment humans can reinfect themselves if they do not follow good hygiene practices. The eggs will be present in the human stools. If the individual does not wash his/her hands after going to the toilet, there is a risk of reinfection.


• Dog tapeworm - called echinococcosis, hydatid disease, or unilocular hydatid disease. Unilocular means the tapeworm larvae (cyst containing larvae) settles and stays in just one place in the body. Humans, especially children, may accidentally touch dog stools and eventually swallow the eggs when they touch their mouths with their hands. Infection is also possible by having close contact with dogs.
  
  This type of tapeworm is more common in some parts of Australia, Greece, southern Spain, North and South America, Turkey and Asia. It is also more common in rural, rather than urban areas. The National Health Service, UK, says that hydatid disease is rare in the UK, with virtually all cases occurring in sheep-farming areas.

Diagnosing tapeworm infection

Any individual who suspects tapeworm infection, or has the signs and symptoms described above should see their GP (general practitioner, primary care physician). Some patients may notice infection themselves by checking their stool for parts of the adult tapeworm. However, a doctor is still needed to check the stool (by sending samples to a lab).

Diagnosis of adult tapeworms - this is done by searching for and detecting eggs, larvae or segments of tapeworms in the patient's stool. If infection is with a pork or beef tapeworm the segments will be motile (they wiggle, move). The patient will be asked to provide a sample of his/her stool in a sterile container.

Laboratories may use microscopic identification methods to try to detect eggs or tapeworm segments in the feces. It may be necessary to collect two or more samples over a given period to detect the parasite because eggs and tapeworm segments are not released in a regular pattern into the stool.

The doctor may also examine the area around the patient's anus for signs of eggs or larvae.

Diagnosing tapeworm larvae infection - the following diagnostic aids may be used, depending on the type of tapeworm larvae infection:

• Blood tests - the aim here is to look for antibodies to infection.


• Imaging scans - this could include a chest X-ray, ultrasound scan, computerized tomography (CT) scan, or a Magnetic Resonance Imaging (MRI) scan.


• Organ tests - the doctor may want to check that the organs are working properly.

What are the treatment options for tapeworm infection?

Treating tapeworm larvae infection is more complicated than treating an adult tapeworm infection. While the adult tapeworm stays in the gut, the larvae may settle in other parts of the body. When larvae infection finally produces symptoms, the infection may have been present for years. In some rare cases larvae infection can be life-threatening.

• Oral medications for treating tapeworms - oral medications such as, praziquantel (Biltricide) or albendazole (Albenza), and niclosamide may be prescribed. Niclosamide is not currently available in the USA (November, 2009). In the UK, niclosamide and praziquantel are only available on a named-patient basis - because tapeworm infections in the UK are so rare, the doctor or pharmacist may have to make special arrangements to get hold of the medication.
  
  Our digestive system does not absorb these drugs well. They either dissolve or attack (and kill) the adult tapeworm.
  
  The tapeworm's scolex (neck and head) needs to come out of the patient's intestine in their stools. If the scolex is not destroyed the tapeworm can grow again.
  
  A doctor may advise the patient to take a laxative to help the tapeworm come out in the stools. If the patient has a pork tapeworm infection, in order to prevent vomiting, which can lead to reinfection by swallowing the tapeworm larvae, they may be given an anti-emetic (prevents vomiting) medication.
  
  These medications to do not target the eggs. It is therefore very important for patients to wash their hands thoroughly after going to the toilet and before eating so that they do not reinfect themselves.
  
  The patient's stools will be checked several times one to three months after the course of medication. These medications, if procedures are followed properly, are 95% effective.
  
  Medication used for treating adult tapeworm infection is often referred to as anthelmintic medication. Anthelmintic means that it kills the parasitic worm, and makes the worm pass out of the gut in the patient's stools.


• Anti-inflammatory medication - if the infection affects tissues outside the intestine, the patient may have to take a course of anti-inflammatory steroid to reduce swelling caused by the development of cysts.


• Surgery - if the patient has life-threatening cysts that have developed in vital organs, such as the lungs or liver, surgery may be required. The doctor may inject a cyst with medication, such as formalin, to destroy the larvae before removing the cyst. In some cases the patient may need organ transplantation. If surgery to remove a cyst is not possible because it is too close to major blood vessels or organs, the doctor may prescribe albendazole to try to slow down or control the cyst's growth.

What are the possible complications of tapeworm infection?

The risk of complications depends on several factors, including the type of tapeworm and whether or not the patient receives treatment.

• Beef tapeworm - as the beef tapeworm lives in the gut and can easily be treated it is relatively harmless.


• Cysticercosis - if a human ingests pork tapeworm eggs there is a risk of larvae infection (cysticercosis). The larvae can exit the intestine and infect tissues and organs elsewhere in the body, resulting in lesions or cysts. Lesions or cysts can eventually affect the normal function of an organ. In some cases they can rupture.


• Neurocysticercosis - a dangerous complication of pork tapeworm infection. The brain and nervous system are affected. The patient has headaches and vision problems, as well as convulsions (seizures), meningitis, and possibly dementia. In very severe cases the infection can be fatal.


• Echinococcosis (hydatid disease) - the echinococcus tapeworm, which is most commonly found in sheep and dogs, can cause an infection called echinococcosis. The larvae leave the gut and infect organs, most commonly the liver. The infection can result in large cysts, which place pressure on nearby blood vessels and affect circulation. Sometimes the blood vessels may rupture. In severe cases surgery or liver transplantation is required. Infection may start during childhood, but symptoms may not become apparent for many years.

Prevention

• Good hygiene - wash your hands thoroughly with soap and water after using the toilet and before eating.


• Food precautions - if you are in an area where tapeworms are common, make sure you wash and cook all fruits and vegetables with clean water.


• Livestock - properly dispose of animal and human feces. Minimize animal exposure to tapeworm eggs.


• Meat - cook meat to a temperature of at least 66C (150F) thoroughly. This will kill larvae or eggs.


• Meat and fish - freeze fish for at least 24 hours and meat for at least 12 hours. This will kill tapeworm eggs and larvae.


• Raw foods - do not consume raw or undercooked pork, beef and fish.


• Dogs - make sure your dog is treated for tapeworms. Follow your veterinarian's advice about treating your dog regularly with de-worming medication. Take special care with your own personal hygiene. Sheepdogs are especially vulnerable to tapeworm infection because sheep are intermediate hosts for the dog tapeworm. Make sure your dog only eats cooked meat and fish.


• Kitchen hygiene - make sure all work surfaces are regularly cleaned and disinfected. Do not allow raw foods to touch other foods. If you have touched raw meat/fish wash your hands before moving on to touching other things.

Experts say that smoking or drying meat or fish are not considered reliable ways of killing larvae or eggs.

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