Diphyllobothriasis
| Diphyllobothriasis | |
|---|---|
| Classification and external resources | |
| Specialty | infectious disease |
| ICD-10 | B70.0 |
| ICD-9-CM | 123.4 |
| DiseasesDB | 29539 |
| MedlinePlus | 001375 |
| eMedicine | med/571 |
| MeSH | D004169 |
Diphyllobothriasis is the infection caused by tapeworms of the Diphyllobothrium genus, commonly Diphyllobothrium latum and Diphyllobothrium nihonkaiense.
Diphyllobothriasis occurs in areas where lakes and rivers coexist with human consumption of raw or undercooked freshwater fish. Such areas are found in Europe, newly independent states of the former Soviet Union, North America, Asia, Uganda, Peru (because of ceviche), and Chile. Diphyllobothriasis nihonkaiense was once endemic to coastal provinces of central and northern Japan, where salmon fisheries thrived. In recent decades, regions with endemic diphyllobothriasis nihonkaiense have disappeared from Japan, though cases continue to be reported among urbanites who consume sushi or sashimi. In Kyoto, it is estimated that the average incidence in the past 20 years was 0.32 cases per 100,000 population per year, and that in 2008 was 1.0 case per 100,000 population, suggesting that D. nihonkaiense infection is equally as prevalent in Japan as D. latum is in some European countries.
The disease is rare in the United States. It was, however, once more common and was referred to as "Jewish housewife's disease" because Jewish housewives preparing the traditional "gefilte fish" frequently tasted the fish before it was cooked.
Diphyllobothriasis can last for decades if untreated. Most infections are asymptomatic. Manifestations may include abdominal discomfort, diarrhea, vomiting and weight loss. Vitamin B12 deficiency with subsequent megaloblastic anemia may occur, but has not for several decades in D. latum infections, possibly because of improved nutrition. In one test, nearly half of the ingested vitamin was absorbed by D. latum in otherwise healthy patients, while 80-100% was absorbed by the worm in patients with anemia. It is not known why anemia occurs in some cases but not others. Massive infections may result in intestinal obstruction. Migration of proglottids can cause cholecystitis or cholangitis.
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