Watch out for berries and other forest fruits straight from the bush – warns the Sanepid. Due to unwashed fruit, we can get infected with echinococcosis, a dangerous disease caused by a tapeworm. Many people are unaware they have it.
Although berries are one of the healthiest fruits in the world, they can be the cause of a deadly disease. By picking or eating unwashed forest fruits, we can become infected with a tapeworm that causes a disease as dangerous as cancer. Dr. Piotr Borkowski, a specialist in infectious diseases from the Medical University of Warsaw, talks about multi-chamber echinococcosis.
Doctor, do you eat blueberries?
Raw – never. Tapeworm eggs causing multichamber echinococcosis remain contagious at minus 30 to plus 60 degrees Celsius. Which means that neither freezing in a home freezer nor pouring hot water on it will do nothing. It is also difficult to rinse the berries thoroughly, because the eggs of the parasite can hide near the green tip of the fruit and will not run off with the water. That is why I like to eat these fruits, but only boiled or baked, e.g. in blueberries.
However, multi-chamber echinococcosis is a rare disease?
In some regions of Poland it is rarer, but for example in Masuria 35%. the foxes are infected. There are regions of Poland where it concerns even 70 percent. these animals. At the clinic where I work in Warsaw, we currently treat 25 patients with multi-chamber echinococcosis. So when I go to Masuria and see blueberry sellers standing by the road, I’m afraid they may be my potential patients.
How is this disease most often diagnosed in patients?
The presence of the parasite is most often found when it has the volume of a fist, which is about 10 years after infection. It is rare for an experienced physician to come up with such an idea and perform a serology for echinococcosis. The disease is usually detected during an ultrasound examination and diagnosed as cancer. Only the histopathological examination shows that there are no cancer cells in the removed fragment. Instead, there are parasite cells.
It’s good news that the tumor isn’t cancer, is it?
This is not very good news in the case of multi-chamber echinococcosis. The tapeworm can affect the liver, lung or brain. If we observe a 10 cm tumor in the liver, then in the case of this parasite there is almost certainly a huge mass of microscopic metastases in other organs that are not visible in research.
Can it not be killed pharmacologically?
Theoretically it is possible, but a dead parasite of this size is life-threatening, because it will almost certainly be suppurated, which will result in the patient’s death. Standard treatment is to excise the tapeworm where possible. But even if it succeeds, we are not sure if it is still hiding somewhere in microscopic dimensions. Therefore, up to 3 years after its excision, drugs are still administered to kill it. Often, however, it is too large and takes up adjacent organs. Then deletion turns out to be impossible. Then a drug is administered to prevent its further development. However, if the drug kills the tapeworm, it becomes a problem with the dead remnants of it.
What is the prognosis of patients diagnosed with the disease in such an advanced stage?
In the case of large parasites, bad as in the case of liver, lung or brain cancer. Only an early detection of the parasite enables a complete cure.
Did you manage to cure someone of this disease completely?
We had such a case. While on vacation, the patient rode a bicycle with his family in Masuria. When they saw the berries, they decided to eat fresh fruit straight from the bush. After returning home, they told their family living in the area. Relatives warned them that this might alienate themselves from the tapeworm. Finally, about 3 months later, the whole family did serological tests in Warsaw, which 99 percent. confirm infection. It turned out that only the father showed the presence of the parasite. It is virtually impossible to find a tapeworm at an early stage, as it is the size of a pinhead three months after infection. Therefore, the patient, despite the lack of imaging studies, only on the basis of serology, received a drug that destroys the parasite. And after six months of treatment, the results returned to normal.
Where can such a test be done?
Only in a few places in Poland. In Warsaw at the National Institute of Health of the National Institute of Hygiene. It costs about PLN 150 and is not refunded. So far, the drug that kills the parasite has not been reimbursed, because the manufacturer has not included such an indication in its summary of product characteristics and has not applied for a refund. Daily treatment costs about PLN 40. Meanwhile, treatment often has to last for the rest of the patient’s life.
Why does the parasite kill its host?
In the case of intermediate host parasites, they almost always try to kill or greatly weaken the host. A man by eating contaminated, contaminated with fox droppings becomes a random intermediate host, the so-called the blind end. The ultimate host is usually a benefactor of its parasite, therefore it is safe – for example, pinworms never kill us for this reason.
So who are the natural hosts of this tapeworm?
This tapeworm, in many hundreds of copies, lives in the small intestine, mainly of foxes, where it lays hundreds of thousands of eggs that end up in the environment with faeces. Along with the small fruit contaminated with fox droppings, it is eaten by small forest rodents, which are the intermediate hosts of this parasite. The tapeworm is dangerous for them. Infected fall prey to foxes, which eat them along with the tapeworm. The eaten echinococcus is again laying eggs in the fox’s intestines. Man, tasting an unwashed blueberry or wild strawberry, can introduce tapeworm eggs into the body with it. We can also get infected when collecting undergrowth, if we do not wash our hands after returning from the forest.
How does the parasite develop in the human body?
The larva that gets into the human body always settles first in the liver, where it grows slowly without causing any symptoms for a long time. By nesting in the liver, lungs and brain, a tapeworm develops similar to a cancerous tumor. Sometimes the parasite growing in the liver can give symptoms of aches and pains in the right hypochondrium, malaise, and in the case of pressure on the bile ducts, also jaundice. Late detecting echinococcosis sometimes necessitates a liver transplant, which creates new problems, as the immunosuppression used to support the transplant by killing our immunity means that we do not fight the parasite, and it develops rapidly without antiparasitic drugs.
What can we do to improve the detection of this disease at an early stage?
In Poland, less cases of this disease are detected than in Germany, although the number of infected foxes is similar. And yet it is here that people eat more blueberries and strawberries. Means that there are still many people with undetected disease and they can be helped. For example, by encouraging berry pickers from the Warmian-Masurian Voivodeship to do ultrasound examinations or perform a echinococcosis test. Someone could sponsor such research for the inhabitants of endangered regions.
You don’t want to get infected with a tapeworm? Reach for freeze-dried berries available on the Medonet Market.