Primary prevention
Preventing human tapeworm infections can serve to decrease the number of carriers of tapeworm eggs. Education regarding routes of transmission, good personal hygiene, careful washing of fruit/vegetables, and hand washing prior to food preparation could help prevent egg transmission to humans.
Risk of infection can also be reduced with adequate cooking of beef, pork, and fish; inspection of pork for cysticerci; and/or freezing of meat.
Prevention of cystic echinococcosis can often be achieved merely by avoiding close contact with dogs. Regular deworming of dogs, improved livestock slaughtering hygiene, and public education can help prevent transmission.[17]
Preventing infection in pigs can be accomplished by changing pig-raising practices in endemic areas. Prohibition of home-slaughter of sheep will prevent dogs from consuming infected viscera, thus disrupting the life cycle of the parasite. Sheep are vaccinated to help prevent cystic echinococcosis in some countries.[17]
Temporary elimination of Taenia solium transmission is possible through mass antiparasitic treatment of humans along with mass antiparasitic treatment and vaccination of pigs.[10] The Pan American Health Organization recommends preventive antiparasitic chemotherapy with niclosamide, praziquantel, or albendazole for control of T soliumin endemic areas.[24] Prolonged elimination will likely require additional measures.[25]
Preventive antiparasitic chemotherapy programs with praziquantel and albendazole are not without risk. As the time between infection and symptom development can be as long as 20 years, these drugs could be administered to people who have viable cysticerci in the brain but who are asymptomatic (asymptomatic neurocysticercosis). This could result in serious neurologic adverse events (e.g., status epilepticus, intracranial hypertension), relating to the development of an inflammatory reaction around the cysts, although the frequency appears to be low. These complications require emergency management, and the World Health Organization has produced guidance for management of these complications in rural areas where health infrastructure may be limited.[26] There is no risk of serious neurologic adverse events with niclosamide as it is not absorbed through the gastrointestinal tract and therefore does not reach the central nervous system.
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