Hymenolepidosis is a chronic parasitic disease that develops when the tapeworm Hymenolepis nana or dwarf tapeworm enters the intestine.

The disease is spread almost everywhere in the world, with the exception of regions with a dry and hot climate, and in our country those infected are subject to mandatory medical examination.

Parasitism mainly affects the urban population and most often children between the ages of 4 and 14, due to the lack of established hygiene habits and especially their weaker immunity compared to adults .

parasite foci can form in kindergartens, schools and orphanages.
The source of helminthiasis is the infected person. Of secondary importance are rodents, rats and mice, which are susceptible to H. nana.

The greatest epidemiological significance as a source of the parasitosis is children, as well as workers in the food industry and staff caring for children in kindergartens.

Helmintosis is transmitted through the fecal-oral route – the main factors for the transmission of the invasion are toys, kitchen utensils, children’s pots, door handles, etc.. Dwarf tapeworm eggs can enter the mouth from dust, soil and food products, as they are carried by flies.

At room temperature, the eggs of H. nana remain viable for 1-2 days, on the fingers 3-4 hours, under conditions of constant humidity and water 3-4 weeks. A temperature of +60 degrees Celsius will kill all eggs in minutes and at -3 degrees Celsius, tapeworms die within 30-40 minutes. Drought and sunlight are harmful to eggs.

What are the symptoms?

The clinical picture differs, both in the presence or predominance of some symptoms, and in the degree of their acuteness. In 1/3 of those infected, the invasion proceeds subclinically.< /strong>

Due to the nature of the symptoms, 3 syndromes are distinguished – painful, dyspeptic and asthenoneurotic, since the digestive and nervous systems are initially affected.

The main complaints of those affected are: abdominal pain, loss of appetite, nausea, frequent changes in the structure of feces – mushy stools, malaise, weakness, fatigue, irritability and headache.

In the case of intense parasite infestations, the infected also show more severe symptoms: attacks of severe abdominal pain, frequent vomiting, dizziness, seizures, memory loss, hypothermia, insomnia.

In a number of patients, disorders in the functions of the liver, stomach, intestines, constant fatigue, mild anemia and eosinophilia are observed – increase in the levels of eosinophils in the blood. These are a type of white blood cells whose their main function is to destroy and remove proteins and aldehydes foreign to the body.

In children, the main complaints – loss of appetite, thirst, deterioration of memory abilities are joined by memory loss, convulsions without loss of consciousness, more severe anemia, leukopenia, monocytopenia and lymphocytosis.

Treatment of hymenolepidosis

Prazinquantel, albendazole and niclosamide are used for dehelminthization – destruction and removal of worms, the dose being determined depending on the weight and age of the patient.


The drug Fenasal is considered the most effective, but it is rarely imported into Bulgaria and the Regional Health Inspections rely on donations from European health organizations. Fenasal is administered orally in a daily dose:

• For adults between 2 and 3 grams, which represent 8 to 12 tablets.
• For children under 2 years of age 0.5 grams – 2 tablets;

The daily dose is divided into 4 parts and taken every 2 hours. It is taken for 4 days, then a break of 4-7 days is made. After the break, the treatment is repeated. 15 days after the course of treatment, tests are done for the presence of tapeworms.

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