BPSC 69th CCE Prelims General Studies · Question 4 of 144

Correct — C, Both 1 and 2. Both statements are lifted almost word for word from the World Health Organization's fact sheet on taeniasis and cysticercosis, and both stand exactly as written. Statement 1: under "Transmission and burden" the fact sheet opens "Taeniasis is an intestinal infection caused by 3 species of tapeworm: Taenia solium (pork tapeworm), Taenia saginata (beef tapeworm) and Taenia asiatica." All three produce an adult worm in the human intestine and all three cause mild, non-specific symptoms — abdominal pain, nausea, diarrhoea or constipation — appearing about eight weeks after the infected meat is eaten, and an untreated T. solium infection generally persists for two to three years. WHO does add that only T. solium causes major health problems, and that T. saginata and T. asiatica have no major impact on human health, but that qualifier does not touch the statement: the claim is about what causes taeniasis, and three species do. Statement 2: the same fact sheet says the larvae, called cysticerci, may develop in the muscles, skin, eyes and central nervous system, and that "when cysts develop in the brain, the condition is referred to as neurocysticercosis (NCC)" — the statement is that sentence. The term is not a nicety. WHO calls neurocysticercosis the most frequent preventable cause of epilepsy worldwide, estimated to cause 30 per cent of all epilepsy cases in countries where the parasite is endemic and up to 70 per cent in specific high-risk communities where people and roaming pigs live close together; between 2.56 and 8.30 million people are estimated to be living with NCC, and its symptoms run from chronic headache and seizures to hydrocephalus, meningitis and blindness. Since neither statement contains an error, the answer is both.

• (a)Only 1 — Accepts the three species but rejects the brain terminology, usually because a candidate is unsure whether the condition is called neurocysticercosis or something built on the word taeniasis. It is neurocysticercosis, and WHO uses that exact wording — cysts in the brain, NCC in brackets. The term also carries the whole clinical weight of the parasite: imaging is the gold standard for diagnosing it, WHO has issued dedicated guidelines on its management, and it lies behind a large share of adult-onset epilepsy in endemic regions, which is why the World Health Assembly's Resolution 68.20 of 2015 on epilepsy is part of the response to this worm.
• (b)Only 2 — Rejects statement 1, almost always because the candidate has learned only two tapeworms — pork and beef — and treats the third name as invented. Taenia asiatica is a genuine third species, recognised from East Asia and transmitted through inadequately cooked pig liver tissue rather than muscle meat, and WHO lists it in the same sentence as the other two. The temptation is strengthened by a real fact half-remembered: WHO does say only T. solium causes major health problems. But "causes no major health problem" is not "does not cause taeniasis", and the statement makes only the second claim.
• (d)None of the above — Requires both statements to be wrong, but both reproduce WHO's published wording. The only route to this option is to confuse taeniasis with cysticercosis and then reject each statement for a fault that belongs to the other — deciding, for instance, that statement 1 must be about cysts because tapeworms are dangerous, and that statement 2 must be about the gut because taeniasis is intestinal. Separating the two diseases, and remembering that they arrive by two different routes, removes the temptation entirely.

Taenia is a cestode — a segmented flatworm of the phylum Platyhelminthes with a head, the scolex, bearing suckers and, in T. solium, a crown of hooks, followed by a chain of proglottid segments. It has no mouth and no gut and absorbs nutrients straight through its body wall, and each proglottid is hermaphrodite. The life cycle needs two hosts. The human is the definitive host, carrying the adult worm in the intestine; the pig or the cow is the intermediate host, in which swallowed eggs hatch and the larvae encyst as cysticerci in muscle. Eating undercooked infected meat completes the loop and gives a human taeniasis. The dangerous variant happens when that cycle is short-circuited: if a person swallows T. solium eggs directly — by the faecal-oral route, through contaminated food or water, or where open defecation lets eggs into the environment — the human becomes an accidental intermediate host, and larvae encyst in that person's own tissues. That is cysticercosis, and in the brain it is neurocysticercosis. The public-health shape of the disease follows from that two-host cycle. Because the parasite passes between people and pigs, no purely medical intervention can end it; WHO's package is explicitly One Health, pairing treatment of human carriers with vaccination of pigs using the TSOL18 vaccine and treatment with oxfendazole, an end to open defecation and to free-roaming pigs, and better meat inspection. It is also a disease of poverty: it concentrates in subsistence farming communities in Africa, Asia and Latin America, and it destroys the market value of the pigs those households depend on.

The statements are quotations, so the question rewards precision rather than cleverness, and both of the ways to get it wrong come from over-correcting. The first is arithmetic on species: a candidate who knows the pork tapeworm and the beef tapeworm assumes "three" must be padding and marks statement 1 false. It is not — Taenia asiatica is a separately described species with its own transmission route through pig liver. The second is a definitional slip, and it is the single discriminating idea on this card: taeniasis, cysticercosis and neurocysticercosis are three different things, and each is defined by a different combination of stage, site and route. Taeniasis is the adult worm sitting in the gut, acquired from meat, and is comparatively harmless. Cysticercosis is the larva in the tissues, acquired from eggs. Neurocysticercosis is that larva in the brain. Fix which of the three each statement is describing and neither can be rejected. Note the counter-intuitive consequence that follows: a vegetarian who never touches pork can still develop neurocysticercosis by ingesting eggs shed by a tapeworm carrier — which is exactly why WHO's control package is built around sanitation and pig husbandry rather than meat avoidance alone, and why the disease is a sanitation story as much as a food-safety one.

• WHO: taeniasis is an intestinal infection caused by three tapeworm species — Taenia solium (pork tapeworm), Taenia saginata (beef tapeworm) and Taenia asiatica; only T. solium causes major health problems, and taeniasis due to the other two has no major impact on human health.
• Transmission differs by species: T. solium from raw or undercooked infected pork, T. saginata from infected beef, and T. asiatica from inadequately cooked pig liver tissue. Symptoms are mild and appear about 8 weeks after the meat is eaten; an untreated T. solium infection generally persists 2–3 years.
• Cysticercosis is a different disease from taeniasis and is acquired by swallowing T. solium eggs by the faecal-oral route; the larvae, or cysticerci, may lodge in muscle, skin, the eyes and the central nervous system — and when cysts develop in the brain the condition is neurocysticercosis.
• WHO calls neurocysticercosis the most frequent preventable cause of epilepsy worldwide, estimated to cause 30 per cent of all epilepsy cases in endemic countries and up to 70 per cent in specific communities; between 2.56 and 8.30 million people are estimated to be living with NCC, and more than 80 per cent of the world's 50 million people with epilepsy live in low and lower-middle income countries.
• In 2015 the WHO Foodborne Disease Burden Epidemiology Reference Group identified T. solium as a leading cause of deaths from foodborne diseases, amounting to 2.8 million disability-adjusted life-years.
• Diagnosis: the Kato-Katz faecal test finds Taenia eggs but is not species-specific, so positives must be confirmed as T. solium; imaging is the gold standard for neurocysticercosis, and WHO published Target Product Profiles for NCC, taeniasis and porcine cysticercosis in 2017.
• Treatment: taeniasis takes a single dose of praziquantel (10 mg/kg) or niclosamide (2 g for adults and children over 6, 1 g for children aged 2–6), with albendazole 400 mg for 3 days also used. Neurocysticercosis needs specialist care — long, high-dose courses of albendazole and/or praziquantel with corticosteroids and anti-epileptic drugs, sometimes surgery — because destroying the cysts itself provokes inflammation.
• Control is a One Health package: treat human carriers, vaccinate pigs with TSOL18 and treat them with oxfendazole, end open defecation and free-roaming pigs, and improve meat inspection. WHO works with FAO and the World Organisation for Animal Health on the animal side, and WHA Resolution 68.20 (2015) frames the epilepsy response.

• Assuming there are only two Taenia species of medical importance and rejecting Taenia asiatica
• Treating cysticercosis as simply a severe form of taeniasis, when it comes from swallowing eggs rather than from eating meat
• Believing that avoiding pork rules out neurocysticercosis — the egg route means a person who never eats pork can still develop it

BPSC prefers a two-statement item quoted straight from an authoritative fact sheet, where the marks go to a candidate who can confirm terminology without second-guessing it — the source is usually a WHO, UNEP or ministry page from the previous year, and the safest instinct is to ask whether the sentence sounds like official prose rather than whether it sounds surprising. UPSC handles the same biology through classification and mechanism — whether a tapeworm is hermaphrodite, whether guinea worm is a nematode, which class of organism causes a named disease — so the recall it wants is deeper but the vocabulary is textbook rather than clinical, and a fact sheet alone will not carry a candidate through it.

• practice — not a real PYQ

  The condition in which the larval cysts of Taenia solium develop in the human brain is known as:

  • (a)Taeniasis
  • (b)Cysticercosis
  • (c)Neurocysticercosis
  • (d)Trichinosis

  Answer(c) Neurocysticercosis — cysticercosis is larval cysts anywhere in the tissues, and the brain-specific form is neurocysticercosis, WHO's most frequent preventable cause of epilepsy.

• practice — not a real PYQ

  Human cysticercosis is acquired mainly through which of the following routes?

  • (a)Eating undercooked pork containing cysticerci
  • (b)Ingesting Taenia solium eggs passed in human faeces, through contaminated food, water or hands
  • (c)The bite of an infected mosquito
  • (d)Drinking unpasteurised milk

  Answer(b) Ingesting Taenia solium eggs passed in human faeces, through contaminated food, water or hands — eating infected pork gives taeniasis, the adult worm in the gut, while swallowing eggs gives cysticercosis.