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April 23, 1982

Diphyllobothriasis in Americans and Asians-Reply

JAMA. 1982;247(16):2231. doi:10.1001/jama.1982.03320410016009

In Reply.—  Since 1968, the PDDS of the CDC has provided niclosamide to physicians in the United States requesting it to treat patients with Diphyllobothrium and other cestode infections. In 1981 the PDDS filled 4,916 such requests, of which 212 were for reported fish tapeworm infections; 28 of these reported Diphyllobothrium infections were in persons with southeast Asian surnames.As Dr Dooley points out, the operculated eggs of various flukes (Trematoda) endemic in southeast Asia may resemble fish tapeworm (Diphyllobothrium) eggs, and lead to misdiagnosis when measurement of egg size is not used in stool examination to distinguish Diphyllobothrium (58 to 75 μm long) from these other parasites. Of course, it is possible that some reports to the PDDS of fish tapeworm infection in southeast Asian refugees may be mistaken. However, two screening studies1,2 of these refugees have reported a few fish tapeworm infections. Although Diphyllobothrium has not been