Phyllis Ritchie, M.D.

My family and I are about to get a rescue dog. The dog has tapeworms and my sister told me the worms can be transmitted to my children. Is this true?

Joe in Warrenton

Yes this is true. Your sister is correct.

The most common dog tapeworm in the United States is called Dipylidium caninum.  This infection is common and found throughout the world. The cycle begins when tapeworms are excreted in a dogs feces. Fleas ingest the feces and get the tapeworms in their guts. The dog then eats the infected flea by licking itself. Once the flea is digested in the dog, it develops into an adult tapeworm.

Dogs dont usually get very ill from tapeworms, though they may lose weight. The tapeworm may be diagnosed by actually seeing the worms in the feces or crawling near the dogs anus. The owner usually lets the vet know they saw the worms in their dogs feces, and then the dog is prescribed deworming medication (praziquantel).

Humans can get a tapeworm infection from their dog. For a person to get infected, they must accidentally swallow an infected flea. Most cases involve children. The children touch the dirt around where the dog defecates and then put their fingers in their mouths.  Parents will usually find evidence of the tapeworm in their childs stools or around their buttocks. The treatment is the same for humans as it is for dogs.

To prevent the infection from occurring altogether in dogs and humans, pet owners should keep the house and yard clean and free from fecal matter and treat dogs with flea products regularly to prevent infestations. Also, encourage hand-washing in children frequently after playing with the dogs.

My husband recently caught strep throat and took a week of antibiotics. He then got a severe bout of diarrhea. The doctor told him the diarrhea was caused by the antibiotics themselves, and he was given another antibiotic to cure the diarrhea. How can we prevent getting this complication in the future with antibiotic usage?

Marjorie in Portland

Antibiotic associated diarrhea can be a complication from taking any antibiotic. Antibiotics kill good bacteria and normal flora in the gut and allow overgrowth of bad bacteria (clostridium difficile) which causes the diarrhea.

The symptoms of clostridium difficile diarrhea (c. diff diarrhea) are frequent watery diarrhea, blood in the stool, fever, dehydration and severe stomach cramps. Usually, the symptoms are mild and the infection resolves on its own after stopping the antibiotics. Other times, the diarrhea requires treatment with an oral antibiotic (flagyl or vancomycin). 

Complete prevention of this antibiotic-associated complication is avoiding antibiotics altogether. Otherwise, take antibiotics only when absolutely necessary and use the antibiotics exactly as prescribed. Doubling up on missed doses may increase the chance of getting this infection. Probiotics may help prevent c. diff overgrowth.

The term probiotic means for life and refers to concentrated supplements of beneficial bacteria similar to those that occur naturally in the digestive tract. They are sold in health food stores and can be found in some yogurt. More studies need to be done on probiotics, but my feeling is they couldnt hurt.

In conclusion, if one needs to take antibiotics, make sure they are only taken for a limited amount of time, take them as directed, and get some probiotics at a health food store or eat some yogurt with probiotics already mixed in.

Doctor Phyllis Ritchie is a medical doctor who lives in Gearhart and Portland. If you have any medical questions for Dr. Ritchie please email them to drphyllisritchie@gmail.com