Diphyllobothriasis in a U.S. Military Aviator

Area of Science:

• Parasitology
• Infectious Diseases
• Aerospace Medicine

Background:

• Diphyllobothriasis, caused by the fish tapeworm, affects millions globally.
• This is the first reported case in a United States military aviator.
• Infection occurs via consumption of raw or undercooked freshwater or anadromous fish.

Observation:

• A 32-year-old F-22 pilot presented with gastrointestinal symptoms.
• The pilot self-identified and extracted tapeworm segments.
• Diagnosis confirmed as diphyllobothriasis (likely D. latum or D. nihonkaiense) based on ova and proglottid morphology.

Findings:

• Successful treatment achieved with a single oral dose of praziquantel (>10 mg·kg⁻¹).
• Post-treatment stool examinations remained negative for 60 days.
• The pilot likely contracted the infection from raw fish consumption (sushi/sashimi) while stationed in Japan.

Implications:

• Mild physical symptoms contrasted with significant psychological distress and operational distraction for the aviator.
• Prompt treatment was essential for the resumption of military aviation duties.
• Education on safe fish consumption practices (thorough cooking or freezing) is recommended for aviators, particularly when consuming cultural cuisines.