DEAR DR. DONOHUE: Is it true that someone can get worms in the brain from eating undercooked pork? I know you can get worms, but in the brain? – D.

ANSWER: The pork tapeworm has a complicated, somewhat distasteful life history, one best avoided while eating.

There are two different consequences that can occur should one eat either pork tapeworm eggs or pork tapeworm cysts. If a human ingests the eggs, the eggs hatch in the digestive tract and mature into larvae, which penetrate the intestinal lining and find their way into the circulation. From there, they are swept to various body sites ­- the muscles and the brain being the two principal ones. In tissues, like the brain, the larvae form cysts that enlarge, compress the brain and lead to a variety of symptoms. This illness does not originate in pigs. It comes from tapeworm eggs that infected humans pass in their stool. The eggs find their way to food and into a variety of drinks. Don’t blame this infection on pigs; blame it on humans.

The second kind of infection comes from eating pork that has tapeworm larvae cysts in it. Pigs get this infection from human feces containing the eggs. If pork with cysts is not cooked thoroughly, digestive juices in the human gut peel away the cyst, and the immature form within it develops into an adult tapeworm. The worm’s head is in the small intestine, and its body grows to anywhere from 7 to 16 feet (about 2 to 5 meters) long. In the intestine, the adult worm most often causes no symptoms other than revolting a person when he or she learns it’s living in his or her digestive tract.

In Canada and the United States, either infection is a rarity because pigs here are raised under sanitary conditions. All the same, pork should be cooked until the meat reaches a temperature of 160°F (71°C). A meat thermometer is a piece of equipment that should be found in everyone’s kitchen. Cook all meat until it is well-done.

DEAR DR. DONOHUE: My daughter is 37 years old, the mother of three lovely children, and the wife of a very generous and caring man. She is a wonderful mother and a spotless homemaker. However, she is afraid to leave her house. She won’t go anywhere. She says that when she leaves the house, she becomes terribly frightened. Her heart races, she sweats and she feels like she is going to pass out or die. Her husband has taken her to the emergency room on two separate occasions. The doctors can find nothing wrong with her. What do you think is going on? – C.F.

ANSWER: Your daughter has agoraphobia, a fear of going into public places. It a form of panic attacks, which are episodes of intense fear in situations that ought not to generate any fear. The attacks make people tremble, sweat, have racing hearts, develop chest pain and feel like they are at the point of dying. All of these sensations are quite real and quite terrifying. Affected people do anything to avoid them, even if it means they have to become housebound.

It’s not likely that your daughter will get better on her own. She needs to see a mental-health professional. The family doctor can recommend one. Such a person can show your daughter how irrational her thinking has become and can desensitize her to the situations that provoke attacks. Medicine can help her cope while she’s learning how to resume a more normal existence.

DEAR DR. DONOHUE: Is it hard to diagnose Hodgkin’s disease? I ask for a personal reason. – K.O.

ANSWER: Hodgkin’s disease is lymph node cancer.

People with the illness often run a low-grade fever, lose weight, are constantly tired and sometimes complain of itching. The most prominent sign of Hodgkin’s disease is swollen lymph nodes that can be felt in the neck, under the arms, above the collarbone and in other places. When a person has swollen lymph nodes and the other symptoms I mentioned, then the diagnosis is not hard to make.

However, if nodes buried deep in the body are the only ones that have become large, the diagnosis is much more difficult to make.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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