Pigs ingest the eggs, which develop into larvae, then into oncospheres, and ultimately into infective tapeworm cysts, called cysticerci.

One is "primary hosting", called taeniasis, and is due to eating under-cooked pork that contains the cysts, resulting in adult worms in the intestines.

The other form, "secondary hosting", called cysticercosis, is due to eating food, or drinking water, contaminated with faeces from someone infected by the adult worms, thus ingesting the tapeworm eggs, instead of the cysts.

Human primary hosting is best diagnosed by microscopy of eggs in faeces, often triggered by spotting shed segments.

T. solium deeply affects developing countries, especially in rural settings where pigs roam free,[1] as clinical manifestations are highly dependent on the number, size, and location of the parasites as well as the host's immune and inflammatory response.

The anterior end is a knob-like attachment organ (sometimes mistakenly referred to as a "head") called a scolex, 1 mm in diameter.

A hermaphroditic species, each mature proglottid contains a set of male and female reproductive systems with numerous testes and an ovary with three lobes.

[9] The cirrus, a sex organ at the terminus of the vas deferens, and vagina open into a common genital pore or atrium.

[citation needed] The tiny oncosphere larvae, activated by exposure to host enzymes and bile salts,[15] penetrate the intestinal wall and migrate in the blood stream or lymphatics to reach sites where they can develop into cysticerci.

[17] The common one is the ordinary "cellulose" cysticercus, which has a fluid-filled bladder 0.5 to 1.5 cm (¼" to ½") in length and an invaginated scolex.

In the secondary host, the eggs develop into oncospheres which bore through the intestinal wall and migrate to other parts of the body where the cysticerci form.

Each microscopic cysticercus is oval in shape, containing an inverted scolex (specifically "protoscolex"), which everts once the organism is inside the small intestine.

[22] The exact life span of an adult worm is not determined; however, evidences from an outbreak among British military in the 1930s indicate that they can survive for 2 to 5 years in humans.

The zygote undergoes holoblastic and unequal cleavage resulting in three cell types, small, medium and large (micromeres, mesomeres, megameres).

The surviving oncospheres preferentially migrate to striated muscles, as well as the brain, liver, and other tissues, where they settle to form cysts — cysticerci.

[25] Humans are also accidental secondary hosts when they are colonised by embryonated eggs, either by auto-colonisation or ingestion of contaminated food.

Such symptoms will arise when the tapeworm has fully developed in the intestine, this would be around eight weeks after the contraction (ingestion of meat containing cysticerci).

[1][29] In more severe cases, dementia or hypertension can occur due to perturbation of the normal circulation of cerebrospinal fluid.

The severity of cysticercosis depends on location, size and number of parasite larvae in tissues, as well as the host immune response.

The downside of this tool is it has high costs, an ELISA reader and reagents are required and trained operators are needed.

[31] A studies using Coproantigen (CoAg) ELISA methods are considered very sensitive but currently only genus specific.

[32] A 2020 study in Ag-ELISA test on Taenia solium cystercicosis in infected pigs and showed 82.7% sensitivity and 86.3% specificity.

[33] Current standard for serologic diagnosis of NCC is the lentil lectin-bound glycoproteins/enzyme-linked immunoelectrotransfer blot (LLGP-EITB).

[38] A 2014 double blind randomized control study showed increased parasiticidal effect with albendazole plus praziquantel.

[42] T. solium is found worldwide, but its two distinctive forms rely on eating undercooked pork or on ingesting faeces-contaminated water or food (respectively).

[43] In Europe it is most common in pockets of Slavic countries and among global travelers taking inadequate precautions in eating pork especially.

[13][44] The secondary host form, human cysticercosis, predominates in areas where poor hygiene allows for mild fecal contamination of food, soil, or water supplies.

Rates in the United States have shown immigrants from Mexico, Central and South America, and Southeast Asia bear the brunt of cases of cysticercosis caused by the ingestion of microscopic, long-lasting and hardy tapeworm eggs.

[45] For example, in 1990 and 1991 four unrelated members of an Orthodox Jewish community in New York City developed recurrent seizures and brain lesions, which were found to have been caused by T. solium.

Global prevalence rates remain largely unknown as screening tools, immunological, molecular tests, and neuroimaging are not usually available in many endemic areas.