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PubMed1977

[Involvement of the nervous system in trichinosis (author's transl)].

Since the introduction of the obligatory inspection of meat, trichinosis has become a very rare disease in Germany. Nevertheless, the possible occurrence of sporadical epidemies and isolated cases of trichinosis has to be kept in mind. During the last 30 years about 1300 cases of human trichinosis have been reported in Germany. The involvement of the central nervous system ranges from 6-24%; the symptoms may be caused by meningeal inflammation or/and a focal or generalized encephalitis. Myelitis is a very rare finding, some patients develop signs of peripheral neuropathy. During the acute stage pareses may be caused as well by myositis as by peripheral neuropathy. Various serological tests allow to confirm the diagnosis of trichinosis, but muscle biopsy is still the most informative piece of evidence leading to the diagnosis of trichinosis. Tiabendazole (trade name in Germany: Minzolum) is at present the drug of choice in the treatment of trichinosis; in addition good results have been found by corticosteroid therapy. Although most cases have a good prognosis, chronic sequelae may occur (for instance "rheumatic" pains in the muscles, loss of reflexes, convulsions and psychiatric distrubances).

Biopsy↗
PubMed1996

[The epidemiological and clinical features of 208 patients with trichinosis].

In order to know the epidemiological and clinical features of trichinosis, the data of 208 patients with trichinosis from 1992 to 1994 were analysed. The results showed that these patients came from 11 districts, and acquired the infection mainly by tasting the raw pork filling for dumplings or ingesting instant-boiled pork or mutton. The incidence of trichinosis is high in winter. Young and middle-aged workers and cadres constituted the majority of the patients and the infection was more common in the males than in females. The main clinical manifestations of trichinosis were prolonged fever, general myalgia, muscle weekness and eosinophilia. Most of the patients had no gastrointestinal symptoms and skin eruption. Eyelid edema was only seen in the early stage. Serological tests were significant value in the diagnosis of trichinosis. The key measures to prevent trichinosis were that meat inspection should be strictly carried out and bad eating habit changed.

Adolescent↗
PubMed1981

Trichinosis-related polyarteritis nodosa.

During an outbreak of trichinosis, two young men--one with established trichinosis and the other with suspected infection--were found to have clinical, radiologic and histologic stigmata of a systemic necrotizing vasculopathy equivalent to classic polyarteritis nodosa. The parasitosis manifested as a pentad of fever, myalgias, facial edema, eosinophilia and hyperimmunoglobulinemia E. Features of the arteritis included mononeuritis multiplex, pain in the abdomen and joints, weight loss, hypertension, leukocytosis, thrombocytosis, microhematuria and raised alkaline phosphatase levels. A sustained remission was achieved by the administration of thiabendazole, prednisone and cyclophosphamide. Pathogenetic links between the two diseases are presented: (1) deposition of circulating immune complexes in the vessel wall; (2) adjuvant activity with cross reaction between parasitic antigen and human vessel wall; (3) immunoglobulin E (IgE) aggregates and soluble antigen IgE complexes precipitation in vessel wall; and (4) hypereosinophilia-induced tissue damage. A causal relationship of trichinosis to polyarteritis nodosa is persuasive, and we suggest that cases of hepatitis B surface antigen (HBsAg) negative polyarteritis nodosa, especially those in which myalgias and eosinophilia are prominent, may be related to trichinosis and that, conversely, patients with trichinosis and multiorgan disease should be studied for polyarteritis nodosa.

Adult↗
PubMed2002

[Current epidemiological situation of trichinosis in Chile. 1991-2000].

BACKGROUND: Human and animal trichinosis has been recorded in Chile since the late XIX century and is irregularly distributed along the country. From high rates of infection in the early 1900, the frequency of this parasitosis in man has progressively decreased. AIM: To describe and discuss the epidemiological situation of trichinosis in Chile during the decade 1991-2000. MATERIAL AND METHODS: Human infection was assessed using annual incidence and lethality reports provided by the Ministry of Health, periodic photostrichinoscopies in corpses of non selected individuals autopsied at the Medico Legal Service and periodic national serologic surveys. The advise of one of the authors in an epidemic that occurred in 1999 in the VIII Region was also used. Animal infection was assessed using the annual prevalence of infection in pigs slaughtered in abattoirs, furnished by the Ministry of Health. RESULTS: A total of 631 clinical cases with 4 deaths (0.6%) was recorded. A decline in the incidence, from 0.7 x 100,000 in 1991 to 0.2 x 100,000 in 2000 was recorded. The higher frequency of the parasitosis was observed in the Metropolitan, VI, VIII and X regions. Although human trichinosis has been observed in all seasons, its frequency increases in close relation with the higher pork consumption in cold seasons (45.8% in winter and 37.5% in spring). There has been a decrease of infection rates in pigs from 0.17@1000 in 1991 to 0.04@1000 in 1998-2000. CONCLUSIONS: The incidence and prevalence of trichinosis shows a constant decline in Chile. Considering the geographical characteristics of Chile, it is possible that an undetermined number of pigs are home reared and butchered without veterinary control, constituting an important source of human trichinosis.

Adolescent↗
PubMed1992

[A family outbreak of trichinosis acquired in Israel].

Trichinosis is a parasitic disease transmitted to man by ingestion of contaminated raw meat, usually pork, containing cysts of Trichinella spiralis. Formerly appearing as serious epidemics, it has now become uncommon due to public health control measures. Since the Jewish and Moslem religions forbid consumption of pork, the disease is even rarer in Israel. The literature indicates that all the cases of trichinosis hospitalized in Israel were contaminated abroad. We describe an Israeli family in which trichinosis following the eating of boar meat, hunted along Israel's northern sea coast (Hof HaCarmel). We believe that this is the first report of trichinosis acquired in Israel. Only family members who ate the meat raw became ill, while those who ate it well-cooked were spared. However, not all of our cases were symptomatic, some showing only laboratory evidence (eosinophilia and a rise in CPK). In accord with postmortem data in the USA, this indicates that trichinosis is probably more common than estimated due to the many asymptomatic cases (about 4% of all Americans).

Adult↗
PubMed2004

[Trichinosis outbreak among Thai immigrant workers in the Hadera sub-district].

INTRODUCTION: Trichinosis also referred to as Trichinelliasis or Trichiniasis occurs sporadically in Israel and is not prevalent. Most reported cases have occurred in foreign born residents who were infected outside of Israel or in foreign workers who have eaten raw or undercooked meat. We report an outbreak of Trichinosis in Thai agricultural workers that occurred in February-March 2002. Of 120 workers in Moshav Sde Yitzchak, 30 became ill with thrichinosis. To the best of our knowledge, this is the largest outbreak of its kind reported in Israel. OBJECTIVES: To alert physicians in hospitals and clinics to consider the possibility of trichinosis in their differential diagnosis in light of the substantial population of foreign born workers in Israel, currently estimated at 238,000. We describe the outbreak and review the symptoms and signs of the disease, as well as the modes of transmission and treatment. RESULTS: Eosinophilia was found in 22 (73.3%) of the cases. The average CPK level in 27 of the cases was 1312. Antibodies to trichinella were positive in the 12 persons who agreed to be tested. CONCLUSION: The demographic changes in Israel over the past years should lead physicians to consider trichinosis in their differential diagnosis when presented with a patient with a suggestive history as well as compatible signs and symptoms. The physician has a legal obligation to report outbreaks of trichinosis to the District Health Office. Health education for at-risk populations is indicated.

Agriculture↗
PubMed2005

Intercellular adhesion molecule-2 (ICAM-2) in experimental trichinosis.

The estimation of the serum adhesion molecules (ICAM-2) levels in experimental trichinosis and evaluation of its impact on the course of infection as well as its possible role in the diagnosis of early trichinosis were studied. Serum levels of ICAM-2 correlated significantly with the inflammatory and course sequences of trichinosis in mice and had a similar relation with blood eosinophilia. So, estimation of ICAM-2 serum levels may prove useful in diagnosis of trichinosis recent infections, and in monitoring the prognosis and response to treatment. Investigations of the ICAM-2 role in human trichinosis and applying the findings to improve the diagnostic approaches are highly recommended.

Animals↗
PubMedDate not supplied

[The epidemiological and clinicoimmunological aspects of the outburst of trichinosis in the Krymsky District of the Krasnodar Territory].

The present paper presents the epidemiological and clinicoimmunological aspects of the outburst of trichinosis in the Krymsky District of the Krasnodar Territory in January 2001. Six hundred and forty-eight persons ate infested wild boar meat, 119 (74.8%) fell ill with moderate and severe trichinosis. The authors provide the results of 3.5-year immunological studies of the patients with trichinosis and convalescents, infection-risk and healthy individuals; those of autopsies of the corpses of those who died from accidental causes unassociated with trichinosis, as well as examinations of domestic, synanthropic, and wild animals. The findings indicate that there is a focus of trichinosis with the low level of endemia in the Krymsky District of the Krasnodar Territory.

Adolescent↗
PubMed2005

[Use of the Western Blot assay in the diagnosis of trichinosis.].

Trichinosis is a worldwide parasitic disease acquired by the consumption of raw or uncooked meat containing encysted larva. The western blot (WB) technique has an important role in the serological diagnosis of trichinosis as a confirmatory test. In our study, IgG antibodies specific for Trichinella were found in the sera of 25 patients with trichinosis seropositivity by In house ES ELISA. Of 10 control individuals, 2 were found to be positive for toxocariasis, 2, positive for fascioliasis and 6 were found to be healthy by the WB test. In WB analysis, serum samples from the 25 persons suffering from trichinosis showed common profile bands with the band size ranging from 14 to 123 kDa. These serum samples showed the following important three antigenic bands with different sensitivities of 45 kDa (88.0%), 55 kDa (60%), and 88-90 kDa (64%). As a result of this study, these three antigenic bands in WB test are considered to be valuable in the diagnosis of human trichinosis.

English Abstract↗
PubMedDate not supplied

Sylvatic trichinosis in British Columbia: potential threat to human health from an independent cycle.

The results of a 3-year study of trichinosis in British Columbia wild-life, based on the testing of more than 9,000 tissue specimens from a large variety of animal species, indicated that trichinosis is widespread among wild mammals in the southern and central parts of British Columbia. This continuing survey has established that the disease is carried by at least 15 species of terrestrial mammals including 3 species of rodents. The finding of Trichinella spiralis in ground squirrels and nonsynanthropic mice may be the first reported in North America. Although trichinosis appears to be eradicated in domestic pigs in British Columbia, a sylvatic cycle of the disease continues to exist independently and poses a potential threat to human health. It is possible for human beings to contract trichinosis by consuming inadequately cooked meat from certain wildlife species, especially bears, as well as meat products (such as pork or beef sausage) to which game meat has been added; several local outbreaks were caused by this source. Another hazard of unknown potential is the spread of trichinosis from the wild animal reservoir--from rodents in particular--to domestic pigs and thus to man.

Animals↗
PubMed1999

Low incidence of cardiac abnormalities in treated trichinosis: a prospective study of 62 patients from a single-source outbreak.

PURPOSE: The reported incidence of cardiac involvement in trichinosis is highly variable, ranging from 21% to 75%. This study sought to determine the incidence and type of cardiac lesions in trichinosis using serial echocardiographic examinations. SUBJECTS AND METHODS: Sixty-two consecutive patients admitted to the Banja Luka Medical Center during an outbreak of trichinosis (November to December 1996) were included in the study. Diagnosis was made by typical clinical presentation, positive epidemiologic history, serologic testing, and the detection of Trichinella larvae in contaminated meat. All patients underwent serial electrocardiograms and two-dimensional and Doppler echocardiographic examinations within 20 days after the onset of symptoms. Repeated echocardiographic examinations were performed weekly during the hospital stay in all patients with electrocardiographic abnormalities or an abnormal initial echocardiogram. RESULTS: Cardiac involvement (electrocardiographic and/or echocardiographic changes) was detected in 8 (13%) of the 62 patients. Nonspecific transient electrocardiographic ST-T changes were found in 6 patients (10%); 1 patient had frequent premature ventricular complexes. Echocardiographic examinations revealed pericardial effusions in 6 patients (10%), 5 of whom had minimal effusions without impairment of global and regional left ventricular systolic function. One patient had hypokinesis of the interventricular septum with a small pericardial effusion, both of which resolved within 2 weeks. Only 2 of the patients with electrocardiographic abnormalities lacked echocardiographic evidence of cardiac involvement. At 6-month follow-up, none of the patients had electrocardiographic or echocardiographic abnormalities. CONCLUSIONS: The incidence of cardiac involvement in trichinosis appears to be lower than previously reported. Pericardial effusion is the most common manifestation of cardiac involvement, and nonspecific transient electrocardiographic changes, traditionally ascribed to myocarditis, more frequently reflect pericarditis.

Adult↗
PubMed1991

[Retinochoroidopathy in a patient with seropositive trichinosis].

A 28 years old butcher contracted a systemic trichinosis after fasting sausage. Twelve days after onset of systemic symptoms he developed a hemorrhagic maculopathy in his left eye. In addition, on both eyes there were focal atrophies of the retinal pigment epithelium in the mid-periphery. We believe a causal connection of the maculopathy with his serologically proven trichinosis as a retinal involvement is well known in trichinosis and histologically demonstrated by Herrenschwand (1928). To our knowledge this is the first case of hemorrhagic maculopathy in trichinosis.

Adult↗
PubMed1992

A trichinosis outbreak among Southeast Asian refugees.

The number of cases of trichinosis reported to Centers for Disease Control has declined steadily, with an average of only 44 cases per year from 1984 through 1988. This decline was almost entirely due to a reduction in cases acquired from ingestion of fresh commercial pork. However, from July 21 through September 3, 1990, 90 (72%) of 125 Southeast Asian refugees from six states and Canada developed trichinosis after attending or eating pork sausage taken from a wedding held in Des Moines, Iowa, on July 14, 1990. Eating uncooked sausage prepared at home from commercially obtained pork was associated with the development of this illness (odds ratio = 34.0, p less than 0.001). Analysis by amount of pork consumed was significant (Mann-Whitney U rank sum test, p less than 0.001). This outbreak of trichinosis in Iowa is the fourth reported within the last 15 years among the 900,000 Southeast Asian refugees resident in the United States and one of the largest reported outbreaks in US history. The continued presence of Trichinella spiralis in commercial pork emphasizes the need for further education and control measures for persons whose dietary habits place them at risk for developing trichinosis.

Animals↗
PubMed1976

Suppression of giardiasis during the intestinal phase of trichinosis in the mouse.

The interaction of the intestinal phases of Giardia muris and Trichinella spiralis was investigated in Swiss albino mice. Intraoesophageal inoculation of G. muris cysts seven days before, or seven days after, similar inoculation of T. spiralis larvae resulted in significant reduction in the numbers of Giardia trophozoites in small bowel and Giardia cysts in stools. This effect was not observed when G. muris cysts were administered after resolution of the intestinal phase of trichinosis. Giardiasis had no effect on trichinosis as assessed by numbers of adult worms in small bowel and larvae in skeletal muscles. Studies of small bowel morphology showed that the intestinal phase of trichinosis was associated with increased numbers of inflammatory cells in the lamina propria, a significant increase in Paneth cells in crypts, and a marked reduction in the villus:crypt ratio of jejunum. These observations suggest that the intestinal phase of trichinosis induced environmental changes in small bowel, perhaps related to inflammation, which resulted in suppression of proliferation of Giardia trophozoites.

Animals↗
PubMed1975

Trichinosis (Trichinella spiralis infestations) in wild animals of the Kruger National Park.

In Africa trichinosis is essentially a disease of wild carnivores. Once established in a suilline cycle it becomes a more important threat to man. The results of tests on 8,000 specimens of 20 wildlife species in the Kruger National Park are discussed and the epizootiology of trichinosis in South Africa is briefly reviewed. The first case of trichinosis in an African civet, Viverra civetta Schreber, 1776, is reported. The confirmed absence of trichinosis in true herbivores is of practical significance in view of the increasing utilization of game meat as food.

Animal Diseases↗
PubMed2006

[Epidemiological characteristics of trichinosis in Federation of Bosnia and Herzegovina].

The territory of Bosnia and Herzegovina, by its geographical setting and climate characteristics has the conditions for breeding and spreading the cause of trichinosis in environment. This, under certain conditions, in the context of different socio-economic, social and zoological-sanitary circumstances, can lead to the periodical epidemic outbreaks of the disease among people on a small or larger scale. Data on registered cases of human trichinosis collected during annual monitoring of trichinosis cases on the territory of Federation of Bosnia and Herzegovina in the past fourteen years, show its continual presence in this area, with a varying rate of morbidity, from 0,1 (2002) to 11,73 (1998) per 100.000 inhabitants. In the mentioned period, during 51 epidemics, 775 cases of trichinosis have been registered altogether, with approximately 10-15 cases per outbreak.

Adolescent↗
PubMed1991

Trichinosis surveillance, United States, 1987-1990.

Since the Public Health Service began recording statistics on trichinosis in 1947, the number of cases reported by state health departments each year has declined. In the late 1940s, health departments reported an average of 400 cases and 10-15 deaths each year; from 1982 through 1986, the number declined to an average of 57 cases per year and a total of three deaths for the period. From 1987 through 1990, 206 cases of trichinosis from 22 states, including 14 multiple-case outbreaks, were reported to CDC. In 1990, two large outbreaks associated with commercial pork accounted for 106 cases. In the 192 instances in which a suspect food item was identified, pork was implicated in 144 (75%) cases, walrus meat in 34 (18%), and bear meat in 14 (7%). Sausage, the most frequently implicated pork product, was associated with 128 of the 139 cases for which a form of ingested pork was specified. Before 1990, the proportion of cases of trichinosis attributable to consumption of commercial pork had declined steadily. This decline was probably due to a combination of factors, including laws prohibiting the feeding of garbage to hogs, the increased use of home freezers, and the practice of thoroughly cooking pork. Although the incidence of trichinosis has decreased substantially since national reporting was initiated in 1947, a dramatic increase in 1990, resulting from two large outbreaks, emphasizes the need for further education and control measures.

Adolescent↗
PubMedDate not supplied

[The indirect hemagglutination reaction in the diagnosis of trichinosis].

An indirect hemagglutination test (IHAT) for trichinosis using a Melcher's antigen was evaluated and compared with a precipitin test (PT) and a bentonite flocculation test (BFT). One hundred and forty eight serum samples from patients from the whole country confirmed or suspected to have trichinosis by clinical or epidemiological evidences were studied: 117 (79.1%) samples resulted positive by IHAT, 138 (93.2%) by PT and 65 (43.9%) by BFT. Sixty three serum samples from patients with strong clinical suspect of trichinosis presented the PT and the BFT positive and were compared with the IHAT for sensitivity study. IHAT was positive in 60 (95.2%) serum samples. In order to determine the specificity of IHAT 25 serum samples from healthy volunteers and 124 serum samples from individuals with other parasitoses, such as cysticercosis (48), hydatidosis (45) and fascioliasis (31) were studied. The specificity, using a titre > or = 1:16 as a possible diagnostic value was 96%. The use of IHAT with RP and BFT in the diagnosis of human trichinosis is discussed.

Complement Hemolytic Activity Assay↗