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PubMedDate not supplied

[Neurologic manifestations in trichinosis].

Neurologic manifestations are present in about 10-20 percent of patients with trichinosis. They could be a serious diagnostic problem in the absence of corresponding epidemiological data and typical symptoms and signs of the disease. In untreated patients the mortality rate is about 50%. Several pathogenic mechanisms are responsible for the neurological complications in trichinosis: obstruction of brain blood vessels by larvae, cysts or granulomas, toxic vasculitis with secondary thrombosis and haemorrhages, granulomatous inflammation of the brain parenchyma and allergic reaction. Neurotrichinosis is manifested with clinical symptoms and signs of meningitis, encephalitis, polyradiculoneuritis, poliomyelitis, myastenia gravis, paresis and paralysis, with the clinical picture of systemic disease of the connective tissue involving the nervous system and, extremely rare, as a sinus thrombosis. Thus, the broad spectrum of neurological lesions in trichinosis is, probably, the results of the fact that Trichinella spiralis larvae, during haematogenic dissemination has no special affinity for particular parts of the nervous system. We present five patients with encephalitis and focal cerebral lesions in trichinosis. In one patient the neurologic manifestations were the only sign of the disease. We believe that all pathogenic mechanisms mentioned above, were involved in the onset of neurological manifestations in our patients. The diagnosis of the disease was based on the clinical picture, epidemiological data, microscopic identification of larvae in the muscular tissue, the presence of antibodies against Trichinella spiralis in cerebrospinal fluid (with preserved blood brain barrier) and in serum confirmed by IIF method, computerised tomography and magnetic resonance imaging of the brain, eosinophilia in the peripheral blood picture. One patient died, and in the remaining patients the course of the disease was favourable; they were discharged from the hospital with minimal neurologic sequelae.

Adult↗
PubMed2004

Application and assessment of a dipstick assay in the diagnosis of hydatidosis and trichinosis.

The aim of the present work was to apply and evaluate a dipstick assay for the serodiagnosis of human hydatidosis as well as human and experimental trichinosis using camel hydatid cyst fluid (HCF) and Trichinella spiralis muscle larval (TSML) antigens, respectively, and compare this to enzyme-linked immunoelectrotransfer blot (EITB) and Falcon assay screening test-enzyme-linked immunosorbent assay (FAST-ELISA). Sera samples were collected from patients with confirmed hydatidosis and trichinosis and with other parasitic diseases as well as from normal healthy individuals. Also, sera samples were collected from mice experimentally infected with T. spiralis which were sacrificed at different time points post-infection (PI). HCF and TSML antigens were used in EITB after separation and characterization of their antigenic components using 5-22.5% sodium dodecyl sulphate-polyacrylamide gel electrophoresis under non-reducing condition. For the diagnosis of hydatidosis, the sensitivity, specificity and diagnostic accuracy of the dipstick assay and EITB were 100, 91.4 and 95.1% while those of FAST-ELISA were 96.2, 100 and 98.4%, respectively. For the diagnosis of human trichinosis, the sensitivity, specificity and diagnostic accuracy of the dipstick assay and EITB were 100% while those of FAST-ELISA were 85.7%. FAST-ELISA proved to be more sensitive in the early diagnosis of experimental T. spiralis infection (100% sensitivity from the second week PI) than the dipstick and EITB (100% sensitivity from the third week PI). All tests retained their sensitivity till the 12th week PI. Since the dipstick assay is extremely easy to perform with a visually interpreted result within 15 min, in addition to being both sensitive and specific, the test could be an acceptable alternative for use in clinical laboratories lacking specialized equipment and the technological expertise needed for EITB and FAST-ELISA.

Adolescent↗
PubMed1975

Studies of immunoglobulins, bentonite flocculation and IgE, IgG and IgM antibodies in serum from patients with trichinosis.

Serial serum samples were obtained from two patients from a family of four who ingested raw pork at a known time and in whom trichinosis developed. Single and occasionally two serum samples were obtained from other patients with proved trichinosis. Studies of these serum samples showed that elevations of serum immunoglobulin E (IgE) levels do occur but not in all serum samples and that even when these levels are elevated, they are not high enough to be of diagnostic value. This is also true for serum immunoglobulin M (IgM). Using a solid phase radioimmunoadsorbent test, IgE, IgG and IgM antibodies were detected in the serums. The IgE antibody activity appeared early but was not present in all samples. The IgM antibody activity appeared later than the IgE and IgG antibody activity, and there was a statistically significant correlation between IgM antibodies as determined by radioimmunoassay and the bentonite flocculation titers suggesting that the bentonite flocculation is due to IgM antibody. IgM antibodies detected by radioimmunoassay were positive in all serum samples from patients with trichinosis except for a sample obtained 3 days after the onset of symptoms. The early increase in IgG antibodies and the occurrence of these antibodies in all serum samples obtained more than 3 days after onset of symptoms suggest a potential diagnostic use if serial samples are available early in the course of the disease.

Bentonite↗
PubMed1977

Trichinosis in an immunosuppressed human host.

The clinical presentation and autopsy findings in the case of a patient with acute myelomonocytic leukemia and trichinosis are described. Cellular immunity is an important host defense against nematode infections such as strongyloidiasis. It is therefore probable that the severe trichinosis seen in this immunosuppressed patient was more than coincidental. Due to concomitant failure of humoral immunity, serodiagnosis of trichinosis would have been impossible. The only means of making the diagnosis antemortem would have been muscle biopsy.

Female↗
PubMed1993

Trichinosis with ventilatory failure and persistent myocarditis.

Life-threatening infections with Trichinella spiralis are rare in countries that have adopted laws requiring cooking of raw garbage fed to pigs. Thus such infections may pose a diagnostic dilemma for clinicians unfamiliar with their presentation. We report a case of imported trichinosis in a Mexican national who developed respiratory failure, myocarditis, and sinus arrest. The patient recovered uneventfully after the administration of benzimidazole and corticosteroid drugs, although a pacemaker was required to maintain normal cardiac rhythm. Symptomatic myocarditis is a rare complication of trichinosis that is often associated with increased morbidity and mortality. This report illustrates and reviews important features of the epidemiology, clinical presentation, and management of trichinosis.

Adult↗
PubMedDate not supplied

Trends in the incidence and transmission patterns of trichinosis in humans in the United States: comparisons of the periods 1975-1981 and 1982-1986.

Since 1947, the U.S. Public Health Service has recorded statistics on reported cases of trichinosis in humans. More complete clinical and epidemiologic data on cases became available after 1965, when trichinosis was officially made a notifiable disease. The numbers of reported cases declined markedly from an average of approximately 400, with 10-15 deaths reported each year in the late 1940s, to 57 per year, with three deaths in the 5 years 1982-1986. Although annual incidence was highest in sparsely populated Alaska, the highest numbers of cases are reported from the northeastern United States. Food sources of this infection vary in different geographic regions. The decline in annual incidence during the past 12 years appears to be accounted for largely by a decline in the number of cases attributed to commercially purchased pork, although pork products continue to be the major source of infections in humans. The number of cases due to ingestion of wild animal meat have remained relatively constant. Activities at the national and state level that have improved the prospects for control and prevention of trichinosis in commercial products are discussed.

Animals↗
PubMed1993

Trichinosis: a prospective controlled study of patients ten years after acute infection.

The existence of chronic trichinosis as a disease entity is still a matter of debate. For 10 years after an outbreak of infection with Trichinella spiralis, we conducted a prospective controlled study of the patients involved. At the termination of this investigation, we undertook clinical, biochemical, serological, immunologic, neuroradiological, radiological, and psychological studies of 128 originally infected persons and 16 controls. The categories of symptoms most often documented in persons who had been infected were muscular (90%), ocular (59%), neurological (52%), and psychological (52%). Impaired muscle strength (56%), conjunctivitis (55%), and impaired coordination (32%) were the clinical manifestations most frequently encountered. Thirty-eight percent of the 128 originally infected patients still had IgG antibodies to T. spiralis after 10 years. Magnetic resonance imaging of the brain revealed no abnormalities. No calcifications of residual larvae were detected by mammography or muscle biopsy. The level of performance in psychometric tests was lower in the originally infected population than in the general population. Although patients who had had trichinosis differed significantly from controls in terms of a variety of parameters even after 10 years, we found insufficient evidence on which to conclude that chronic trichinosis exists as a distinct entity.

Adult↗
PubMed1976

An epidemic of trichinosis after ingestion of wild pig in Hawaii.

Forty-five percent of young adults who ate roast wild pig at a barbecue in Hawaii experienced an illness compatible with trichinosis. Eosinophilia was present in all of those who were ill and in none who remained well. There were no positive results in skin tests with commercial skin-test antigen. Latex agglutination and counterelectrophoresis were equally good methods for the diagnosis of trichinosis and were more sensitive than the bentonite flocculation test. Levels of IgE in those with illness and eosinophilia were not significantly different from the levels in persons who remained well. It is concluded that skin tests should be abandoned until an improved antigen becomes available, that the relative value of diagnostic serologic methods require continued evaluation, and that levels of IgE may not rise significantly after trichinosis.

Adolescent↗
PubMed1992

Trichinosis: common source outbreak related to commercial pork.

Fifteen patients had trichinosis after eating raw or undercooked commercial pork sausage produced by a local processing plant. Even though it is recommended that all fresh pork be cooked to a temperature of at least 171 degrees F (77 degrees C) to ensure a sufficient margin of safety, this is not always done, and sporadic outbreaks continue to occur. Control strategies to prevent human trichinosis should include trichinosis surveillance of all commercial swine, as well as strict compliance with current regulations.

Animals↗
PubMedDate not supplied

Outbreak of suspected trichinosis among travelers returning from a neighboring island.

BACKGROUND: An outbreak of trichinosis involving a cohort of 33 returning travelers from a resort island in a neighboring country was suspected, beginning with 2 initial cases who were hospitalized with a syndrome of fever, myalgia and eosinophilia. METHOD: At the initial visit, a full history was obtained and a physical examination was performed for each individual. Also, blood was drawn for full blood count, blood film for malaria parasites and Trichinella serology. Extensive epidemiological investigations identified a total of 84 returning travelers from 6 separate groups, of which 58 (69%) were subjected to a detailed interview, including the kinds of meat consumed on the island. RESULTS: Twenty-five of these 33 persons (75.7 %) fulfilled clinical or serological case definition criteria for trichinosis. IgG antibody for Trichinella spiralis was detected in 8 out of 32 persons who had the test done (25%). Symptoms were generally mild, with only one patient (3%) requiring steroids for prolonged myositis. CONCLUSION: We suspect this outbreak to be due to trichinosis although the source could not be identified. Extensive epidemiological investigations identified a total of 84 returning travelers from 6 separate groups, of which 58 (69%) were subjected to a detailed interview, including the kinds of meat consumed on the island, but the source of the outbreak could not be identified.

Animals↗
PubMed1995

Short report: an outbreak of trichinosis in Navarra, Spain.

Trichinosis is an infection contracted by ingestion of meat containing viable larvae of the nematode Trichinella spiralis. This report concerns an outbreak of infections with this parasite in Navarra, Spain that was associated with home-prepared pork products. After the detection of a person with trichinosis, a study of all subjects that had ingested meat from the presumably infected pork was carried out. Forty-four members of eight families were enrolled in the study. Ten had symptoms suggestive of trichinosis, 20 had hypereosinophilia, and 15 had positive serologic test results for anti-Trichinella antibodies. Three groups could be distinguished according to the kind of product each subject had ingested (pork sausage, blood pudding, and loin). Twelve months later, all had a normal eosinophil count and a negative serology.

Animals↗
PubMed1980

Native trichinosis in wild rodents in Henrico County, Virginia.

Encapsulated larvae of Trichinella spiralis were found in wild-trapped, Microtus pennsylvanicus and Sigmodon hispidus. In addition, Peromyscus leucopus and Mus musculus again were found infected. These mammals were trapped from a farm site in Henrico County, Virginia, remote from known potential sources of trichinosis. The possible zoonotic relationship between wild rodent trichinosis and swine trichinosis is discussed.

Animals↗
PubMedDate not supplied

[Standardization of ELISA IgM and IgA for immunodiagnosis of human trichinosis].

An ELISA test for trichinosis using as antigen a larvae soluble fraction from Trichinella spiralis was carried out for the detection of IgM and IgA specific antibodies in 45 serum samples from patients confirmed or suspected to have trichinosis by strong clinical and epidemiological evidences. All the patients had positive serology detected by precipitin test, bentonite floculation test, indirect hemagglutination test and ELISA IgG test. The cut-off value was determined using two criteria. Criterion A was determined in each plate, using three positive controls and two negative ones; the average of the negative controls and the weakest positive control, multiplied by a 1.2 factor was, considered the cut-off value. Criterion B was determined using the average plus three standard deviations from 64 apparently healthy persons serum samples. In both cases, three serum dilutions (1:10, 1:100 and 1:500) were used. The sensitivity of ELISA IgM was 100.0, 93.3 and 82.2% using serum dilutions of 1:10, 1:100 and 1:500 respectively (criterion A) and 100.0, 97.8 and 95.6% for the same dilutions (criterion B), whereas the values for ELISA IgA were: 100.0, 91.1 and 86.7% (criterion A) and 100.0, 100.0 and 91.1% (criterion B). In order to find out the specificity of ELISA IgM and ELISA IgA, additional 118 serum samples from individuals with other parasitoses, such as cysticercosis (18) hydatidosis (39), fascioliasis (12), toxocariasis (30), Chagas' disease (12) and individuals with non-specific eosinophilia (7), were also tested. ELISA IgM presented a specificity of 92.3, 93.4 and 97.3% (criterion A) and 96.2, 97.8 and 97.8% (criterion B) whereas the results for ELISA IgA were 97.8, 98.9 and 99.4% (criterion A) and 98.4% for the 1:10 and 1:100 dilutions and 100.0% for the 1:500 dilution (criterion B). The positive predictive values of ELISA IgM were 76.3, 77.8 and 88.1% (criterion A) and 86.5, 91.7 and 91.5% (criterion B) whereas the negative ones were 100.0, 98.3 and 95.7% (criterion A) and 100.0, 99.4 and 98.9% (criterion B). The positive predictive values of ELISA IgA were 91.8, 95.3 and 97.5% (criterion A) and 93.8, 93.8 and 100.0% (criterion B) whereas the negatives ones were: 100.0, 97.8 and 96.8% (criterion A) and 100.0, 100.0 and 97.8% (criterion B). The use of ELISA IgM and ELISA IgA in the immunodiagnosis of trichinosis is discussed.

Adult↗
PubMedDate not supplied

On skeletal muscle pathology in trichinosis.

A study was carried out on the pathology of trichinosis in human muscle biopsy sample and comparatively in experimental trichinosis in the rat, by current microscopic techniques and Troitsky's method of block silver impregnation of the nerve endings. Stress is laid upon the incipient changes in the parasitized muscle fibers, the sarcolemmic origin of the parasite capsule, the myogenic nature of certain periparasitary but intracapsular clear cells of precocious appearance and other associated, non-specific lesions, such as common myositis changes or giant myogenic foreign-body cells. The intimate relationships between parasitized muscle fibres, cellular interstitial reactions, local new-growth vessels and proliferation of the nerve endings are also described. The morpho-functional significance of such morphological synergic manifestations is discussed as an adaptation to the new local conditions brought about by the appearance of the peculiar muscle fibre-parasite unit in trichinosis.

Animals↗
PubMedDate not supplied

[The course of trichinosis in patients with superinvasion opisthorchiasis].

An analysis of the clinical course of trichinosis in the presence of superinvasion opisthorchiasis is indicative of the prognostic value of the time course of changes in eosinophilia in patients: its gradual amelioration during a complex treatment suggests that there is a positive tendency for recovery from the disease; a drastic fall in the level of eosinophils is constantly accompanied by a more severe course of parasitic cenosis with inflammatory complication and a possible fatal outcome. In trichinosis concurrent with superinvasion opisthorchiasis, myocarditis constantly develops at weeks 3-4 of the onset of nematodosis. Prior myocardial changes (focal and diffuse cardiosclerosis) should be considered to be a complication due to superinvasion opisthorchiasis. Trichinosis accompanied by Opisthorchis invasion substantially deteriorates the course of the underlying disease, chronic alcoholic intoxication exalts the course of parasitic cenosis.

Biomarkers↗
PubMed1991

The value of enzyme-linked immunosorbent assay (ELISA) for diagnosis of human trichinosis.

Sera were collected from proven cases of trichinosis and other helminthic infections and examined for IgG and IgM antibodies by an enzyme-linked immunosorbent assay (ELISA). IgG-ELISA was positive in 68.75, 100, and 100% of cases on 23rd, 50th, 57th day of infection while IgM-ELISA was positive in 12.50, 85.71, 93.33% respectively. In the group with parasitic infections other than trichinosis 20.93% were positive by IgG-ELISA and strong cross-reactivity was prominent with intestinal capillariasis. With IgM-ELISA, positivity in the group with other parasitic infections was 9.30%. It was suggested that sera should be examined not before 1 month after infection to achieve maximum sensitivity for serodiagnosis of human trichinosis.

Adult↗
PubMedDate not supplied

[Seroepidemiological study of human hydatidosis and trichinosis, with the indirect hemagglutination reaction, in San Juan de la Costa County. Osorno, X Region, Chile. 1990-1991].

San Juan de la Costa County (40 degrees 45' South lat., 73 degrees 19' West long.) is located in the Osorno province, South of Chile. Its population is 8,486 inhabitants. The basic economic activities are agriculture, cattle raising, timber production and manufacture of wood and coal. According to official reports, the incidence of human hydatidosis and trichinosis in this locality in 1989 were 24 and 59 per 100,000 respectively. In order to contribute to a better knowledge of the epidemiology of human hydatidosis and trichinosis in San Juan de la Costa County, an indirect hemagglutination test (IHAT) for these parasitoses was performed to 511 randomized people. Nine (1.8%) individuals resulted positive for hydatidosis and twenty four (4.7%) were positive for trichinosis. Some considerations on the corresponding prophylactic measures are proposed.

Adolescent↗
PubMed1990

Trichinosis in a dog.

Trichinella spiralis infection was identified by direct fecal examination as the cause of gastrointestinal disease in a dog. The source of infection was believed to be a woodchuck. Management included supportive care and benzimidazole treatment. Vomiting, diarrhea, anorexia, and myalgia are the main signs of trichinosis, but routine fecal examination seldom reveals T spiralis in natural infections. Mebendazole is the recommended anthelmintic and should be used to eliminate intestinal larvae and prevent muscle invasion. Although the prevalence of trichinosis is decreasing in swine, wild mammals may still be a potential source for dogs and cats. Nevertheless, because of the nonspecific clinical signs of trichinosis, many cases probably go undiagnosed.

Animals↗