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PubMed1966

Human trichinosis: report of four cases, with emphasis on central nervous system involvement, and a survey of 500 consecutive autopsies at the Ottawa Civic Hospital.

In 1963, acute trichinosis was recognized in four patients at the Ottawa Civic Hospital. One presented with cavernous sinus thrombosis and sixth nerve palsy. A second had a severe systemic infection with myocarditis; the signs of myocarditis appeared in the third week. Electrocardiographic abnormalities included T-wave flattening, prolongation of PR interval and QRS complex, and non-specific changes in 25%. Central nervous system involvement occurred in the second week with general symptoms (headache, delirium and psychotic behaviour), followed in the third week by focal signs (nerve palsy, convulsion, pareses and coma).The incidence of trichinosis in the U.S.A. fell from 15.9% before 1948 to 4.5% in the period 1948-1963. The Canadian incidence in the period from 1940 to 1943 was 5.6%. In a survey in Ottawa using the Baermann digestion and compression methods, four positive cases were found out of 500 diaphragms examined. These figures indicate the success of the public health regulations aimed at controlling trichinosis. A gastrocnemius muscle biopsy is still an invaluable diagnostic tool, especially in critically ill patients with negative skin tests and no eosinophilia.

Adrenocorticotropic Hormone↗
PubMed1983

Immunobiology of trichinosis.

Trichinosis is world-wide in distribution, occurring in tropical, temperate, and polar regions. Although incidence of the disease appears to be declining in most regions, it is still widely distributed in Europe and is increasing in many parts of Africa. In recent years, the incidence of trichinosis in the United States also has increased. This article reviews the nature of immunity to trichinosis.

Animals↗
PubMedDate not supplied

[Epidemiology of trichinosis in Chile. Prevalence study by immunodiagnostic reactions].

In the period 1983-1994 a series of seroepidemiological surveys, by using immunodiagnostic tests for trichinosis, was carried out in 138 localities and health institutions from the 13 regions of the country. Thus, a total of 12,882 randomly selected persons, with different sex and age distribution, were submitted to precipitin test and indirect hemagglutination test for trichinosis. One hundred and ninety one (1.5%) persons resulted positive for trichinosis. Higher rates of infection were observed in central and southern Chile. No differences of positivity, according to age sex, but constant increase parallel to age of the individual were detected. The general prevalence rate of infection of 1.5% is in a reasonable accordance with the prevalence of 2.0% found in human corpses in 1992.

Adolescent↗
PubMedDate not supplied

[Diagnostic valve of ELISA-IgG for trichinosis using Melcher's antigen].

An enzyme-linked immunosorbent assay (ELISA) for trichinosis using a Melcher's antigen was developed for the detection of IgG antibodies in 41 serum samples from patients confirmed or suspected to have trichinosis by strong clinical and epidemiological evidences. ELISA- IgG was compared with a precipitin test (PT), a bentonite floculation test (BFT) and an indirect hemagglutination test (IHAT). The cut-off value was determined using serum samples from 67 apparently healthy persons employing two serum dilutions (1:100 and 1:500) with three standard deviations (SD). The sensitivity of ELISA- IgG was 97.6% and 95.2% using serum dilutions of 1:100 and 1:500 respectively, whereas the values for the other tests were: PT (92.7%), BFT (63.4%) and IHAT(85.4%). According to MacNemar test, ELISA-IgG did not present statistical significance (p > 0.05) compared with PT and IHAT, whereas all of them were different compared with BHT (p > 0.01). In order to find out the specificity of ELISA-IgG, additional 124 serum samples from individuals with other parasitoses, such as cysticercosis (31), fascioliasis (17), hydatidosis (51) and toxocariasis (25) were also tested. ELISA-IgG presented a specificity of 99.5% with both serum dilutions. The positive predictive values were 97.6 and 97.5%, whereas the negative one were 99.5 and 99.0% for 1:100 and 1:500 serum dilutions respectively. The use of ELISA-IgG and Melcher's antigen in the diagnosis of human trichinosis is discussed.

Adult↗
PubMed1996

Case report: locally acquired trichinosis in an immigrant from Southeast Asia.

The authors report a case of trichinosis acquired in Oklahoma City by an immigrant from Southeast Asia. The 49-year-old female reported having abdominal discomfort, nausea, and vomiting, and had purchased and eaten lightly cooked pork. She also complained of fatigue, anorexia, and muscle aches for several months. An immigrant from Laos, she stated that she regularly eats pork and prefers it rare or mildly cooked. The authors caution local physicians to be aware of the increased risk of trichinosis among Southeast Asian immigrants in the area, particularly those from Laos and Cambodia. Continued emphasis on the need to thoroughly cook all pork products is necessary if the incidence of trichinosis in the U.S. is to be controlled.

Animals↗
PubMedDate not supplied

Outbreak of trichinosis in Ontario secondary to the ingestion of wild boar meat.

We report an outbreak of trichinosis from the consumption of locally processed, cold smoked wild boar meat of a domestically reared animal from a farm in Dufferin County, Ontario. Between January and March 1993, 24 cases of trichinosis were identified and of these, 21 patients were symptomatic. The most common symptoms were myalgia (75%), weakness (75%), fever (71%) and periorbital edema (67%). Eosinophilia and elevated creatine phosphokinase levels were noted in 86% and 89% of patients respectively. Trichinella serology was positive in 55%. Two patients were hospitalized, one with severe diarrhoea and another with myalgia and fever. Several patients appeared to improve temporarily after treatment with albendazole. This outbreak reminds us that although trichinosis is rare in Ontario, physicians must maintain a high index of suspicion for the disease. To prevent further outbreaks, the Ontario Government has instituted new guidelines for the processing of all wild boar meat.

Adult↗
PubMedDate not supplied

[Clinico-laboratory characteristics and treatment of patients with trichinosis].

The severity of clinical features of trichinosis and cardiac involvement incidence were examined in the study. The values of eosinophiles, serum enzymes and serologic response to T. spiralis were determined in relation to the disease severity. Twenty-nine patients, of mean age from 24 to 29 years treated in the Clinic in the period from January to April 1995 were presented-7 with severe form of trichinosis, 10 with moderately severe and 12 with light. The fever was noticed in 93.1% of patients, gastrointestinal disorders in 65.5%, myalgias in 96.6%, facial edema in 79.3%, cardiac disorders in 31% and rash in 20.7%. Positive IIF test result was found in 100% of patients with severe clinical features, and only in 58.3% of patients with light clinical features. The patients were treated with mebendazole in the dose of 25 mg/kg BM a day during 14 days. It was concluded that severe trichinosis forms were frequently followed by myocardial damage, that severe forms responded faster and better serologically to trichinella and those patients should be treated with high mebendazole doses.

Adult↗
PubMedDate not supplied

[Current trends of the epidemiology of human trichinosis in Chile].

Surveillance of the epidemiology of human trichinosis in Chile has been maintained during the last 30 years by the Department of Parasitology. Incidence and prevalence have been followed-up by analysing Ministry of Health annual reports and periodical phototrichinoscopic examination of diaphragm samples from individuals autopsied at the Santiago Medico Legal Service. A decrease has been observed on: incidence from 1.4 per 100,000 in the 1960s to 0.7 in the 1980s down to 0.3 in 1993 and 1994 and to 0.5 in 1995, and prevalence from 3.4% to 2.8%, 2.0% and 0.8% in 1972, 1982, 1992 and 1997 respectively. A predominance of the prevalence in the groups of more age, with the observation of calcified Trichinella spiralis larvae should be indicating a decline of new infections in the general population. This decrease of frequency of human trichinosis in Chile is possible due to the interaction of two main factors, efficacy and higher implementation of control measures and significant advances in porcine technology with a resulting provision to consumers of pork from young animals practically trichinosis free.

Adolescent↗
PubMed1997

Serum beta 2-microglobulin in patients with trichinosis.

beta 2-microglobulin (beta 2-m) has been identified as the light chain of the class I major histocompatibility complex proteins, which plays an important role in immune response, especially in T-lymphocytes activation. The aim of the study was to evaluate serum beta 2-m concentration in patients with trichinosis in different phases of this illness. beta 2-m was determined with ELISA in 7 patients twice: in the first week of the hospitalization during acute phase of trichinosis and 21-25 days later, after abatement of clinical signs. It was found that beta 2-m was significantly elevated at the beginning of the illness and decreased, but in the fourth week of the hospitalization it was still high. There was a positive correlation between beta 2-m and absolute count of eosinophils in blood in the first (r = 0.77, p < 0.05) and in the fourth week of hospitalization (r = 0.65, p < 0.05). It is concluded that beta 2-m may have certain importance in the activation of eosinophils and may serve as a marker of immune activation in the course of trichinosis.

Adolescent↗
PubMed1962

Human trichinosis: studies on eleven cases affecting two families in Nova Scotia.

A two-family outbreak of 11 cases of trichinosis with one fatality has been described. Efforts were made to obtain an early assessment of the severity of parasitization on the basis of initial clinical appearance, serial electrocardiograms, changes in eosinophil count, serum protein analyses and SGOT levels. The diagnoses were confirmed by muscle biopsy and by Suessenguth-Kline flocculation tests on serum. Factors portending a severe illness included: (a) rapid decline in total eosinophil count, (b) very low levels of serum albumin, (c) elevation of alpha(1)- and alpha(2)-fractions of serum proteins. A review of current serological methods available for the diagnosis of trichinosis has been presented and emphasis has been placed on the importance of interpreting laboratory tests in conjunction with clinical signs and symptoms. The severity and duration of illness in these cases have shown the importance of enforcing present public health regulations designed to prevent this illness being acquired by humans through consumption of infected pork.

Adrenocorticotropic Hormone↗
PubMed1987

Multifocal central nervous system lesions in three patients with trichinosis.

Three patients with trichinosis developed central nervous system complications. Cerebral computed tomography showed multifocal hypodense lesions in two patients. The lesions were associated with contrast enhancement and cortical gyral enhancement in the first case, suggesting hypoxia and infarction. In the second patient, magnetic resonance imaging showed multiple high-signal-intensity lesions. Early cerebral computed tomography was normal in the third patient. All patients recovered after treatment with antiparasitic drugs and corticosteroids. We suggest that neurologic complications of trichinosis should be treated by corticosteroids and flubendazole.

Adult↗
PubMed1986

Arctic trichinosis presenting as prolonged diarrhea.

We describe an outbreak of trichinosis after the consumption of raw walrus meat in 10 Inuit inhabitants of a northern community. During the presentation of the illness, diarrhea was found in all subjects and was the dominant symptom in 8 of the 10 cases. Myalgia (60%) and muscle weakness (50%) were much less prominent complaints. The diarrhea was characteristically prolonged, lasting up to 14 wk (average 5.8 wk), as opposed to comparatively short episodes of myalgia (average 5.4 days) and muscle weakness (average 4.5 days). Prolonged diarrhea with little or no muscle symptomatology in an epidemic form represents a previously unrecognized clinical presentation of trichinosis. It remains to be determined whether this new clinical presentation is related to variant biological behavior of arctic Trichinella, to previous exposure to the parasite, or to other factors.

Adult↗
PubMed1988

Comparison between standard ELISA and dot-ELISA for serodiagnosis of human trichinosis.

The dot enzyme-linked immunosorbent assay (dot-ELISA) provided rapid and accurate detection of human trichinosis. Comparable sensitivity and specificity of the standard ELISA and dot-ELISA were obtained when sera of 18 confirmed cases of trichinosis were screened. Cross-reactivity was assayed with sera from 31 Chinese subjects with other parasitic infections. Only 2 cross-reactions occurred in the dot-ELISA, compared with 7 in the standard ELISA.

Antigens, Helminth↗
PubMedDate not supplied

An outbreak of trichinosis in Lebanon.

In 1982 an outbreak of trichinosis occurred in an area of south Lebanon consisting of 4 villages, including 6440 persons. In 267 households, involving 2456 persons, typical clinical signs of Trichinella spiralis infection could be recognized among household members. Twenty-one of these households, including 193 persons, were randomly chosen for further studies. Nearly half of the household members (46%) had clinical symptoms consistent with acute trichinosis. 12 of 16 tested persons had high anti-Trichinella antibody titres (12 positive by indirect immunofluorescence (IIF) and 11 by enzyme-linked immunosorbent assay). Class-specific antibodies, IIF-immunoglobulin (Ig) G, IgM and IgA, were detected in most tested cases. Of the remaining 4 seronegative cases, 3 had a duration of clinical symptoms < or = 12 d. High peripheral eosinophilic counts (> 20%) were noted in 8 of 16 cases. In total, 15 of 16 cases were positive by one or more of these tests. The outbreak constituted one of the most extensive single outbreaks reported with a calculated > 1000 clinical cases. The cause was attributed to consumption of raw pork meat, an ingredient of kebbeh nayyeh, a favourite Lebanese dish.

Adolescent↗
PubMed1985

Rapid diagnosis of trichinosis by percutaneous muscle biopsy.

A new rapid diagnostic procedure for trichinosis is described. Percutaneous needle biopsy of the medial gastrocnemius muscle was used to obtain tissue for examination by a compression method. This procedure may facilitate early diagnosis and treatment of symptomatic trichinosis.

Adult↗
PubMed1987

Kinetics of humoral response during the acute and the convalescent phase of human trichinosis.

After a common source outbreak of trichinosis in Bitburg, FRG, 107 patients, for whom time and source of infection were precisely known, were prospectively studied for a period of eight months in order to investigate the kinetics of the humoral immune response. Antibodies were assessed by IHA, and by ELISA to quantify IgG, IgM and IgE isotypes. For four different periods of the observation time sensitivity and predictive value of tests to identify acute or convalescent trichinosis were determined. The results demonstrated characteristic kinetics of the different antibody isotypes and varying diagnostic value of the tests. Only IgG-ELISA and double-sandwich IgM-ELISA reliably identified diseased patients shortly after onset of clinical illness and showed a negative predictive value of almost 100% from seven weeks to eight months after infection. IgE antibodies and elevation of total serum IgE occurred only in about 20% of patients and showed no consistent pattern during the course of the disease. Circulating immune complexes were moderately increased four weeks after infection. They rapidly returned to normal values, after the symptoms of the acute phase had disappeared.

Acute Disease↗
PubMed1994

Trichinosis: infrequent diagnosis or frequent misdiagnosis?

Trichinosis, a disease of wild and domestic animals caused by the nematode Trichinella spiralis, is an infrequently diagnosed infection in human beings. We present the case of a 33-year-old man with trichinosis whose diagnosis was complicated by the presence of maxillary sinusitis.

Adult↗
PubMed1992

Trichinosis and cancer of the larynx.

A case of trichinosis of the laryngeal muscles which was discovered accidentally during total laryngectomy for cancer of the larynx is presented. Trichinosis is a rare parasitic disease, particularly for the ENT specialist. It is difficult to identify during life. No specific treatment is available. In our case it is suggested that the chronic irritation of the larynx may have resulted in the growth of the cancer.

Animals↗