Global & Disaster Medicine

Archive for the ‘Trichinosis’ Category

Argentina: In the town of Canals, an outbreak of trichinosis has sickened at least 45 people possibly due to the consumption of salamis and sausages that came from an authorized slaughter

Outbreak News

Lifecycle

Depending on the classification used, there are several species of Trichinella: T. spiralis, T. pseudospiralis, T. nativa, T. murelli, T. nelsoni, T. britovi, T. papuae, and T. zimbabwensis, all but the last of which have been implicated in human disease. Adult worms and encysted larvae develop within a single vertebrate host, and an infected animal serves as a definitive host and potential intermediate host. A second host is required to perpetuate the life cycle of Trichinella. The domestic cycle most often involved pigs and anthropophilic rodents, but other domestic animals such as horses can be involved. In the sylvatic cycle, the range of infected animals is great, but animals most often associated as sources of human infection are bear, moose and wild boar.Trichinellosis is caused by the ingestion of undercooked meat containing encysted larvae (except for T. pseudospiralis and T. papuae, which do not encyst) of Trichinella species The number 1. After exposure to gastric acid and pepsin, the larvae are released from the cysts The number 2 and invade the small bowel mucosa where they develop into adult worms The number 3. Females are 2.2 mm in length; males 1.2 mm. The life span in the small bowel is about four weeks. After 1 week, the females release larvae The number 4 that migrate to striated muscles where they encyst The number 5. Diagnosis is usually made based on clinical symptoms, and is confirmed by serology or identification of encysted or non-encysted larvae in biopsy or autopsy specimens.

Geographic Distribution

Worldwide. Most common in parts of Europe and the United States.

Clinical Presentation

Light infections may be asymptomatic. Intestinal invasion can be accompanied by gastrointestinal symptoms (diarrhea, abdominal pain, vomiting). Larval migration into muscle tissues (one week after infection) can cause periorbital and facial edema, conjunctivitis, fever, myalgias, splinter hemorrhages, rashes, and peripheral eosinophilia. Occasional life-threatening manifestations include myocarditis, central nervous system involvement, and pneumonitis. Larval encystment in the muscles causes myalgia and weakness, followed by subsidence of symptoms.


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