International Commission on Trichinellosis: recommendations on methods for the control of Trichinella in domestic and wild animals intended for human consumption

Frequency and severity of musculoskeletal symptoms in humans during an outbreak of trichinellosis caused by Trichinella britovi

Musculoskeletal symptoms such as myalgia are well-known features in the course of trichinellosis; however, the characteristics of musculoskeletal findings have been described in detail in only 1 study. The present study was aimed to determine the joint and muscle symptoms in subjects diagnosed with acute trichinellosis at our rheumatology unit during a Trichinella britovi outbreak that occurred in Izmir, Turkey, in 2004. In total, 98 patients (55 females, 43 males; mean age 32.3 +/- 10.9 yr) were included in the study. A detailed history and full musculoskeletal examination were obtained in each patient. A self-administered questionnaire developed for recording the musculoskeletal symptoms was completed monthly until all the symptoms were resolved. Pain at the joints, restriction of movements (in shoulders, elbows, wrists, knees, ankles, and temporomandibular joints), myalgia, and muscle weakness (neck and shoulder girdle, muscles of the upper and forearm, back, thigh, and calf muscles) were assessed in every patient. Eosinophil counts, serum levels of creatine kinase, and lactate dehydrogenase also were analyzed. The most frequent musculoskeletal symptoms were muscle pain (86 cases [87.8%]), joint pain (83 [84.7%]), subjective muscle weakness (75 [76.5%]), and restriction of joint movements (63 [64.3%]). Calves, upper arm, neck and shoulder girdle, and forearms were the most affected muscle groups. Muscle pain was reported more frequently in the upper than in the lower extremities and during activity. The most frequent painful joints were shoulders, knees, wrists, and ankles. Upper extremity joints were affected more frequently than the lower extremity joints (77.6 vs. 70.4%). Joint pain occurred more frequently at rest. Both muscle weakness and restriction of joint movements were reported in and around the most frequently affected regions. No evidence of arthritis and objective muscle weakness was noted on physical examination in any patient. Musculoskeletal symptoms in the course of T. britovi infection are frequent but with an excellent prognosis. Joint pain in people suffering from acute trichinellosis may occur more frequently than reported previously.

Irritable bowel syndrome in persons who acquired trichinellosis

BACKGROUND AND AIM

The postinfectious irritable bowel syndrome (PI-IBS) frequently follows bacterial infections. Since people suffering from PI-IBS and Trichinella spiralis-infected mice develop similar findings, this animal model has been successfully used for PI-IBS studies; however, IBS has never been studied in humans after trichinellosis. The aim of this study was to evaluate the IBS symptoms in people who had acquired trichinellosis.

PATIENTS AND METHODS

A large outbreak of trichinellosis caused by Trichinella britovi occurred in Izmir, Turkey, in 2003-2004. The diagnosis of trichinellosis was confirmed by serology and muscle biopsy. After clinical and laboratory evaluations, 72 patients (38 women, 34 men, mean age 33.2 +/- 10.4 yr) with trichinellosis without preexisting IBS were enrolled in the study. Noninfected people (N=27) were used as control group. A questionnaire was developed to assess symptoms of IBS and alarm symptoms. The first interview was done face-to-face. After 2, 4, and 6 months of the first interview, the questionnaire was readministered to the patients without any information on the occurrence of a previous trichinellosis syndrome, while it was applied after a year only to the patients who had suffered IBS symptoms according to at least one of the previous interviews.

RESULTS

According to Rome II criteria, PI-IBS developed in 10 of 72 (13.9%) people with confirmed trichinellosis, who had no preexisting IBS. The rate of PI-IBS was 13.9% and 13.9% at the 4th and 6th months, respectively. The symptoms of PI-IBS persisted in five of them up to 1 yr. People without trichinellosis did not develop any IBS symptoms.

CONCLUSIONS

This is the first report of the development of PI-IBS after T. britovi. Consequently, IBS can be considered as a secondary syndrome induced by trichinellosis.

Viability and infectivity of Trichinella spiralis muscle larvae in frozen horse tissue

Many aspects of the biology and epidemiology of Trichinella infection in the horse are poorly understood, including survival of Trichinella spp in horse muscle. In this study, we have assessed the freeze tolerance of T. spiralis in horse meat stored at 5, -5, and -18 degrees C for 1 day to 24 weeks. Results demonstrate a steady reduction in the number of live ML recovered from the cold stored meat samples. On Day 1, recovery of live larvae had been reduced by 18.6%, 50.1%, and 37.2%, and by 4 weeks, recovery of larvae had been reduced by 65.4%, 66.5%, and 96.2% in samples stored at 5, -5, and -18 degrees C, respectively. Infectivity results (measured as reproductive capacity index (RCI)) from mice inoculated with larvae recovered from non-frozen meat samples at day 0 was 23.5. Following storage at -18 degrees C for one and two days, the RCIs were 2.09 and 0.99, respectively. Small numbers of infective larvae were still present in meat samples stored at -18 degrees C for 4 weeks. The RCI of ML recovered from meat samples stored at -5 degrees C was 14.99 and 6.36 at 2 weeks and 4 weeks respectively; the RCI of samples stored at 5 degrees C was 23.1 at 8 weeks, and fell rapidly thereafter (12 week RCI 1.33; 0 at 24 weeks). These data demonstrate that infective T. spiralis, a non-freeze tolerant species, can survive for at least 4 weeks in horse tissue frozen at -5 or -18 degrees C, and that the numbers of infective larvae decrease substantially by day 2 at -18 degrees C and by week 4 at -5 degrees C.

Systematics and epidemiology of trichinella

In this review, we describe the current knowledge on the systematics, ecology and epidemiology of Trichinella and trichinellosis, and the impact of recent research discoveries on the understanding of this zoonosis. The epidemiology of this zoonosis has experienced important changes over the past two decades, especially with regard to the importance of the sylvatic cycle and the sylvatic species. Outbreaks of trichinellosis due to Trichinella spiralis from domestic swine, while still frequent, increasingly are caused by other Trichinella spp. infecting hosts such as horses, dogs, wild boars, bears and walruses. The latter revelations have occurred as a result of a series of discoveries on the systematics of Trichinella spp., facilitated by new molecular tools. As a consequence, the genus is now composed of two clades, an encapsulated group (five species and three genotypes) and a non-encapsulated one (three species). This has sparked renewed investigations on the host range of these parasites and their epidemiological features. Most dramatic, perhaps, is the recognition that reptiles may also serve as hosts for certain species. This new knowledge base, in addition to having an important relevance for food safety policies and protection measures, is raising important questions on the phylogeny of Trichinella spp., the ecological characteristics of the species and their geographic histories. Answers to these questions may have great value for the understanding of the evolutionary biology for other parasitic helminths, and may increase the value of this genus as models for research on parasitism in general.

Trichinella nativa and Trichinella T9 in the Hokkaido island, Japan

Trichinella sp. muscle larvae were isolated from the thigh muscle of two red foxes (Vulpes vulpes) captured in Sapporo and Otofuke, Hokkaido, Japan, in 2003. Multiplex PCR designed for genotyping the genus Trichinella revealed that the Sapporo isolate showed a specific pattern to T. britovi complex (T. britovi, Trichinella T8 and Trichinella T9) and the Otofuke isolate showed that to T. nativa. Nucleotide sequences of a part of the mitochondrial cytochrome oxidase subunit I (COI) gene and internal transcribed spacer 2 (ITS2) of the Sapporo isolate showed the highest similarity to those of Trichinella T9, a species detected in the mainland of Japan. This study shows that both T. nativa and Trichinella T9 are circulating in wildlife of the Hokkaido island.

Trichinella zimbabwensis in wild reptiles of Zimbabwe and Mozambique and farmed reptiles of Ethiopia

In 1995, a new species of Trichinella (Trichinella zimbabwensis) was discovered in farmed Nile crocodiles (Crocodylus niloticus) in Zimbabwe, where the mode of transmission was the consumption of the meat of slaughtered crocodiles, used as feed. To determine whether T. zimbabwensis affects poikilotherm vertebrates in the wild, monitor lizards (Varanus niloticus) and Nile crocodiles were collected in Zimbabwe and Mozambique. In 5 (17.6%) of the 28 monitor lizards from Zimbabwe, T. zimbabwensis larvae were identified. For the wild Nile crocodiles from Mozambique, species-level identification was not possible, yet immunohistochemical analysis revealed that 8 (20%) of the 40 animals harboured non-encapsulated Trichinella sp. larvae, which probably belonged to T. zimbabwensis. This is the first report of T. zimbabwensis in wild reptiles, and the findings are consistent with reports that vertebrates with scavenger and cannibalistic behaviour are the most important hosts of Trichinella spp. The wide distribution of monitor lizards and crocodiles in Africa and the development of national crocodile breeding programs in many African countries should be taken into consideration when evaluating the risk of transmission of this parasite to mammals, including humans.

Human outbreak of trichinellosis in the Mediterranean island of Sardinia, Italy

Trichinella sp. infection has been documented in both humans and animals in most Mediterranean countries, yet in the past 60 years no infections have been reported on the Mediterranean islands. We describe the first outbreak of Trichinella sp. infection to have been reported on the island of Sardinia. The outbreak occurred in two villages in 2005 and involved 11 persons who had eaten raw sausages made from the same free-ranging sow. All 11 persons developed signs and symptoms of trichinellosis and seroconverted within 48 days of consuming the infected meat. The etiological agent was Trichinella britovi. Sardinia, like all Mediterranean islands, had been considered to be Trichinella-free. The present report, together with a recent report of T. britovi infection in animals on the nearby island of Corsica (France), raises questions as to the validity of the concept of Trichinella-free areas or regions.

Recent advances on the taxonomy, systematics and epidemiology of Trichinella

Since Owen first described Trichinella as a human pathogen in 1835, the number of organisms comprising this genus has grown dramatically. Where it was once thought to be a monospecific group, this genus is now comprised of eight species and three additional genotypic variants that have yet to be taxonomically defined. Along with the growth in the genus and description of the parasites has come a concomitant increase in our understanding of the epidemiology and geographical distribution of these organisms. Recent expansion of the non-encapsulated group to include three species biologically defined by their unique host ranges encompassing mammals, birds and reptiles, has raised substantial questions as to the term, 'Trichinella-free' as it applies to geographical localities. A true appreciation of the adaptability of this genus to host and environmental selection factors, as well as its dissemination to the far reaches of the world can best be appreciated by reviewing what we know and what we hope to know about this ancient and elusive parasite. The review herein consolidates our current understanding of the taxonomy, epidemiology, and phylogeny of the genus Trichinella, and identifies areas where data are lacking and our knowledge requires additional clarification.

The epidemiology of human trichinellosis in China during 2000-2003

The endemic foci of trichinellosis continue to be mainly located in the southwestern, the central and northeastern China. The seroepidemiological surveys of T. spiralis infection in humans were carried out in six Provinces or Municipals (P/M) of China during 2000-2003, the overall seroprevalence was 3.57%. From 2000 to 2003, 17 outbreaks of human trichinellosis, with 828 cases and 11 deaths, were recorded in 8 P/A of China. All of 11 deaths occurred in the southwestern China (1 case in Sichuan, 4 cases in Tibet and 6 cases in Yunnan), where the ethnic groups have the habit of eating raw meat. Pork is the predominant source of outbreaks of human trichinellosis in China. Out of 17 outbreaks, 13 (76.47%) outbreaks were caused by eating raw or poorly cooked pork, 2 (11.77%) outbreaks caused by eating raw dog meat and 2 (11.77%) outbreaks by eating game meat (wild boar and bear), suggesting the increasing significance of dog and game meat as source of infection for human trichinellosis. The partial effects of health education interventions for control of trichinellosis have been achieved in some counties of Yunnan province. The number of inhabitants eating raw meat has decreased from 72.74% (1561/2146) before interventions to 47.43% (489/1031) after interventions. The decrease of incidence of trichinellosis in China during the past 4 years was probably due to a combination of factors, including the reduction in the prevalence of Trichinella infection in domestic swine, the strengthened meat inspection, the increased use of home freezers and the development of heath education practice.

Absence of Trichinella infection in adult pigs slaughtered in Palmas, State of Parana (Brazil), detected by modified artificial digestion assay

Samples of 2,490 adult pigs, slaughtered under federal inspection between May 2004 and February 2005 in the county of Palmas, State of Paraná, Brazil, were examined by pooled sample artificial digestion with magnetic stirrer assay for a survey of Trichinella spp. larvae. Animals originated from 53 counties in three states of southern Brazil. Test sensitivity was increased with modifications of the European standard for artificial digestion. In this survey, a 5-g sample of tongue and 5-g sample of diaphragm pillar were collected from each pig into a pool of 100 g (up to 10 animals for each assay). A 355-microm mesh sieve was used, but no larvae were detected in the pigs, indicating that trichinellosis does not occur in the examined stocks.

Trichinella britovi etiological agent of sylvatic trichinellosis in the Republic of Guinea (West Africa) and a re-evaluation of geographical distribution for encapsulated species in Africa

In West Africa, Trichinella infection was documented in humans and animals from Senegal in the 1960s, and the biological characters of one isolate showed a lower infectivity to domestic pigs and rodents when compared with that of a Trichinella spiralis pig isolate from Europe. To identify the Trichinella species present in West Africa, a survey was conducted in a total of 160 wild animals in the Republic of Guinea. Three Viverridae, one true civet (Viverra civetta) and two African palm civets (Nandinia binotata) from the Fouta Djallon Massif, Pilimini Subprefecture, were found positive by artificial digestion of muscle samples. Trichinella larvae from these three viverrids were identified as Trichinella britovi and no difference was detected in three examined sequences from these African isolates and the reference strain of T. britovi from Europe, indicating common ancestry, an historically continuous geographic distribution, and recent isolation for African and European populations. The detection of T. britovi in West Africa modifies our knowledge about the distribution of encapsulated species of Trichinella in Africa. Thus, Trichinella nelsoni is now considered to have a distribution limited to the Eastern part of the Afrotropical region from Kenya to South Africa. This provides a plausible explanation for the presence of Trichinella T8 in Namibia and South Africa, and further suggests that T. britovi could be the Trichinella species circulating among wild animals of Northern Africa.

The involvement of the macrophage mannose receptor in the innate immune response to infection with parasite Trichinella spiralis

The macrophage mannose receptor (MR) is a pattern recognition receptor of the innate immune system that binds to microbial structures bearing mannose, fucose and N-acetylglucosamine on their surface. The MR can mediate endocytosis and phagocytosis, as well as activation of macrophages and antigen presentation. Since Trichinella spiralis antigens are rich in oligomannose residues, we investigated whether a mannose-recognizing receptor, such as the MR, participated in the host-parasite interaction. The results show that the MR (either on the surface of macrophages or in the purified form) recognizes and binds components of T. spiralis muscle larvae. The presence of parasites provoked activation of peritoneal macrophages, which was indicated by down-regulation of MR expression, and the stimulation of NO secretion. In vitro stimulation of macrophages with T. spiralis components resulted in increased NO and IL-6 production. However, while the MR was partially involved in stimulation of NO production, it did not mediate IL-6 secretion.

Comparative analysis of Trichinella spiralis and Trichinella nativa proteins by two-dimensional gel electrophoresis

Trichinella spiralis and Trichinella nativa are both common wildlife parasites in Finland. However, they differ substantially in their resistance to below 0 degrees C temperatures in their natural hosts. T. nativa can live in frozen fox meat for years, whereas T. spiralis dies when frozen. In mouse muscle, the difference is not as evident; even T. nativa cannot maintain infectivity when kept at -20 degrees C for 1 week. Crude larval protein extracts of these two parasite species were analyzed by two-dimensional gel electrophoresis (2DE). The protein patterns showed clear differences, but matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) peptide mass fingerprint followed by database searches failed to identify these proteins, suggesting that they may still be uncharacterized. The patterns compared after freezing treatment at -20 degrees C revealed changes in the intensity of some protein spots. The antigenic differences of the species were analyzed with two-dimensional Western blots, which showed T. spiralis-specific proteins.

The prevalence of Trichinella infection in domestic dogs in Finland

In this study, we examined the prevalence of Trichinella infection in domestic dogs in Finland, which is known to have a high prevalence of Trichinella infection in sylvatic hosts. Altogether 727 dog serum samples were tested serologically by ELISA with ES-antigen in dilutions 1:50, 1:100, 1:200, and 1:400. Additionally, muscle samples from 102 dogs' front leg extensors were tested parasitologically by HCl-pepsin-digestion. The tested dogs originated from the University Veterinary Hospital (244 of the sera and all of the parasitologically tested muscle samples) and from a serum bank of the National Veterinary and Food Research Institute (465 serum samples), representing healthy dogs mostly from southern Finland. As negative controls, we tested sera from 18 experimental dogs known to be negative for Trichinella infection. Trichinella spp. was isolated from one dog (1%) with a low infection intensity. High OD% were found in both groups of serum samples. Of the hospitalized dogs, 4.9% were classified positive, and 8.6% of the healthy dogs were classified positive (7.3% in total). The sex or breed of the tested dogs did not correlate with the positive results, but the age correlated positively in the serum bank group. The serological results suggest that dogs may be exposed to Trichinella spp. in Finland; however, confirmation of low-level infections requires confirmation by direct testing methods.

Trichinae certification in the United States pork industry

Control of Trichinella infection in U.S. pork has traditionally been accomplished by inspection of individual carcasses at slaughter or by post-slaughter processing to inactivate parasites. We propose that an alternative to individual carcass testing or processing can be used when pigs are raised in production systems where risk of exposure to Trichinella spiralis has been mitigated. Declines in prevalence of this parasite in U.S. domestic swine during the last 30 years, coupled with improvements in pork production systems, now allow Trichinella control to be shifted to the farm through implementation of specific pork production practices. Knowledge of risk factors for exposure of swine to T. spiralis was used to develop an objective audit of risk that can be applied to pork production sites. In a pilot study, 461 production site audits were performed by trained veterinary practitioners. The on-farm audit included aspects of farm management, bio-security, feed and feed storage, rodent control programs and general hygiene. Of the 461 production site audits, 450 audits (97.6%) indicated compliance with the required good production practices. These sites are eligible for certification under the U.S. Trichinae Certification Program and will be audited regularly to maintain that status. The described trichinae certification mechanism will establish a process for ensuring the Trichinella safety of swine, and ultimately food products derived from swine, at the production level.

Experimental studies in pigs on Trichinella detection in different diagnostic matrices

A total of 72 specific pathogen-free (SPF) and Iberian pigs (three animals per group) were inoculated with 200, 1000 or 20,000 muscle larvae of T. spiralis, T. nativa, T. britovi and T. pseudospiralis. For each animal, the muscle larva burden was evaluated in nine muscle samples by digestion. The anti-Trichinella IgG kinetics in blood samples, taken twice prior and at days 5, 10, 15, 20, 25, 30, 40, 50 and 60 post-inoculation, and in muscle juice, obtained at necropsy, was evaluated by an ELISA using an excretory/secretory antigen. The mean larval recovery rate in SPF/Iberian pigs corresponded with the level of inoculum dose, and tongue, diaphragm and masseter were identified as predilection muscles. In SPF and Iberian pigs receiving 20,000 larvae of T. spiralis, an earlier seroconversion was detected from day 25 post-inoculation. At a 10-fold dilution, the muscle juice showed a good test agreement with blood serum.

Changes in the EU legislation on Trichinella inspection--new challenges in the epidemiology

The European Union (EU) countries are searching for new ways to certify meat free of Trichinella; however, with the expansion of the EU, the acceptance of a unilateral method is complicated by the variability of pig and human trichinellosis among EU countries, where significantly higher prevalence rates have been observed in the newly added eastern countries. Several attempts have been made to define Trichinella-free areas, but certification of Trichinella-free pig production farms appears to be the only feasible approach. The increasing prevalence of the non-encapsulating species, Trichinella pseudospiralis, in game, domestic pigs and humans has eliminated the compression technique from the new EU legislation to be enacted in 2006. Also, the observation that several species of Trichinella tolerate freezing in horse meat for up to 4 weeks has forced a change in legislation as well where freezing is no longer an option for certifying horse meat. Because current serological detection methods are not suited for meat inspection, classical direct detection methods and inactivation by freezing remain the methods of choice for pork. It has been proposed, therefore, to automate direct inspection methods as a cost effective alternative to certify pig farms free of Trichinella.

Anti-Trichinella antibodies detected in chronically infected horses by IFA and Western blot, but not by ELISA

In the Balkan countries, where trichinellosis is a re-emerging zoonosis, it is of great importance to determine Trichinella infection prevalence among the major hosts, including horses. One method for monitoring prevalence is serological surveillance; however, the validity of serological methods in horses is not well understood. The dynamics of anti-Trichinella IgG production and circulating excretory/secretory (ES) antigens were investigated in three horses experimentally-infected with Trichinella spiralis. Horses were slaughtered at 32 week post infection (p.i.). Low worm burdens were found in all three animals. Anti-Trichinella IgG was detected up to 32 weeks p.i. by an indirect immunofluorescence assay (IFA) and by Western blot (Wb), but not by ELISA. The ELISA test detected antibodies for only a short period of time (up to 18 weeks p.i. using ES antigen or up to 20 weeks p.i. using tyvelose-BSA antigen). The presence of circulating muscle larvae ES antigen in sera of infected horses was observed by dot blot from the 4th week p.i. up to the 32nd week p.i.

Comparison of two antigens for demonstration of Trichinella spp. antibodies in blood and muscle fluid of foxes, pigs and wild boars

For the surveillance of trichinellosis, the digestion method is reliable but also labour intensive. The serological methods for the detection of Trichinella-specific antibodies using ELISA offer a sensitive and relatively specific alternative. For serological studies, sera or plasma from blood samples are the most common source of antibodies, but although the concentration of antibodies is approximately 10-fold lower, muscle fluid can be a good alternative particularly for testing of wildlife samples. In the present study, an indirect ELISA technique was evaluated on both sera and muscle fluids from experimentally infected foxes, pigs, and wild boars using both excretory/secretory (E/S) antigens and a synthetic glycan antigen, beta-tyvelose. Although the synthetic antigen appears to be less sensitive than the E/S antigens, Trichinella-specific IgG antibodies were detected in both serum samples and muscle fluid samples from pigs, wild boars and foxes infected at levels which would be important for food safety or represent a significant reservoir for further transmission.

Acute trichinellosis in children compared with adults

OBJECTIVES

Trichinellosis is a cosmopolitan parasite infection caused by Trichinella nematodes that is acquired from consumption of raw meat from several animal species. Knowledge of the clinical pattern and laboratory features of the disease in childhood is limited. The purpose is to study the clinical pattern of trichinellosis caused by Trichinella britovi in children and to compare it in household adults.

METHODS

We evaluated all children up to 17 years of age and their adult householders exposed to the consumption of infected meat during an outbreak of trichinellosis. A questionnaire was developed to record clinical data. The blood sample was collected for blood count, muscle enzymes, serum electrolytes, albumin and serology. All exposed children were treated with mebendazole, and severe symptomatic patients received prednisolone. Clinical and laboratory presentations and outcome were recorded. To evaluate the clinical picture of trichinellosis in childhood, clinical and laboratory findings were compared between children and household adults with a confirmed diagnosis who consumed the same amount of infected meat.

RESULTS

In 47 (62%) of 76 children with suspected trichinellosis, the diagnosis was serologically confirmed. The main clinical and laboratory findings in children were fever, abdominal pain, myalgia, facial and/or eyelid edema, rash, eosinophilia and increased muscular enzymes. The incubation period was similar in children and adults, but myalgia (66% versus 96%, P < 0.01), facial and/or eyelid edema (57% versus 86%, P < 0.05), eosinophilia (52% versus 96%, P < 0.01) and increased serum creatine kinase (38% versus 79%, P < 0.01) were less common in children than in adults. Seroconversion occurred in fewer children than adults, but the difference was not statistically significant.

CONCLUSIONS

T. britovi infection shows a benign course and a milder clinical picture in children than in adults who consumed the same amount of infected meat.

The need for implementation of International Commission on Trichinellosis recommendations, quality assurance standards, and proficiency sample programs in meat inspection for trichinellosis in Serbia

Implementation of methods to control inspection for Trichinella in meat recommended by International Commission on Trichinellosis (ICT), particularly the introduction of the quality assurance standards and proficiency panels for certified analysts is extremely important in Serbia and other countries where Trichinellosis is endemic. In spite of existing regulations, including the inspection of 0.5 g samples of diaphragm by the compression method or by artificial digestion of 1g samples, in Serbia 280 people were diagnosed with clinical trichinellosis after consumption of inspected meat during the period 2001--2002. These outbreaks, which occurred in the municipalities of Kumane, Surcin and Bogatic, were a consequence of inadequate application of inspection methods and insufficient education of some veterinary inspectors. The problem of inadequate veterinary inspection in Serbia can be overcome by strict application of the ICT recommendations for the control of Trichinella with specific emphasis on implementing the quality assurance system (QAS) and proficiency sampling (PS/--PP/panel).

Comparison of trichinelloscopy with a digestion method for the detection of Trichinella larvae in muscle tissue from naturally infected pigs with low level infections

The identification of Trichinella infection in pigs in Croatia has traditionally been done by inspection of individual carcasses. In response to outbreaks of human trichinellosis in the last decade, the Croatian Ministry of Agriculture and Forestry instituted compulsory trichinelloscopic examination of tissue from both commercially and privately slaughtered swine. The purpose of this study was to compare trichinelloscopy and artificial digestion for use in samples containing low numbers of larvae. Each assay was used to test 1,769 field positive samples, 290 of which contained 6 or less larvae per gram of muscle tissue. The sensitivity and specificity of trichinelloscopy with 6 or less l pg was 43.4 and 88%, respectively. kappa-Value as a measure of agreement between trichinelloscopy and artificial digestion was 0.27%. It is noteworthy that a considerable number of the 103 (52%) negative animals on trichinelloscopy contained>or=6l pg which is enough to cause clinical trichinellosis. These findings support other studies that indicate trichinelloscopy is not a method of choice and that it is necessary to implement more sensitive procedures such as artificial digestion.

Evaluation of ELISA for detection of Trichinella antibodies in muscle juice samples of naturally infected pigs

The performance characteristics of an ELISA test for trichinellosis in pigs applied to muscle juice was assessed using 314 samples collected from pigs located in endemic areas of Croatia. Peptic digestion was used as the reference method. The diagnostic accuracy of the two compared dilutions (1:10 and 1:100) was considered to be high because the area under the curve (AUC) index was 0.922 and 0.920 for each dilution, respectively. In this study the two graph-receiver operating characteristic (TG-ROC) analysis was used as a tool for selecting cut-off points. Sensitivity, specificity, likelihood ratios, efficiency and Youden's index were used as indices of test accuracy. The cut-off values that minimize overall misclassification cost under an assumption of 3% prevalence were calculated. Our results indicate that the ELISA applied to muscle juice is a highly accurate test and can be adapted to process a large number of samples.

First record of Trichinella pseudospiralis in the Slovak Republic found in domestic focus

Infection of Trichinella spp. is widespread among wildlife in Slovakia and the red fox (Vulpes vulpes) is the main reservoir of Trichinella britovi. Trichinella spiralis has been rarely documented in sylvatic and domestic animals of this country. During routine examination of domestic pigs at the slaughter, Trichinella larvae were detected by artificial digestion in a domestic pig of a large-scale breeding farm in Eastern Slovakia. The parasite has been identified by molecular (PCR) and biochemical (allozymes) analyses and by the morphology of the nurse cell as the non-encapsulated species Trichinella pseudospiralis infecting both mammals and birds. The epidemiological investigation carried out at the farm level revealed the presence of the same parasite species in other three pigs of 192 examined (2.1%), in 3 of 14 (21.4%) examined synanthropic rats (Rattus norvegicus) and in a domestic cat. The farm was characterized by inadequate sanitary conditions, insufficient nutrition, cannibalism and the presence of rat population. A different profile has been observed at the phosphoglucomutase locus in T. pseudospiralis isolates from Slovakia in comparison with the T. pseudospiralis reference isolate from the Palearctic region. This is the first documented focus of T. pseudospiralis from Central Europe. The detection in domestic pigs of a non-encapsulated parasite infecting both mammals and birds stresses the need to avoid the use of trichinelloscopy to detect this infection at the slaughterhouse.

Clinical aspects, diagnosis and treatment of trichinellosis

Trichinellosis, the human disease induced by worms of the genus Trichinella, is caused by the consumption of raw or undercooked meat of various types of animals and has a worldwide prevalence of approximately eleven million. Since there are no pathognomonic signs or symptoms, clinical diagnosis is difficult and the only reliable diagnostic methods are serodiagnosis and muscle biopsy. Treatment consists of benzimidazoles and glucocorticosteroids, yet in order for these drugs to be effective, they must be administered before the end of the acute stage; thus early diagnosis is fundamental. To aid in the recognition and treatment of trichinellosis, an overall description of its clinical aspects, diagnosis and treatment has been prepared.

Inappropriate feeding practice favors the transmission of Trichinella papuae from wild pigs to saltwater crocodiles in Papua New Guinea

The recent discovery of Trichinella zimbabwensis in farmed crocodiles (Crocodilus niloticus) of Zimbabwe and its ability to infect mammals, and the development of both T. zimbabwensis and Trichinella papuae in experimentally infected reptiles led to an investigation of Trichinella infection in saltwater crocodiles (Crocodylus porosus) and in wild pigs (Sus scrofa) of Papua New Guinea, to see if T. papuae also, is present in both cold- and warm-blooded animals. Of 222 crocodiles examined, 47 animals (21.2%), all from Kikori, Gulf Province, were positive for non-encapsulated larvae in the muscles. The greatest number of larvae was found usually in the biceps, with an average of 7 larvae/g. One isolate from a crocodile infected successfully both laboratory rats and mice. Of 81 wild pigs examined, 9 from Bensbach river area (Western Province) and 1 from Kikori area (Gulf Province) were positive for non-encapsulated larvae in the muscles. Trichinella larvae from both saltwater crocodiles and wild pigs have been identified by multiplex-PCR analysis as T. papuae. The sequence analysis of the region within the large subunit ribosomal DNA, known as the expansion segment V, has shown the presence of a molecular marker distinguishing T. papuae isolates of Bensbach river area from those of Kikori area. This marker could be useful to trace back the geographical origin of the infected animal. The epidemiological investigation carried out in the Kikori area has shown that local people catch young crocodiles in the wild and keep them in holding pens for several months, before sending them to the crocodile farm in Lae (Morobe Province). They feed the crocodiles primarily with wild pig meat bought at the local market and also with fish. These results stress the importance of using artificial digestion for routinely screening of swine and crocodiles, and of adopting measures for preventing the spread of infection, such as the proper disposal of carcasses and the adequate freezing of meat.

Trichinella pseudospiralis foci in Sweden

In Sweden, the prevalence of Trichinella infection in domestic pigs has greatly decreased since the 1970s, with no reports in the past 4 years. However, infected wild animals continue to be found. The objective of the present study was to identify the species of Trichinella present in animals of Sweden, so as to contribute to the knowledge on the distribution area and hosts useful for the prevention and control of this zoonosis. In the period 1985-2003, Trichinella larvae were detected in the muscles of 81/1800 (4.5%) red foxes (Vulpes vulpes), 1/6 (16.7%) arctic fox (Alopex lagopus), 1/7 (14.3%) wolf (Canis lupus), 10/200 (5.0%) lynxes (Lynx lynx), 4/8000 (0.05%) wild boars (Sus scrofa), and 27/66 x 10(6) (0.000041%) domestic pigs. All four Trichinella species previously found in Europe were detected (Trichinella spiralis, T. nativa, T. britovi and T. pseudospiralis). The non-encapsulated species T. pseudospiralis was detected in three wild boars from Holo (Stockholm area) and in one lynx from Froso (Ostersund area), suggesting that this species is widespread in Sweden. These findings are consistent with those of a study from Finland, both for the unexpected presence of T. pseudospiralis infection and the presence of the same four Trichinella species, suggesting that this epidemiological situation is present in the entire Scandinavian region. The widespread diffusion of T. pseudospiralis in the Scandinavian region is also important in terms of it potential impact on public health, given that human infection can occur and the difficulties to detect it by the trichinelloscopic examination.

Toxocara canis in experimentally infected pigs: migratory pattern and tissue lesions

Fifteen Yorkshire female pigs were inoculated with 100,000 infective T. canis eggs. Three animals were used as uninfected controls. Groups of three infected pigs were euthanized by accepted methods on days 7, 14, 21, 28 and 126 p.i., respectively. Larvae were recovered from all animals included in each group slaughtered on days 7 and 14 p.i.; on day 21 p.i. from two pigs, on day 28 p.i. from one, and no larvae were found on day 126 p.i. Differences in the mean number of larvae per gram in lymph nodes, liver and lungs between slaughter days, were significant for livers on day 7 p.i. and for lungs on day 14 p.i. (P < 0.10). The decrease over time was significant in all the organs that previously had larvae. Larvae were not found in the other organs and tissues analysed. Macroscopical lesions were found in the liver, lungs and lymph nodes on days 7, 14, 21, and 28 p.i. The entire surface of the liver was covered with small white spots on day 7 p.i., on days 14 and 21 p.i. the spots were distinctly nodular and, in some places, individual lesions were confluent. Lesions had apparently started to heal on days 28 and 126 p.i. appearance was normal. Lymph nodes were enlarged and oedematous during the first 4 weeks and the lungs had small areas of consolidation visible all over the surface, but by day 126 p.i., no visible lesions could be seen. Microscopical lesions were observed in the liver on day 7 p.i., with a largely periportal hepatitis. Numerous eosinophils and lymphocytes were present. The typical granulomatous reaction was observed on days 14 and 21 p.i. with a central necrotic core and a narrow region of fibroblastic tissue. By day 28 p.i. lesions had almost disappeared and the number of eosinophils was fewer. There were fewer leukocytes and the fibrous tissue had disappeared from the liver on day 126 p.i. For the first 3 weeks, pictures of the lymph nodes and the lungs were characterised by the formation of a granuloma. In the center of the granuloma larvae were observed. The majority of the lesions had healed by day 126 p.i.

Influence of methods for Trichinella detection in pigs from endemic and non-endemic European region

A total of 1401 German and 226 Croatian pigs raised either indoors or outdoors were tested for Trichinella infection by direct and indirect detection methods. A 10 g sample of diaphragm were examined for muscle larvae by the artificial digestion method; the species was determined by multiplex polymerase chain reaction (PCR). For detection of anti-Trichinella IgG, serum samples diluted 1:100, and meat juice samples diluted 1:10, were tested by enzyme-linked immunosorbent assay. All German pigs and those Croatian pigs raised indoors proved to be Trichinella-negative by all methods. Muscle larvae were detected in a total of eleven of the Croatian pigs, which were raised on small outdoor farms. For eight isolates, PCR results demonstrated that recovered larvae were Trichinella spiralis. Anti-Trichinella-IgG was detected in serum and meat juice of digestion positive animals when the worm burdens exceeded 0.38 larvae per gram of muscle. Positive results in Croatian pigs indicate a higher risk of infection for outdoor farming in areas where Trichinella is endemic. Results of direct and indirect detection were compared and are discussed with special regard to specificity and sensitivity of methods.

Comparison of synthetic tyvelose antigen with excretory-secretory antigen for the detection of trichinellosis in swine using enzyme-linked immunosorbent assay

Two enzyme-linked immunosorbent assay (ELISA) systems, one using natural excretory-secretory (ES) antigens and the other a synthetic glycan antigen (3,6-dideoxy-D-arabinohexose [tyvelose, TY]), were evaluated for the serological diagnosis of trichinellosis in swine. Sensitivity was estimated using samples (n = 113) collected 3-21 wk PI from 15 experimentally infected pigs, and specificity was estimated using samples (n = 397) from a population of Trichinella spp.-free pigs. Results were analyzed using 2 cutoff values recommended in international guidelines (Office Internationale des Epizooties [OIE]) and by the optimal cutoff level as determined by receiver-operator characteristic (ROC) analysis. The ROC-optimized TY-ELISA consistently performed better than all other combinations. None of the combinations of test and cut-off detected infected pigs sooner than 35 days; however, the ROC-optimized TY-ELISA identified 8 of 15 pigs earlier than the ES-ELISA and detected 2 pigs missed by all other tests. At 49 days PI the sensitivity and specificity of the ROC-optimized TY-ELISA were 94.3 and 96.7%, respectively, as compared with the ROC-optimized ES-ELISA at 84.9 and 96.0%, respectively. The ROC-optimized TY-ELISA was 100% specific at OIE-recommended cut-offs. This study indicates that the TY-ELISA is as good or better than the ES-ELISA for the detection of trichinellosis in swine.

Epidemiology of Trichinella infection in the horse: the risk from animal product feeding practices

A discovery in 2002 of a Trichinella spiralis-infected horse in Serbia offered an opportunity to conduct needed epidemiological studies on how horses, considered herbivores, acquire a meat-borne parasite. This enigma has persisted since the first human outbreaks from infected horse meat occurred in then 1970s. The trace back of the infected horse to a farm owner was carried out. Interviews and investigations on the farm led to the conclusion that the owner had fed the horse food waste in order to condition the horse prior to sale. Further investigations were then carried out to determine the frequency of such practices among horse owners. Based on interviews of horse producers at local horse markets, it was revealed that the feeding of animal products to horses was a common practice. Further, it was alleged that many horses, particularly those in poor nutritional condition would readily consume meat. A subsequent series of trials involving the experimental feeding of 219 horses demonstrated that 32% would consume meat patties. To confirm that horses would eat infected meat under normal farm conditions, three horses were offered infected ground pork balls containing 1100 larvae. All three became infected, and at necropsy at 32 weeks later, were still positive by indirect IFA testing, but not by ELISA using an excretory-secretory (ES) antigen. This result indicates that further study is needed on the nature of the antigen(s) used for potential serological monitoring and surveillance of horse trichinellosis, especially the importance of antigenic diversity. The experimentally-infected horses also had very low infection levels (larvae per gram of muscle) at 32 weeks of infection, and although the public health consequences are unknown, the question of whether current recommended inspection procedures based on pepsin digestion of selected muscle samples require sufficient quantities of muscle should be addressed. It is concluded that horses are more willing to consume meat than realized and that the intentional feeding of animal products and kitchen waste is a common occurrence among horse owners in Serbia (and elsewhere?). This is a high risk practice which demands closer scrutiny by veterinary and food safety authorities, including the implementation of rules and procedures to ensure that such feeds are rendered safe for horses, as is now required for feeding to swine.

The epidemiological investigation of Trichinella infection in brown rats (Rattus norvegicus) and domestic pigs in Croatia suggests that rats are not a reservoir at the farm level

Whether the brown rat (Rattus norvegicus) is a reservoir of Trichinella spp. infection or merely an accidental host, which may be vector of Trichinella spp., continues to be debated. We estimated the prevalence of Trichinella sp. infection in brown rat populations and in domestic pigs in 2 villages in Croatia, where Trichinella sp. infection in pigs has been endemic in the past 10 yr. Trichinella spiralis larvae, identified by a multiplex polymerase chain reaction analyses, were the only species detected in both rats and pigs. In 2001 and 2002, 2,287 rats were collected on 60 farms with different levels of sanitation and with, or without, T. spiralis-infected pigs. The prevalence of infection in rats ranged from 0.2 to 10.7%. Infected rats were detected only on farms with T. spiralis-positive pigs and low sanitation or formerly with low sanitation (P = 0.007, Fisher's exact test), yet no infected rat was detected on farms with T. spiralis-negative pigs. The finding that no infected rat was found on farms with T. spiralis-negative pigs suggests that, in the investigated area, the brown rat is not a reservoir but only a victim of improper pig slaughtering.

Interaction of mannan-binding lectin with Trichinella spiralis glycoproteins, a possible innate immune mechanism

Complex and variable glycoconjugates presented by parasitic nematodes during infection are very important in the host-parasite interplay. Predominantly carbohydrate-rich antigens are involved in the stimulation and modulation of the stage-specific immune response of the host. The non-specific innate immune system, however, acts as the first line of host defence against pathogens, before the appearance of antigen-specific responses. The functional entities of the innate system are lectins that recognize the surface ligands of pathogens: mannan-binding lectin (MBL) is a key recognition element involved in binding oligosaccharide structures exposed on microorganisms. In the present study we investigated whether MBL binds to the parasitic nematode Trichinella spiralis (T. spiralis). Since the parasite is coated with mannose-containing glycans, these structures could represent potential ligands for MBL and contribute to activation of the innate immune response of the host. Histochemical staining revealed MBL on the surface and internal organs of T. spiralis muscle larvae. MBL bound in a mannose-inhibitable manner to both crude extracts of T. spiralis muscle larvae and larvae excretory/secretory products. Western blot analyses showed that MBL recognized glycoproteins from all stages of T. spiralis. In vitro complement activation assays suggested that MBL is capable of fixing complement components on T. spiralis crude extract coated plates and activating the complement cascade through the 'lectin pathway'.

Infectivity of Trichinella nativa in traditional northern (country) foods prepared with meat from experimentally infected seals

The infectivity of Trichinella nativa larvae in three traditional northern (country) foods was assessed. Foods were prepared with meat from seals experimentally infected with Trichinella nativa and evaluated over a 317-day period during which this food was fed directly to cats while mice were orally inoculated with larvae recovered following the digestion of the food in a solution containing 1% pepsin and 1% HCl at 37 degrees C. Foods examined were igunaq (meat and blubber placed in a seal skin bag and allowed to ferment), nikku (air-dried meat), and sausage (meat, fillers, salt, and spices). Sausage was examined both in a raw state and after partial cooking. Infective T. nativa larvae survived in igunaq, nikku, raw frozen sausage, and poorly cooked sausage for at least 5 months under controlled laboratory conditions. Core temperatures of partially cooked sausage never exceeded 50 degrees C. Caution should be exercised in using these data to establish guidelines for the consumption of raw products, since the survival of infective larvae could be unpredictably extended under field conditions. These data indicate significant food safety risks associated with igunaq, nikku, and sausage prepared with Trichinella-infected meat and provide information for use in risk management and in directing future research.

Comparison of a modified digestion assay with trichinoscopy for the detection of Trichinella larvae in pork

A pepsin-HCl digestion assay and two compressorium techniques (trichinoscopy) for the identification of swine muscle tissue containing low levels of Trichinella larvae were compared as part of the test validation process for quality assurance purposes. Compressoria read with a stereomicroscope detected more larvae (P < 0.0001, n = 57) and more tissues (P = 0.0047, n = 57) than did compressoria read with a projection microscope (trichinoscope). The digestion assay evaluated was 3.2 times as likely as the best compressorium technique to identify a positive tissue when these procedures were used to test 1 g of infected muscle (P < 0.001; 95% confidence interval for the odds ratio, 2.0 to 5.4; n = 161 and n = 189, respectively). Detection by trichinoscopy improved as the number of larvae in tissues increased to > 2 larvae per g, but trichinoscopy was less sensitive than the digestion assay regardless of the tissue larval load. These data indicate that the quality controlled digestion assay used in this study is more sensitive than trichinoscopic techniques in the detection of tissues containing low levels of Trichinella larvae.

Social, political, and economic factors responsible for the reemergence of trichinellosis in Serbia: a case study

Over the past decade, eastern Europe has experienced a resurgence of trichinellosis. A recent outbreak in Serbia, Yugoslavia, from December 2001 to January 2002, involving 309 people, revealed many of the causes for this reemergence. Epidemiological investigations indicate that the immediate cause of the recent outbreak was the consumption of smoked sausages produced by a small slaughterhouse or meat processor. However, failure of in-house meat inspection procedures and quality assurance as well as oversight by official veterinary control were also responsible. Further analysis of this breakdown in the food safety net revealed additional general factors that have yielded a seriously deficient veterinary control system, and these are factors that are relevant to the problems experienced throughout eastern Europe and other regions. The recent civil war that led to the breakup of the former Federation of Yugoslavia resulted in severe economic and demographic changes, including high inflation and external economic sanctions. This led to (1) the loss of large numbers of experienced veterinary control officers and their replacement with inexperienced personnel, (2) a change in the swine industry with reduction in the number of large establishments with in-house inspection and replacement with more than 1,000 small abattoirs, too small to afford full-time in-house inspection, and (3) an increase in smallholder pig farming with reduced government oversight to ensure high standards in pig-rearing practices (infection risk management). The consequences of these events have been a 300% increase in Serbian pig infection and a concomittant large increase in human outbreaks. Before 1990, swine trichinellosis in Serbia was confined to 4 small districts, but today about one third of the Republic is considered endemic for trichinellosis. The reemergence of trichinellosis in Serbia illustrates the ability of this zoonosis to "leak" through a poorly maintained food safety barrier and the vulnerability of effective veterinary control to national and international events.

Evaluation of a digestion assay and determination of sample size and tissue for the reliable detection of Trichinella larvae in walrus meat

A digestion assay was validated for the detection of Trichinella larvae in walrus (Odobenus rosmarus) meat, and appropriate samples for testing were determined using tissues from infected walruses harvested for food. Examination of muscles from 3 walruses showed that the tongue consistently contained approximately 2-6 times more larvae than the pectoral and intercostal muscles. Comparison of numbers of larvae in the root, body, and apex of the tongue from 3 walruses failed to identify a predilection site within the tongue, but the apex was considered an optimal tissue because of the high larval density within the tongue and the ease of collection. All 31 spiked samples weighing 50 g each and containing between 0.1 and 0.4 larvae per gram (lpg) were correctly identified as infected, indicating that the sensitivity of this procedure is adequate for diagnostic use. A sample size of 10 g consistently detected larvae in 2 walrus tongues containing > or = 0.3 lpg (n = 40), and until additional data are available, sample sizes from individual walrus tongues should be a minimum of 10 g. This study provides the preliminary data that were used for the development of a food safety analytical protocol for the detection of Trichinella in walrus meat in arctic communities.

Trichinellosis in China: epidemiology and control

The first outbreak of human trichinellosis in China, according to official national publication, was registered in Tibet in 1964. Since then, more than 500 outbreaks, numbering 25161 cases with 240 deaths, have been recorded. However, this reported quantity is probably highly underestimated because adequate diagnostic techniques might not have been available in the whole area. Moreover, infection in animals is widespread over China, with the prevalence of pig trichinellosis being as high as 4% in some provinces. The estimated situation of trichinellosis in China highlights the necessity not only for its control, but also for the government to elaborate new regulations and guidelines for animal inspection.

Evaluation of ELISA and Western Blot Analysis using three antigens to detect anti-Trichinella IgG in horses

We assessed a serological method for detecting Trichinella infection in horses, specifically, an ELISA using three antigens to detect anti-Trichinella IgG (i.e. a synthetic tyvelose glycan-BSA (stg-BSA) antigen, an excretory/secretory (ES) antigen, and a crude worm extract (CWE) antigen). Serum samples were collected from 2502 horses (433 live horses from Romania and 2069 horses slaughtered in Italy and originating from Italy, Poland, Romania, and Serbia). Serum samples were also taken from horses experimentally infected with different doses of T. spiralis and T. murrelli larvae, as controls. The cut-off value of ELISA was determined on serum samples from 330 horses from Trichinella-free regions of Italy, which were also examined by artificial digestion of preferential-muscle samples. In the experimentally infected horses, the stg-BSA and ES antigens were less sensitive than the CWE antigen. Trichinella spiralis showed a higher immunogenicity than T. murrelli, and the IgG immunoresponse was dose-dependent. The kinetics of anti-Trichinella IgG were similar among all experimentally infected horses. No circulating antibodies were detected 4-5 months after experimental infection, although these horses still harbored infective larvae. Depending on the antigen used, for 4-7 of the 330 horses from Trichinella-free areas, the optical density (OD) of the serum sample was higher than the cut-off value, yet these samples were negative when subjected to Western Blot. Similar results were obtained for the 1739 horses slaughtered in Italy (originating from Italy, Poland, Romania, and Serbia) and the 433 live Romanian horses. Of the 4 horses with muscle larvae, only one was positive by ELISA and Western Blot. Because the anti-Trichinella IgG remain circulating for only a short period of time, whereas the larvae remain infective for longer periods, serology cannot be used for either diagnosing Trichinella infection in horses or estimating the prevalence of infection. Artificial digestion of at least 5 g of preferential-muscle tissue continues to be the method of choice at the slaughterhouse for preventing equine-borne trichinellosis in humans.

Opinion on the diagnosis and treatment of human trichinellosis

The clinical diagnosis of trichinellosis is difficult because there are no pathogenic signs or symptoms and in diagnosing the infection epidemiological data are of great importance. Trichinellosis usually begins with a sensation of general discomfort and headache, increasing fever, chills and sometimes diarrhoea and/or abdominal pain. Pyrexia, eyelid or facial oedema and myalgia represent the principal syndrome of the acute stage, which can be complicated by myocarditis, thromboembolic disease and encephalitis. High eosinophilia and increased creatine phosphokinase activity are the most frequently observed laboratory features and the parasitological examination of a muscle biopsy and the detection of specific circulating antibodies will confirm the diagnosis. The medical treatment includes anthelmintics (mebendazole or albendazole) and glucocorticosteroids. Mebendazole is usually administered at a daily dose of 5 mg/kg but higher doses (up to 20 - 25 mg/kg/day) are recommended in some countries. Albendazole is used at 800 mg/day (15 mg/kg/day) administered in two doses. These drugs should be taken for 10 - 15 days. The use of mebendazole or albendazole is contraindicated during pregnancy and not recommended in children aged < 2 years. The most commonly used steroid is prednisolone, which may alleviate the general symptoms of the disease. It is administered at a dose of 30 - 60 mg/day for 10 - 15 days.

Novel prevention program for trichinellosis in inuit communities

Repeated outbreaks of trichinellosis caused by the consumption of Trichinella-infected walrus (Odobenus rosmarus) meat, which have sometimes led to serious morbidity, have stimulated Inuit communities in Nunavik (northern Quebec), Canada, to develop an innovative trichinellosis prevention program. The program involves preconsumption testing of meat samples from harvested walrus at a regional laboratory and the rapid dissemination of the results of such testing to communities. Local health authorities in Inukjuak conducted an epidemiological investigation after testing identified Trichinella-positive walrus meat in September 1997. This report describes the events that occurred before, during, and after the trichinellosis outbreak and also documents how the prevention program contributed to successful resolution of the outbreak.

Persistence of Trichinella spiralis in rat carcasses experimentally mixed in different feed

Trichinella spiralis infected rat carcasses were incubated for 6 weeks in several animal feeds to assess how long Trichinella can present a risk for an outbreak in contaminated feeds. In groups of 6, 24 infected target rats were placed in silage, grained barley, propionic acid-preserved feed, and also into simulated pasture conditions. Test environments were sampled after one-, 2-, 4-, and 6-week-incubations. Trichinella larvae were recovered by digestion, and their infectivity was evaluated in rats. A two-week incubation reduced the number of recovered larvae, but still after 6 weeks low numbers were isolated from all feeds except from the experimental group simulating pasture conditions. After 2 weeks storage, the larvae were infective in all storage environments. However, up to 4 weeks, they survived only in the propionic acid-fermented feed and there in small numbers with reduced reproductive capability. This indicates the possibility of farm animals to get infection from rats or other infected material being hazardously mixed with hay or other feed. If silage is stored for at least one month before use, however, the risk from this forage appears to be minimized.

Detection of Trichinella infection in food animals

The first part of this review article deals with classical methods used for the detection of Trichinella larvae in muscle samples of those animal species which are recognized as traditional sources of trichinellosis for human beings, as well as those species which are important for epidemiological reasons. Special consideration is given to the main applications of these methods (routine slaughter inspection, and epidemiological studies in reservoir animals), and to the major factors that may influence detection methods (sampling site, sample size). Historical, current and future aspects concerning national and EU legislation for Trichinella inspection are also presented. The latter part of this review is directed at serodiagnostic methods for the detection of Trichinella-specific antibodies in different animal species. Classical methods of serodiagnosis such as the complement fixation test and immunofluorescence antibody test are reviewed and the characteristics and performance of the ELISA are discussed. Factors dependent upon the animal species being tested or on components of the ELISA test system are considered. This paper also reviews systematic development of the ELISA in relation to improvements in test specificity and sensitivity. Additionally, remarks are made on implementing this test for surveillance and control programs in domestic pigs and wildlife.

Epidemiology of trichinellosis in Mexico, Central and South America

Trichinella species are widely distributed throughout the world and are found in a large number of carnivorous animals, humans and incidental hosts. The data presented in this review show that Trichinella infection has been reported in both humans and animals in Mexico, Argentina and Chile since the end of the 19th century, and more recently in Bolivia. This parasitic infection is still a public health problem in countries such as Argentina and Chile. Although efforts have focused on the control and prevention of trichinellosis in these countries, there were still human cases and outbreaks of trichinellosis reported. Diagnosis of infection in animals such as pigs still includes, in many endemic areas, the use of trichinoscopy. In Argentina, however, artificial digestion has been recently introduced in slaughterhouses to detect Trichinella infection in pigs. In some endemic areas in Mexico, the use of serological assays for human trichinellosis and pig infections have resulted in improved detection. Most of the outbreaks of human trichinellosis in Mexico, Argentina and Chile have occurred as a result of the consumption of undercooked pork or pork products from animals raised under poor hygienic conditions and which are clandestinely slaughtered. In several studies, rats, dogs and cats have been found to be infected with Trichinella and may be considered a risk for transmission of the infection to pigs or other animals intended for human consumption. Another potential source of transmission of Trichinella to humans is horsemeat; however, information related to horse trichinellosis in Latin-American countries is scarce. In most cases the etiological agent of human trichinellosis in Central and South America has been reported to be Trichinella spiralis; however, only in a few cases has the parasite species been properly identified. Based on the reports available, it is clear that there is a need to carry out better controlled epidemiological studies to determine the true prevalence of the infection in this region of the world. Also, more sensitive methods of diagnosis and improvements in conditions for pig production as well as better sanitary inspection systems, are needed for controlling and preventing transmission of trichinellosis in these countries.

Historical perspectives and current global challenges of Trichinella and trichinellosis

Trichinella spiralis and related species of Trichinella have had a long history of causing human disease, and as a foodborne pathogen have had a major impact on international commerce of pork and other meat animal species which are known to transmit the parasite. Our knowledge of Trichinella has increased substantially over the past few years particularly in the areas of phylogeny, host diversity, epidemiology and control. In this paper, we provide a brief overview of our understanding of Trichinella from its discovery to present time. Past and current challenges of the control of Trichinella and trichinellosis are summarized. As editors of this special issue of Veterinary Parasitology, we introduce a series of invited review articles prepared by experts from around the world, summarizing recent knowledge in Trichinella and trichinellosis.