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

From wildlife to humans: The global distribution of Trichinella species and genotypes in wildlife and wildlife-associated human trichinellosis

Zoonotic nematodes of the genus Trichinella are foodborne parasites that have a global distribution in wild carnivores and omnivores, with spillover and spillback into domestic livestock and people, with concomitant trade and health consequences. Historically, most human cases were linked to domestic pigs infected with Trichinella spiralis, but under current high biosecurity swine production in many countries, wildlife have become a more important source of human trichinellosis. The aim of this review is to update the global distribution of Trichinella species and genotypes reported in wildlife, as well as reported human outbreaks from the consumption of wildlife. Using several online databases and by "snowballing" references, hundreds of reports of Trichinella spp. in wildlife published between January 1991 and December 2023 provide an important update to the host and geographic range for each of the recognized 13 species/genotypes, grouped by continent. Surveillance effort was highest in Europe and North America, while Africa, Asia, Central and South America have had limited surveillance, in some instances with human cases serving as sentinels of transmission in a region. Dozens of human outbreaks are described, with wild boars (Sus scrofa) being the most frequently implicated wildlife species in human outbreaks globally. Bears are an important source of infection in North America, for wildlife tourism, and importation of bear meat has also been implicated in multicountry outbreaks. The largest study limitation was the dearth of molecular identification of larvae in both wildlife surveillance studies and human outbreaks, particulary in under-studied regions. We highlight the need for enhanced molecular epidemiological approaches to outbreaks of this important foodborne parasite, and emphasize the need for a One Health approach to manage Trichinella spp. which transmit among terrestrial and marine wildlife (including migratory birds), pigs, horses, and people, often across large geographic scales and borders.

Infection, genetics, and evolution of Trichinella: Historical insights and applications to molecular epidemiology

Genetic variation in pathogen populations provides the means to answer questions in disease ecology and transmission, illuminating interactions between genetic traits, environmental exposures, and disease. Such studies elucidate the phylogeny, evolution, transmission and pathogenesis of viruses, bacteria and parasites. Here, we review how such studies have fostered understanding of the biology and epidemiology of zoonotic nematode parasites in the genus Trichinella spp., which impose considerable economic and health burdens by infecting wildlife, livestock, and people. To use such data to define ongoing chains of local transmission and source traceback, researchers first must understand the extent and distribution of genetic variation resident in regional parasite populations. Thus, genetic variability illuminates a population's past as well as its present. Here we review how such data have helped define population dynamics of Trichinella spp. in wild and domesticated hosts, creating opportunities to harness genetic variation in the quest to prevent, track, and contain future outbreaks.

Trichinella britovi as a risk factor for alternative pig production systems in Greece and Europe

Trichinellosis is an important zoonosis and the most common source of human infection is meat from pigs and wild boars. The European Union (EU) supports alternative pig production systems (organic and free-ranging) as sustainable farming systems. However, these systems that allow outdoor access for farm animals, may create new or reintroduce old risks to public health. During the last years, alternative pig production systems (free-ranging or organic pig) are growing in popularity in Greece due to the increasing interest of consumers for organic products. The majority of the trichinellosis outbreaks in the EU were associated with pork and meat products including wild boars. In Greece, from 2009 to 2012, 37 Trichinella spp. positive free-ranging pigs were reported in free-ranging pig farms of Northern-Eastern Greece (31 were identified as T. britovi). The recent re-emerging present of the Trichinella spp. infections in free-ranging pigs and wild boars are a high risk for the consumers and should alarm the Public Health Authorities in Greece and the EU. During the last years, the organic or free-ranging pig production systems are growing in popularity in the EU. However, these systems increase the risk of Trichinella spp. infections, since pigs are possible to be infected by feeding on carcasses or the offal of hunted or dead wild animals. For this reason, it is important for Public Health Authorities to be focused on the training of hunters and farmers in order to avoid the transmission among free-ranging pigs and prevent the cases of human infection.

Epidemiology and hypothetical transmission cycles of Trichinella infections in the Greater Kruger National Park of South Africa: an example of host-parasite interactions in an environment with minimal human interactions

Knowledge on the epidemiology, host range and transmission of Trichinella spp. infections in different ecological zones in southern Africa including areas of wildlife-human interface is limited. The majority of reports on Trichinella infections in sub-Saharan Africa were from wildlife resident in protected areas. Elucidation of the epidemiology of the infections and the prediction of hosts involved in the sylvatic cycles within specific ecological niches is critical. Of recent, there have been reports of Trichinella infections in several wildlife species within the Greater Kruger National Park (GKNP) of South Africa, which has prompted the revision and update of published hypothetical transmission cycles including the hypothetical options based previously on the biology and feeding behaviour of wildlife hosts confined to the GKNP. Using data gathered from surveillance studies and reports spanning the period 1964-2019, confirmed transmission cycles and revised hypothesized transmission cycles of three known Trichinella species (T. zimbabwensis, Trichinella T8 and T. nelsoni) are presented. These were formulated based on the epidemiological factors, feeding habits of hosts and prevalence data gathered from the GKNP. We presume that the formulated sylvatic cycles may be extrapolated to similar national parks and wildlife protected areas in sub-Saharan Africa where the same host and parasite species are known to occur. The anecdotal nature of some of the presented data confirms the need for more intense epidemiological surveillance in national parks and wildlife protected areas in the rest of sub-Saharan Africa to unravel the epidemiology of Trichinella infections in these unique and diverse protected landscapes.

No evidence of Trichinella spp. in domestic pig carcasses at a selected abattoir in southern Botswana

Trichinellosis is a worldwide zoonosis with genotypes affecting different domestic and wild animals and is widely distributed throughout the world. Species and genotypes of this genus affecting different animals have been identified. Despite its occurrence in Sub-Saharan countries, the presence of trichinellosis in Botswana is yet to be confirmed. The objective of this study was to determine the prevalence of Trichinella infection in domestic pigs slaughtered at an abattoir in Gaborone, Botswana. Of the 111 pig carcasses selected, 5 g of crus of the diaphragm was collected from each carcass, trimmed of all fat and fascia and then cut into 1- to 2-g samples. The muscle samples were pooled into 100-g muscle sample and then processed by the OIE prescribed digestion method. A stereomicroscope was used to examine each grid of the Petri dish for the presence of Trichinella larvae. No Trichinella larvae were found in any digested muscle samples. Future studies should target a wider pig population and other host animals.

First Report of the Occurrence of Trichinella-Specific Antibodies in Domestic Pigs in Central and Eastern Uganda

Previous research on trichinellosis in Africa focused on isolating Trichinella from wildlife while the role of domestic pigs has remained highly under-researched. Pig keeping in Uganda is historically recent, and evidence on zoonotic pig diseases, including infection with Trichinella species, is scarce. A cross-sectional survey on Trichinella seroprevalence in pigs was conducted in three districts in Central and Eastern Uganda from April 2013 to January 2015. Serum from a random sample of 1125 pigs from 22 villages in Eastern and Central Uganda was examined to detect immunoglobulin G (IgG) against any Trichinella spp. using a commercially available ELISA based on excretory-secretory antigen. ELISA positive samples were confirmed using Western Blot based on somatic antigen of Trichinella spiralis as recommended in previous validation studies. Diaphragm pillar muscle samples (at least 5 g each) of 499 pigs from areas with high ELISA positivity were examined using the artificial digestion method. Overall, 78 of all 1125 animals (6.9%, 95% CI: 5.6-8.6%) tested positive for antibodies against Trichinella spp. in the ELISA at significantly higher levels in Kamuli district compared to Masaka and Mukono districts. Thirty-one percent of the ELISA positive samples were confirmed IgG positive by the Western Blot leading to an overall seroprevalence of 2.1% (95% CI: 1.4-3.2%). The large proportion of ELISA positive samples that could not be confirmed using Western blot may be the result of cross-reactivity with other gastrointestinal helminth infections or unknown host-specific immune response mechanisms in local pig breeds in Uganda. Attempts to isolate muscle larvae for species determination using the artificial digestion method were unsuccessful. Due to the large number of muscle samples examined we are confident that even if pigs are infected, the larval burden in pork is too low to pose a major risk to consumers of developing trichinellosis. This was the first large systematic field investigation of Trichinella infection in domestic pigs in Uganda and its results imply that further studies are needed to identify the Trichinella species involved, and to identify potential sources of infection for humans.

Phylogenomic and biogeographic reconstruction of the Trichinella complex

Trichinellosis is a globally important food-borne parasitic disease of humans caused by roundworms of the Trichinella complex. Extensive biological diversity is reflected in substantial ecological and genetic variability within and among Trichinella taxa, and major controversy surrounds the systematics of this complex. Here we report the sequencing and assembly of 16 draft genomes representing all 12 recognized Trichinella species and genotypes, define protein-coding gene sets and assess genetic differences among these taxa. Using thousands of shared single-copy orthologous gene sequences, we fully reconstruct, for the first time, a phylogeny and biogeography for the Trichinella complex, and show that encapsulated and non-encapsulated Trichinella taxa diverged from their most recent common ancestor ∼21 million years ago (mya), with taxon diversifications commencing ∼10-7 mya.

First report of a mixed infection of Trichinella nelsoni and Trichinella T8 in a leopard (Panthera pardus) from the Greater Kruger National Park, South Africa

At least three Trichinella species, namely Trichinella nelsoni, Trichinella britovi and Trichinella zimbabwensis, and one genotype (Trichinella T8), have been isolated from sylvatic carnivores on the African continent. With the exception of T. britovi, the other species are known to circulate in wildlife of the Kruger National Park (KNP), South Africa, and KNP neighbouring game reserves (collectively known as the greater KNP area). Lions (Panthera leo) and spotted hyenas (Crocuta crocuta) appear to be the most important reservoirs of T. nelsoni and Trichinella T8 in the KNP and surrounding areas. Interspecies predation between lions and hyenas has been implicated as a primary mode of maintaining the life cycles of these two Trichinella species. This is the first report of a mixed natural infection of T. nelsoni and Trichinella T8 in a leopard (Panthera pardus) from South Africa. Trichinella muscle larvae were identified to species level by multiplex polymerase chain reaction (PCR). Probable sources of infection, based on the known dietary preference and prey species' range of leopards, are also discussed. The described occurrence of Trichinella species in a leopard from the greater KNP area raises the question of possible sources of infection for this predator species.

New pieces of the Trichinella puzzle

Contrary to our understanding of just a few decades ago, the genus Trichinella now consists of a complex assemblage of no less than nine different species and three additional genotypes whose taxonomic status remains in flux. New data and methodologies have allowed advancements in detection and differentiation at the population level which in turn have demonstrably advanced epidemiological, immunological and genetic investigations. In like manner, molecular and genetic studies have permitted us to hypothesise biohistorical events leading to the worldwide dissemination of this genus, and to begin crystalising the evolution of Trichinella on a macro scale. The identification of species in countries and continents otherwise considered Trichinella-free has raised questions regarding host adaptation and associations, and advanced important findings on the biogeographical histories of its members. Using past reviews as a backdrop, we have ventured to present an up-to-date assessment of the taxonomy, phylogenetic relationships and epidemiology of the genus Trichinella with additional insights on host species, survival strategies in nature and the shortcomings of our current understanding of the epidemiology of the genus. In addition, we have begun compiling information available to date on genomics, proteomics, transcriptomics and population studies of consequence in the hope we can build on this in years to come.

Trichinella infections in animals and humans in sub-Saharan Africa: a review

The aim of this review is to provide information on Trichinella infection in humans, livestock and wildlife in sub-Saharan Africa mainly focusing on geographical distribution of species/genotypes, biology, host range, life cycles and to identify research gaps. Trichinella britovi, Trichinella nelsoni and Trichinella zimbabwensis and one genotype (Trichinella T8) are known to occur in sub-Saharan Africa. Distinct geographic ranges with overlapping of some taxa in some areas have been observed. Genetic variants of T. nelsoni has been reported to occur among parasites originating from Eastern and Southern Africa and sequence heterogeneity also occurs among T. zimbabwensis isolates originating from different regions of Zimbabwe and South Africa. Field observations so far indicate that sylvatic Trichinella infections in the region are common in carnivores (mammals and reptiles) and to a lesser extent in omnivores. Cannibalism, scavenging and predation appear to be the most important routes of transmission and maintenance of the sylvatic cycles of the Trichinella taxa. To date, human trichinellosis has been documented in only four sub-Saharan countries (8.7%, 4/46). Bushpigs and warthogs have been the source of human infection with T. britovi and T. nelsoni being the aetiological agents. An increase in bushmeat trade and the creation of Transfrontier Conservation Areas (TFCAs) may have increased the risk of human trichinellosis in the region. With the creation of TFCAs in the region, sampling of wildlife hosts from protected areas of most sub-Sahara African countries is required to fully map the distribution of Trichinella species/genotypes in this region. More structured field surveys are still needed to determine the sylvatic host distribution of the different Trichinella taxa. Biological data of the Trichinella taxa in both wild and domestic animals of sub-Saharan Africa is very limited and further research is required.

The occurrence of Trichinella zimbabwensis in naturally infected wild crocodiles (Crocodylus niloticus) from the Kruger National Park, South Africa

Trichinella zimbabwensis has been found naturally infecting crocodiles (Crocodylus niloticus) in Zimbabwe, Mozambique, Ethiopia and South Africa, as well as monitor lizards (Varanus niloticus) in Zimbabwe. The reports on natural infections were mostly accidental rather than structured surveys and involved very few animals. Previous surveillance studies in South Africa reported a 38.5% prevalence of T. zimbabwensis among wild crocodiles tested from the Mpumalanga province and Kruger National Park (KNP). No studies have been conducted to date on the geographical distribution and occurrence of T. zimbabwensis in wild crocodiles and varans in countries in southern Africa. Recent outbreaks of pansteatitis in crocodile populations of the KNP, South Africa, provided an opportunity to conduct a more structured survey aimed at elucidating the occurrence and distribution of T. zimbabwensis in culled wild crocodile populations within the KNP. Results from this study showed that T. zimbabwensis occurred in 10 out of 12 culled crocodiles form the KNP. The results also showed that the natural distribution of T. zimbabwensis in crocodiles includes all the major river systems in the KNP. The predilection sites of larvae in muscles followed a different pattern in naturally infected crocodiles compared to observations in experimentally infected mammalian hosts.

Molecular identification of three Trichinella isolates from Heilongjiang Province, People's Republic of China

DNAs of Trichinella dog isolate (HC), Trichinella swine isolate (HH) and Trichinella cat isolate (SW), obtained from Heilongjiang Province, were amplified by the fragments of 18S rDNA and ITS2. Two reference strains, Trichinella spiralis (ISS3) and Trichinella nativa (ISS10) were used for sequence comparison. Sequence and dendrogram analysis indicated that HC belonged to T. nativa and HH together with SW belonged to T. spiralis. This method permits rapid species identification of Trichinella isolates, although further evaluation is required before precisely identification.

Trichinella zimbabwensis in a naturally infected mammal

Trichinella zimbabwensis has been detected in wild and farmed Nile crocodiles (Crocodylus niloticus) and in wild monitor lizards (Varanus niloticus) of several African countries, but it has never been detected in mammals in nature, in spite of its infectivity to rodents, pigs, foxes and monkeys under laboratory conditions. The aim of this work was to describe the first detection of T. zimbabwensis in a naturally infected lion (Panthera leo) of the Kruger National Park (KNP) of South Africa. The sequence of the expansion segment V, a highly variable non-coding sequence of the large subunit ribosomal RNA of the genus Trichinella, of larvae from the lion was identical to that of larvae of T. zimbabwensis collected from a Nile crocodile originating from the same locality as the lion, suggesting a possible transmission of this parasite between mammals and reptiles. The KNP proves to be a very interesting area for parasites of the genus Trichinella since three taxa (Trichinella nelsoni, Trichinella T8 and T. zimbabwensis) circulate among the wildlife of this protected area.

Epidemiology, diagnosis, treatment, and control of trichinellosis

SUMMARY

Throughout much of the world, Trichinella spp. are found to be the causative agents of human trichinellosis, a disease that not only is a public health hazard by affecting human patients but also represents an economic problem in porcine animal production and food safety. Due to the predominantly zoonotic importance of infection, the main efforts in many countries have focused on the control of Trichinella or the elimination of Trichinella from the food chain. The most important source of human infection worldwide is the domestic pig, but, e.g., in Europe, meats of horses and wild boars have played a significant role during outbreaks within the past 3 decades. Infection of humans occurs with the ingestion of Trichinella larvae that are encysted in muscle tissue of domestic or wild animal meat. Early clinical diagnosis of trichinellosis is rather difficult because pathognomonic signs or symptoms are lacking. Subsequent chronic forms of the disease are not easy to diagnose, irrespective of parameters including clinical findings, laboratory findings (nonspecific laboratory parameters such as eosinophilia, muscle enzymes, and serology), and epidemiological investigations. New regulations laying down rules for official controls for Trichinella in meat in order to improve food safety for consumers have recently been released in Europe. The evidence that the disease can be monitored and to some extent controlled with a rigorous reporting and testing system in place should be motivation to expand appropriate programs worldwide.

Trichinella nelsoni and Trichinella T8 mixed infection in a lion (Panthera leo) of the Kruger National Park (South Africa)

In South Africa, Trichinella sp. was first discovered in 1966 in the wildlife of the Kruger National Park (KNP). Since then, both Trichinella T8 and Trichinella nelsoni have been detected in the KNP, leading to a debate on the existence of a gene flow between the two taxa. In 2006-2008, four lions were killed in the Manyeleti Game Reserve, the Mthethomusha Nature Reserve, Numbi Gate, and Skukuza, which border the KNP. Larvae were isolated from muscles by artificial digestion. The molecular identification of single larva by multiplex PCR, followed by a specific PCR to distinguish between Trichinella T8 and Trichinella britovi, revealed Trichinella T8 in the lions from Manyeleti and Skukuza, a mixed infection with T. nelsoni and Trichinella T8 in the lion from Mthethomusha, and T. nelsoni in the lion from Numbi. No larva with a hybrid pattern between the two taxa was observed. No hybrid offspring resulted when crossing single males and females of T. nelsoni and Trichinella T8 in both directions, whereas hybrid offspring were obtained when crossing T. britovi and Trichinella T8 in both directions. This is the first report of a mixed infection with two Trichinella taxa in a host from the KNP, where both Trichinella T8 and T. nelsoni circulate among wildlife. Despite the sympatry status of these two taxa, field and laboratory data seem to exclude the possibility of gene flow, confirming their evolutive separation.

World distribution of Trichinella spp. infections in animals and humans

The etiological agents of human trichinellosis show virtually worldwide distribution in domestic and/or wild animals, with the exception of Antarctica, where the presence of the parasite has not been reported. This global distribution of Trichinella and varying cultural eating habits represent the main factors favouring human infections in industrialised and non-industrialised countries. Human trichinellosis has been documented in 55 (27.8%) countries around the world. In several of these countries, however, trichinellosis affects only ethnic minorities and tourists because the native inhabitants do not consume uncooked meat or meat of some animal species. Trichinella sp. infection has been documented in domestic animals (mainly pigs) and in wildlife of 43 (21.9%) and 66 (33.3%) countries, respectively. Of the 198 countries of the world, approximately 40 (20%) are small islands far from the major continents, or city-states where Trichinella sp. cannot circulate among animals for lack of local fauna (both domestic and wild). Finally, information on the occurrence of Trichinella sp. infection in domestic and/or wildlife is still lacking for 92 countries.

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.

Post-Miocene expansion, colonization, and host switching drove speciation among extant nematodes of the archaic genus Trichinella

Parasitic nematodes of the genus Trichinella cause significant food-borne illness and occupy a unique evolutionary position at the base of the phylum Nematoda, unlike the free-living nematode Caenorhabditis elegans. Although the forthcoming genome sequence of Trichinella spiralis can provide invaluable comparative information about nematode biology, a basic framework for understanding the history of the genus Trichinella is needed to maximize its utility. We therefore developed the first robust and comprehensive analysis of the phylogeny and biogeographic history of Trichinella using the variation in three genes (nuclear small-subunit rDNA, and second internal transcribed spacer, mitochondrial large-subunit rDNA, and cytochrome oxidase I DNA) from all 11 recognized taxa. We conclude that (i) although Trichinellidae may have diverged from their closest extant relatives during the Paleozoic, all contemporary species of Trichinella diversified within the last 20 million years through geographic colonization and pervasive host switching among foraging guilds of obligate carnivores; (ii) mammalian carnivores disseminated encapsulated forms from Eurasia to Africa during the late Miocene and Pliocene, and to the Nearctic across the Bering Land Bridge during the Pliocene and Pleistocene, when crown species ultimately diversified; (iii) the greatest risk to human health is posed by those species retaining an ancestral capacity to parasitize a wide range of hosts; and (iv) early hominids may have first acquired Trichinella on the African savannah several million years before swine domestication as their diets shifted from herbivory to facultative carnivory.

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.