Freeze-tolerance of Trichinella muscle larvae in experimentally infected wild boars

End-to-end donor screening and manufacturing controls: complementary quality-based strategies to minimize patient risk for donor-derived microbiome therapeutics

Advances in microbiome therapeutics have been motivated by a deeper understanding of the role that the gastrointestinal microbiome plays in human health and disease. The FDA approval of two stool-derived live biotherapeutic products (LBPs), REBYOTA® 150 mL enema (fecal microbiota, live-jslm; formerly RBX2660) and VOWST® oral capsules (fecal microbiota spores, live-brpk; formerly SER-109), for the prevention of recurrent CDI in adults following antibiotic treatment for recurrent CDI provides promise and insights for the development of LBPs for other diseases associated with microbiome dysfunction. Donor-derived products carry risk of disease transmission that must be mitigated through a robust donor screening program and downstream manufacturing controls. Most published recommendations for donor screening practices are prescriptive and do not include a systematic, risk-based approach for donor stool-derived products. A general framework for an end-to-end donor screening program is needed using risk management strategies for donor-derived microbiome therapeutic using a matrixed approach, combining the elements of donor screening with manufacturing controls that are designed to minimize risk to patients. A donor screening paradigm that incorporates medical history, physical examination, laboratory testing, and donor sample inspection are only the first steps in reducing risk of transmission of infectious agents. Manufacturing controls are the cornerstone of risk mitigation when screening unwittingly fails. Failure Mode and Effects Analysis (FMEA) can be used as a tool to assess for residual risk that requires further donor or manufacturing controls. Together, a well-reasoned donor program and manufacturing controls are complementary strategies that must be revisited and reexamined frequently with constant vigilance to mitigate risk to patients. In the spirit of full disclosure and informed consent, physicians should discuss any limitations in the donor screening and manufacturing processes with their patients prior to treatment with microbiome-based therapeutics.

Raw meat based diet (RMBD) for household pets as potential door opener to parasitic load of domestic and urban environment. Revival of understated zoonotic hazards? A review

RMBD (acronym of Raw Meat Based Diet) and BARF diets (acronym for Biologically Appropriate Raw Food or Bones and Raw Food) account dietary regimens based on raw ingredients (including raw meat), popular in pet feeding. Animal tissues and organs as well as other uncooked ingredients are more and more popularly used by pet owners to feed household pets. However, the increased risk of exposure to microbiological and parasitic agents poses the question as to whether such diets may be recommendable to be handled and offered to domestic cats and dogs co-living in domestic and urban environment. Above all, the threat of human and animal infections by parasites from raw meat fed to pets is not sufficiently explored and tracked, meanwhile deserving particular surveillance, instead. At this regard, raw meat feeding to pets may represent a route of exposure to the increased risk of environmental load. In fact, some parasites typically found in rural environment can be given the chance to complete their life-cycle, for the closeness between definitive and intermediate hosts. This is of particular concern, as potentially infected pets serving as definitive hosts can become a continuous source of environmental diffusion of parasites, both at domestic and urban level. The handling of raw meat requires adequate knowledge and awareness of the hygienic principles to prevent the onset of disorders related to both manipulation by pet owners and uncooked food consumption by the pet. This review aimed to shed a comprehensive overview of the hygienic aspects related to raw pet feeding, as to handling of raw meat in domestic environment, with special emphasis on parasitic agents and related zoonotic hazards.

Trichinella britovi infection in wild boar in Portugal

Trichinella spp. infection occurs when a host ingests muscle tissue containing infective larvae (L1 stage). Wild boar meat and its products represent the second largest source of human trichinellosis worldwide. For this reason, and since that in Portugal wild boar is the most hunted large game specie, the laboratory of Technology, Quality and Food Safety (TQFS) from the University of Trás-os-Montes e Alto Douro created a free service to test wild boar meat for Trichinella spp. From December 2015 to February 2020, and 857 samples were analysed. From those, the majority (719/857, 83.9%) were tested after October 2018 when a specific national legislation came into force, demanding that meat from wild boar hunted in a defined risk area should be tested for Trichinella spp. Under TQFS laboratory activity, in January 2020, a positive case was identified, being the first molecular confirmation of Trichinella britovi infection in wild boar in Portugal. Additionally to this activity, in 2019, a questionnaire was submitted to 100 hunters to acquire information about wild boar meat usage and consumption behaviours. From the total respondents, 86% declared they intended to use meat for private consumption. Of those, 93% also stated that have sold part of the meat and/or homemade sausages, the majority (80%) without prior testing for Trichinella spp., as required by EU Regulation. These results alert the hunters to a risk for human infection, which could be extended to outside the hunter's household. Given the actual epidemiological situation, it should be emphasized that testing for Trichinella spp. in wild boar meat should be maintained and reinforced, particularly in the risk area. The results presented in this report strongly support the importance of specific national legislation to mitigate the risk of trichinellosis due to consumption of non-tested wild boar meat.

Diversity of Trichinella species in relation to the host species and geographical location

Trichinella nematodes still circulate in various hosts in both domestic and sylvatic environments. Recently, in Europe, the transmission of Trichinella spp. to humans has been attributed more to wild animals than to domestic animals. However, domestic animals could still be a source of human infections in some regions. Therefore, our aim was to determine the species composition of Trichinella and the prevalence and intensity of infections in animal populations from the domestic cycle, namely pigs (Sus scrofa f. domestica); the synantropic cycle, in the form of rats (Rattus norvegicus); and the sylvatic cycle, namely wild boars (Sus scrofa) and red foxes (Vulpes vulpes), in Poland. The findings showed that the nematode prevalence in pigs (0.0002 %) and wild boars (0.3 %) was lower than it was in red foxes (4 %). A very high prevalence was found in rats (23.3 %), but it must be emphasized that the investigated rat samples were collected from farms where pigs were infected with Trichinella spp. The mean larval burden was found to be higher in wild boars and pigs (11.48 lpg and 10.19 lpg) than in red foxes and rats (4.09 and 2.30). Trichinella spiralis was the predominant species in pigs (98.6 %), wild boars (77.3 %) and rats (100 %), while in red foxes, this species occurred less frequently (15.5 %). The most frequently occurring species in red foxes was Trichinella britovi (73.2 %). Moreover, in wild boar and red fox coinfections, T. spiralis/T. britovi were detected (3.1 and 9.9 %, respectively). In addition, Trichinella pseudospiralis was detected in a few wild boars (0.5 %) and Trichinella nativa was found in one red fox and one wild boar. Furthermore, different T. spiralis and T. britovi prevalence ratios in various geographical regions were found. In the wild boar population, a higher frequency of T. spiralis (70-85 % of infected animals) was observed in the western and central parts of Poland, while in the eastern part, this dominance was not as evident (46-59 %). In the red fox population, T. britovi was abundant throughout the entire territory; however, its highest prevalence was in the east (90-100 %).

The Increase of Exotic Zoonotic Helminth Infections: The Impact of Urbanization, Climate Change and Globalization

Zoonotic parasitic diseases are increasingly impacting human populations due to the effects of globalization, urbanization and climate change. Here we review the recent literature on the most important helminth zoonoses, including reports of incidence and prevalence. We discuss those helminth diseases which are increasing in endemic areas and consider their geographical spread into new regions within the framework of globalization, urbanization and climate change to determine the effect these variables are having on disease incidence, transmission and the associated challenges presented for public health initiatives, including control and elimination.

Effect of temperature on the survival of Alaria alata mesocercariae

Recent findings of Alaria alata mesocercariae in wild boars and other animals in Europe reinforced the concern about the public health risk posed by this parasite especially if the game meat is insufficiently heated during preparation. Cooking and freezing are effective methods for the inactivation of parasites in meat whereas refrigeration is considered as an essential part of the Good Hygiene Practice. Additionally, microwave dielectric heating may represent an equally effective tool for parasite inactivation. Therefore, isolated vital mesocercariae were examined with respect to their resilience against heating, refrigeration, freezing, and microwave heating. A. alata mesocercariae stored in Ringer's solution do not survive heating temperatures that exceed 60.0 °C. Similarly, exposure to microwave heating ensured an inactivation of all parasite developmental stages after 90 s of treatment. In contrast, the parasites' tolerance towards cold is far higher as the mesocercariae survived refrigeration temperatures (4.0 ± 2 °C) in Ringer's solution for up to 13 days. An effective inactivation by cold is therefore only guaranteed if the infested game meat is frozen to a core temperature of -13.7 °C for a minimum of 2 h at least. Game meat should be handled with the same or even higher caution than meat of husbandry animals since wild animals may be infected with parasites or other zoonotic agents that are not common in livestock. It is therefore of crucial importance that appropriate temperature time protocols are used for the reliable inactivation of these zoonotic agents.

Trend analysis of Trichinella in a red fox population from a low endemic area using a validated artificial digestion and sequential sieving technique

Freezing of fox carcasses to minimize professional hazard of infection with Echinococcus multilocularis is recommended in endemic areas, but this could influence the detection of Trichinella larvae in the same host species. A method based on artificial digestion of frozen fox muscle, combined with larva isolation by a sequential sieving method (SSM), was validated using naturally infected foxes from Latvia. The validated SSM was used to detect dead Trichinella muscle larvae (ML) in frozen muscle samples of 369 red foxes from the Netherlands, of which one fox was positive (0.067 larvae per gram). This result was compared with historical Trichinella findings in Dutch red foxes. Molecular analysis using 5S PCR showed that both T. britovi and T. nativa were present in the Latvian foxes, without mixed infections. Of 96 non-frozen T. britovi ML, 94% was successfully sequenced, whereas this was the case for only 8.3% of 72 frozen T. britovi ML. The single Trichinella sp. larva that was recovered from the positive Dutch fox did not yield PCR product, probably due to severe freeze-damage. In conclusion, the SSM presented in this study is a fast and effective method to detect dead Trichinella larvae in frozen meat. We showed that the Trichinella prevalence in Dutch red fox was 0.27% (95% CI 0.065-1.5%), in contrast to 3.9% in the same study area fifteen years ago. Moreover, this study demonstrated that the efficacy of 5S PCR for identification of Trichinella britovi single larvae from frozen meat is not more than 8.3%.

Primary characterization and assessment of a T. spiralis antigen for the detection of Trichinella infection in pigs

A clone, designated L20h-Ts3, was selected by immunoscreening of cDNA libraries of Trichinella spiralis worms collected 14h, 20h and 48h post-infection (p.i.) from mice intestines. L20h-Ts3 encodes the full-length of a conserved hypothetical protein of 13.1kDa involving putative interaction with the immune system. PCR analysis showed that L20h-Ts3 mRNA is constitutively expressed throughout T. spiralis life cycle and not restricted to intestinal stages. The L20h-Ts3 fusion protein was obtained in an Escherichia coli expression system and purified by Ni-affinity chromatography before inoculation into mice in order to produce polyclonal antibodies. Then, immunohistochemical study and Western blot analysis revealed its presence within the stichosome of T. spiralis and in excretory/secretory products strengthening a putative fundamental role for the parasite's survival such as host tissue invasion or modification of the host muscular cell phenotype. L20h-Ts3 fusion protein was recognized in Western blot as soon as 15-20 days p.i. by sera from pigs experimentally infected with 20,000 muscle larvae (ML) of T. spiralis. Thus, an indirect L20h-Ts3 ELISA was designed and evaluated using sera from experimentally infected pigs by comparison with the only ELISA currently available for trichinellosis purposes. A gain of precocity from 7 up to 14 days and detection up to 25 weeks p.i. was possible with the L20h-Ts3 ELISA offering a large window for trichinellosis detection. The L20h-Ts3 ELISA was less effective in the case of low infections in pigs. Nevertheless, these results show that the L20h-Ts3 ELISA has a real interest due to its precocity and stability of detection in time. The association of the L20h-Ts3 fusion protein with other antigenic proteins identified previously could appreciably improve the serological test and facilitate its standardization.

Outbreak of Trichinella spiralis infections associated with a wild boar hunted at a game farm in Iowa

BACKGROUND

Rates of trichinellosis have declined significantly in the United States due to improved pork production practices and public awareness of the danger of eating raw or undercooked pork. In April 2011, the Minnesota Department of Health received a report of presumptive trichinellosis in a 50-year-old man with a history of wild boar consumption. A public health investigation was initiated.

METHODS

Medical record reviews and patient and family interviews were conducted. Trichinella species serology was performed on patient and family serum samples, and larval identification was attempted on clinical specimens and meat samples.

RESULTS

The index patient harvested a wild boar from an Iowa game farm; he processed the meat after returning home and developed gastrointestinal symptoms 2 days later. Four days after his illness onset, all 5 family members consumed a roast from the boar. The index patient sought healthcare 4 times after illness onset before being definitively diagnosed with trichinellosis. Following initiation of albendazole therapy, the index patient developed atrial fibrillation. One additional family member who processed the raw meat was diagnosed with trichinellosis. Trichinella spiralis larvae were identified in wild boar meat samples.

CONCLUSIONS

Trichinellosis has long been recognized as a potential hazard of consuming undercooked wild carnivore meat, and historically has been associated with consumption of pork from domestic swine, but may be unfamiliar to practicing clinicians in the United States. Education of hunters and the broader population on the potential for trichinellosis and the importance of proper handling and cooking meat from wild or free-range animals needs to be reinforced.