History of trichinellosis surveillance

Celebrating the 60th Anniversary of the International Commission on Trichinellosis: An early example of Franco-German collaboration to study the Trichinellosis outbreak of Emersleben (1883)

Two prominent physicians, Grancher and Brouardel, were sent by the French Health authorities to study the severe ongoing outbreak of trichinellosis in Emersleben, Germany (1883). They produced a highly accurate description of the outbreak and confirmed that they had never observed such cases in France. Grancher performed two necropsies and very precisely described the histological lesions provoked by the larvae entering and transforming muscular fibers. They also had the opportunity to meet Virchow in Berlin and they emphasized his extreme kindness. This French medical mission and cooperation with famous German scientists such as Virchow is probably one of the first examples of international collaboration on trichinellosis. It prefigured the international collaborative efforts made by the International Commission on Trichinellosis which was created in 1958 and is still active.

The low global burden of trichinellosis: evidence and implications

Trichinellosis is a cosmopolitan foodborne disease that may result in severe health disorders and even death. Despite international awareness of the public health risk associated with trichinellosis, current data on its public health impact are still lacking. Therefore we assessed, for the first known time, the global burden of trichinellosis using the Disability-Adjusted Life Year metric. The global number of Disability-Adjusted Life Years due to trichinellosis was estimated to be 76 per billion persons per year (95% credible interval: 38-129). The World Health Organization European Region was the main contributor to this global burden, followed by the WHO region of the Americas and the World Health Organization Western Pacific region. The global burden of trichinellosis is much lower than that of other foodborne parasitic diseases and is in sharp contrast to the high budget allocated to prevent the disease in many industrialised countries. To decrease the uncertainty around the current estimates, more knowledge is needed on the level of underreporting of clinical trichinellosis in different parts of the world.

An outbreak of trichinellosis in Hungary

In a small village of Hungary, a human trichinellosis outbreak (affecting eight people) occurred in January-February, 2009. In the outbreak investigation (i) Trichinella spiralis larvae were detected in meat products derived from the pigs slaughtered in the backyard of one of the patients (a foxhunter) in December 2008, and in a brown rat captured in the same backyard; (ii) sera of 24 pigs held in 11 yards of the village and that of some dogs of the foxhunter were found Trichinella-positive; (iii) sera of five villagers who could not be infected in the particular outbreak were also found reactive in Trichinella-specific laboratory tests. The followings helped the rise of an outbreak: the geographical position and the presence of empty houses favoured the multiplication of rats; there was no extermination of rats in the previous years; there was no meat inspection; raw meat and improperly processed meat products were tasted at the pig-slaughter; villagers gave tastes to each other. People were informed on the symptoms, the way of transmission, and the possibilities of prevention of trichinellosis by experts. With the help of local authorities, all the properties including the grounds with empty houses were involved in the extermination of rodents.

The roots of evil: the amazing history of trichinellosis and Trichinella parasites

This review aims to investigate, from a historical point of view, the roots of the Trichinella pathogens and the disease they produce, beginning from the times first recorded in the Bible and continuing until the scientific mysteries of the pathogen were finally unveiled. Our journey sheds light on "strange" epidemics developing before the discovery of the parasite and bearing a clinical similitude to trichinellosis; it follows the controversies that erupted after the nineteenth century discovery of the parasite and the subsequent official outbreaks, and then examines the pioneering methods used for its visualization. Finally, it tries to reveal the possible relationship of trichinellosis with the arts. Furthermore, it seems that the saga of the helminth, "destined to remain with us, both in nature and in the laboratory," will continue to haunt and fascinate scientists from both developing and developed countries, as they try to answer new questions about the parasite's "evil" nature.

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.