Outbreak of suspected trichinosis among travelers returning from a neighboring island

Human trichinellosis in Southeast Asia, 2001-2021

To present the situation of human trichinellosis in Southeast Asia in the last 20th years we analyzed outbreak data and seroprevalence studies from 2001 to 2021 for this region. We queried PubMed (https://pubmed.ncbi.nlm.nih.gov) using keywords “Trichinella”, “human” and “Southeast Asia”. In addition, we described Trichinella species circulating in this region.

In Southeast Asia, in communities eating pork, several cultural factors play important roles in the transmission of Trichinella to humans. The seroprevalences of Trichinella infection in humans are known for Laos and Vietnam to be 0–10.5% in some villages. Also, in Cambodia, Laos, Malaysia, Thailand and Vietnam relatively few human outbreaks (13) and cases (1604) have been recorded during the last 21st years. Their associated mortality rates were low (0.75%). Trichinella spiralis and T. papuae were transmitted after consumption of raw or undercooked pork from domesticated and wild pigs. T. papuae transmission was related to consumption of wild boar. In this region, trichinellosis was frequently subclinical and clinical or severe cases were sporadic and occurred more in male patients. Nevertheless, it is likely that trichinellosis is widely under-diagnosed and is an endemic disease.

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In Southeast Asia, trichinellosis occurred mostly in rural populations eating pork or boar meat.

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Since 2001, the majority of cases have been reported in northern Laos and Thailand.

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Trichinella spiralis and T. papuae have been isolated as causative species.

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There is no veterinary surveillance for Trichinella, except in Singapore.

The genus Trichinella and its presence in wildlife worldwide: A review

The genus Trichinella has a worldwide distribution, infecting people, domestic animals, and wildlife. It includes 13 genotypes, which are geographically delimited; Trichinella is transmitted to people through the ingestion of undercooked meat. Historically, it has been associated with pigs, but most Trichinella species affect wildlife, and cases of trichinellosis due to the consumption of game meat have been emerging. Therefore, it is important to monitor the sources of transmission to domestic animals and humans. The objective of this work was to analyse reports of Trichinella spp. in wild/feral animals around the world to identify the needs of future research in the epidemiology of the sylvatic cycle. A search of studies published until 2021 was conducted using Web of Science and SciELO. In the Palearctic, the most commonly studied hosts were wild boars and red foxes, and hosts with the highest prevalence rates were polar bears and martens. In the Nearctic, red foxes and black bears were the most frequently studied hosts, and the highest prevalence was found for wolverines and brown bears. In the Neotropics, positive reports were only identified in two countries, with wild boars being the most commonly studied species, and armadillos featuring the highest prevalence. In the Afrotropics, Trichinella limits its presence to Sub-Saharan Africa, where lions are the most studied hosts, and spotted hyenas have the highest prevalence. In the Indo-Malaya and Australasia ecozones, information on wildlife is scarce; the Norwegian rat is the most frequently studied host, and the Tasmanian devil has the highest prevalence of infection. In the last decade, research on world wildlife has increased which is associated with more frequent trichinellosis outbreaks caused by the consumption of wild meat. The results suggest the need to increase research in developing countries, particularly where more diverse sources of meat are available for human consumption.

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.

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.