A 12-year-old Child with Trichinellosis, Pyomyositis and Secondary Osteomyelitis

Seroepidemological investigation of Toxoplasma gondii and Trichinella spp. in pigs reared by tribal communities and small-holder livestock farmers in Northeastern India

Toxoplasma gondii and Trichinella spp. are critical tissue-dwelling foodborne zoonotic parasites associated with pork consumption and pig rearing. Despite being a major pig-rearing region in the country, Northeastern India has not undergone any investigation regarding the presence of T. gondii and Trichinella spp. in pigs. Therefore, this study aims to determine the seroprevalence of T. gondii and Trichinella spp. and identify associated risk factors in pigs reared by tribal communities and small-holder livestock farmers in the northeastern region of India. In a cross-sectional serological survey, 400 pigs from 400 households across five northeastern states of India underwent testing for the seroprevalence of porcine toxoplasmosis and trichinellosis. Serum samples (80 from each state) were analyzed using commercially available ELISA assays. Data on backyard farm characteristics and various management aspects were collected, and risk factors linked with prevalence were analyzed through univariate and multivariate logistic regression analysis. The findings revealed that the apparent and true prevalence of anti-T. gondii antibodies were 45% (40.12-49.88, 95% CI) and 45.7% (40.7-50.69, 95% CI), respectively. As for anti- Trichinella antibodies, both the apparent and true prevalence were 0.75% (-0.1-1.6, 95% CI). The univariate and multivariate analyses indicated that age above 24 months (OR 7.20, 95% CI 2.45-23.71), exposure to cats (OR = 5.87, 95% CI 2.55-14.05), and farms operating for breeding purposes (OR = 5.60, 95% CI 3.01-11.04) were significant risk factors associated with the seroprevalence of T. gondii. This study marks the initial documentation of the seroprevalence of T. gondii and Trichinella spp. in pigs reared by tribal communities in Northeastern India. The results emphasize the significance of these parasites as foodborne zoonotic threats in the region, potentially posing substantial public health risks, especially within tribal and rural communities. The insights derived from this research could be valuable in formulating targeted preventive and control strategies against T. gondii and Trichinella spp. in pigs, not only in this region but also in areas with similar rearing practices.

Purulent infectious myositis (formerly tropical pyomyositis)

Purulent infectious myositis (PIM), formerly known as tropical pyomyositis, is a pyogenic infection of skeletal muscles. Staphylococcus aureus, a normal human skin inhabitant, is the main pathogen involved, but multiple other microorganisms have been implicated. Although usually a progressive febrile disease with pain in the affected muscle(s), severe, life-threatening forms have been described, especially in immunosuppressed patients and children. PIM may elude early diagnosis given the lack of overlying skin changes. Hence, high index of suspicion followed by imaging modalities (ultrasonography when superficial and computed tomography or magnetic resonance imaging with contrast when deep) help confirm the diagnosis. Treatment requires combination of percutaneous or open surgical drainage along with antimicrobial therapy guided by culture results. The rising incidence of cases due to methicillin-resistant Staphylococcus aureus (MRSA) strains, makes the inclusion of vancomycin be recommended. This paper reviews PIM highlighting its global distribution, causative agents, predisposing factors, management, and potential complications.

Epidemiological Studies on Porcine Trichinellosis in Five States of North East India

BACKGROUND

This study was carried out to evaluate the epidemiological studies of trichinellosis in five states of North East India from Apr 2016 to Dec 2017.

METHODS

Overall, 865 different meat samples for detection of Trichinella larvae and 1580 sera samples for detection of anti-Trichinella antibody were collected. Intensity of infection with Trichinella larvae in meat was determined by HCL: Pepsin digestion procedure and anti-Trichinella IgG in serum were detected using excretory/secretory antigens, according to validated ELISA.

RESULTS

No Trichinella larva was detected by HCL: Pepsin digestion method. However, four (0.25%) samples were seropositive for Trichinella IgG and four inconclusive results as per cut off value. The highest seroprevalence was observed in Meghalaya (0.41%) followed by Assam (0.27%) whereas no seropositive cases were recorded in Arunachal Pradesh, Mizoram and Tripura.

CONCLUSION

Trichinellosis is common in North East, India. However, it is suspected in communities where more than 75% of the population relish pork. Finally, there is a need for more research to establish the facts of trichinellosis in this region. Thus, public awareness, food hygiene, monitoring, and surveillance programme are suggested to implement for prevention of trichinellosis in this region.

Present status of trichinellosis - a neglected zoonosis in India

Trichinellosis is a meat-borne helminthic zoonosis, caused by different species of the genus Trichinella. The disease is cosmopolitan in distribution and affects around 10,000 people annually around the globe. Based on genetic, biochemical and biological variability, 9 valid species (T. britovi, T. murrelli, T. nativa, T. nelsoni, T. papuae, T. patagoniensis, T. pseudospiralis, T. spiralis and T. zimbabwensis) and 3 genotypes (Trichinella T6, T8 and T9) of the parasite have been recognized. These species infect around 100 mammalian species including domestic and wild pigs, horses, game animals and wild carnivores. The infection starts with consumption of raw or undercooked meat or meat products containing encysted muscle larvae of the parasite. Most of the infections or outbreaks have been associated with the consumption of meat or meat products of pigs, wild boars, horses, crocodiles, walruses and dogs. Trichinoscopy is used in the veterinary inspection of pork in slaughterhouses and meat-packing facilities in many countries. It is a rapid process, but low in sensitivity and fails to detect mild infection. The muscle digestion method using HCl-pepsin is more sensitive and thus preferred. Recent outbreak of trichinellosis in Uttarakhand state opened up issues related to rapid diagnosis and lack of consumer awareness regarding safe cooking habits of meat of pig origin. This status report is an attempt to compile the information on Trichinella spp. infection in animals and humans in India at one place to draw the attention of medical and veterinary personnels involved in disease investigation and active research on zoonotic diseases.

Epidemiological studies on trichinellosis in pigs (Sus scofa) in India

The present study was conducted to determine the prevalence of trichinellosis in domestic pigs (Sus scrofa) in India. A total of 319 tissue and 279 serum samples were collected from 279 slaughter pigs. The samples were collected from small slaughter shops located in Assam, Chandigarh (Union territory), Punjab and Uttarakhand states of the country. The presence of Trichinella spp. antibodies in serum was determined using a commercially available enzyme-linked immunosorbent assay (ELISA) kit and tissue samples were digested using the OIE recommended pepsin-HCl digestion method. The overall seroprevalence of trichinellosis was found to be 2.87 %. The age wise seroprevalence was found to be 2.83 % in pigs aged more than 6 months and 3.12 % in pigs <6 months of age. The seroprevalence was more in male (3.38 %) than female (1.96 %) pigs. None of the samples were found positive using pepsin-HCl digestion method. Since none of the samples was found positive for Trichinella, PCR assay could not be employed in the current study. The age, sex and management practices of the animals were not significantly (p > 0.05) associated with seroprevalence. The current research confirms that trichinellosis remains a rare zoonosis in India. However, extensive studies must be carried out in wildlife to identify reservoir hosts in the country.