Abstract
Isolated cases and outbreaks of infection with Trichinella spp. occur frequently throughout the world, sometimes resulting in fatalities. The clinical presentations of signs and symptoms are remarkably constant for most of the species of Trichinella, but in infections with Trichinella nativa and Trichinella britovi, classical symptoms of trichinellosis may be absent. It is important to be able to correlate the clinical presentation of trichinellosis with the life cycle of these helminths in order to make an accurate diagnosis. Knowledge of the epidemiology of the disease enables the physician to identify other potential cases, since most epidemics can be traced back to a common source of raw or undercooked meat. A comprehensive summary relating the most important clinical variables is presented graphically for easy reference to the text. Symptoms and signs are considered in relation to severity of infection. Laboratory findings and diagnostic techniques, including new modalities (e.g., DNA and antigen detection), are discussed. A discussion of treatment and preventive measures concludes our review.
Full Text
The Full Text of this article is available as a PDF (1.2 MB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ahmad A., Wang C. H., Bell R. G. A role for IgE in intestinal immunity. Expression of rapid expulsion of Trichinella spiralis in rats transfused with IgE and thoracic duct lymphocytes. J Immunol. 1991 May 15;146(10):3563–3570. [PubMed] [Google Scholar]
- Alvarez-Chacón R., Riega-Carnero R. E., García-Rosales J. J., Wong-Chío M., Cob-Sosa C. E. Triquinosis en el niño. Informe de 8 casos. Bol Med Hosp Infant Mex. 1992 May;49(5):286–290. [PubMed] [Google Scholar]
- Ancelle T., Dupouy-Camet J., Heyer F., Faurant C., Lapierre J. Outbreak of trichinosis due to horse meat in the Paris area. Lancet. 1985 Sep 21;2(8456):660–660. doi: 10.1016/s0140-6736(85)90020-0. [DOI] [PubMed] [Google Scholar]
- Bailey T. M., Schantz P. M. Trends in the incidence and transmission patterns of trichinosis in humans in the United States: comparisons of the periods 1975-1981 and 1982-1986. Rev Infect Dis. 1990 Jan-Feb;12(1):5–11. doi: 10.1093/clinids/12.1.5. [DOI] [PubMed] [Google Scholar]
- Bandi C., La Rosa G., Comincini S., Damiani G., Pozio E. Random amplified polymorphic DNA technique for the identification of Trichinella species. Parasitology. 1993 Nov;107(Pt 4):419–424. doi: 10.1017/s0031182000067779. [DOI] [PubMed] [Google Scholar]
- Cabral-Soto J., Villicaña-Fuentes H., Fragoso-Uribe R., Contreras A. Perfil epidemiológico de la triquinosis en el estado de Zacatecas. Salud Publica Mex. 1990 Sep-Oct;32(5):575–582. [PubMed] [Google Scholar]
- Capo V., Despommier D. D., Silberstein D. S. The site of ecdysis of the L1 larva of Trichinella spiralis. J Parasitol. 1984 Dec;70(6):992–994. [PubMed] [Google Scholar]
- Compton S. J., Celum C. L., Lee C., Thompson D., Sumi S. M., Fritsche T. R., Coombs R. W. Trichinosis with ventilatory failure and persistent myocarditis. Clin Infect Dis. 1993 Apr;16(4):500–504. doi: 10.1093/clind/16.4.500. [DOI] [PubMed] [Google Scholar]
- Cuperlovic K. Current status of food-borne parasitic zoonoses--eastern Europe. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):72–77. [PubMed] [Google Scholar]
- Despommier D. D., Sukhdeo M., Meerovitch E. Trichinella spiralis: site selection by the larva during the enteral phase of infection in mice. Exp Parasitol. 1978 Apr;44(2):209–215. doi: 10.1016/0014-4894(78)90100-5. [DOI] [PubMed] [Google Scholar]
- Despommier D. D. Trichinella spiralis and the concept of niche. J Parasitol. 1993 Aug;79(4):472–482. [PubMed] [Google Scholar]
- Despommier D., Aron L., Turgeon L. Trichinella spiralis: growth of the intracellular (muscle) larva. Exp Parasitol. 1975 Feb;37(1):108–116. doi: 10.1016/0014-4894(75)90058-2. [DOI] [PubMed] [Google Scholar]
- Despommier D., Weisbroth S., Fass C. Circulating eosinophils and trichinosis in the rat: the parasitic stage responsible for induction during infection. J Parasitol. 1974 Apr;60(2):280–284. [PubMed] [Google Scholar]
- Dissamarn R., Indrakamhang P. Trichinosis in Thailand during 1962-1983. Int J Zoonoses. 1985 Dec;12(4):257–266. [PubMed] [Google Scholar]
- Dordevic M. Detection of Trichinella by various methods in Yugoslavia. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):326–328. [PubMed] [Google Scholar]
- Dzbeński T. H., Bitkowska E., Płonka W. Detection of a circulating parasitic antigen in acute infections with Trichinella spiralis: diagnostic significance of findings. Zentralbl Bakteriol. 1994 Nov;281(4):519–525. doi: 10.1016/s0934-8840(11)80340-3. [DOI] [PubMed] [Google Scholar]
- Eisenman A., Einat R. [A family outbreak of trichinosis acquired in Israel]. Harefuah. 1992 Jun 1;122(11):702-4, 751. [PubMed] [Google Scholar]
- Feldmeier H., Bienzle U., Jansen-Rosseck R., Kremsner P. G., Wieland H., Dobos G., Schroeder S., Fengler-Dopp D., Peter H. H. Sequelae after infection with Trichinella spiralis: a prospective cohort study. Wien Klin Wochenschr. 1991;103(4):111–116. [PubMed] [Google Scholar]
- Foster E. M. Foodborne hazards of microbial origin. Fed Proc. 1978 Oct;37(12):2577–2581. [PubMed] [Google Scholar]
- Fourestie V., Douceron H., Brugieres P., Ancelle T., Lejonc J. L., Gherardi R. K. Neurotrichinosis. A cerebrovascular disease associated with myocardial injury and hypereosinophilia. Brain. 1993 Jun;116(Pt 3):603–616. doi: 10.1093/brain/116.3.603. [DOI] [PubMed] [Google Scholar]
- Fröscher W., Gullotta F., Saathoff M., Tackmann W. Chronic trichinosis. Clinical, bioptic, serological and electromyographic observations. Eur Neurol. 1988;28(4):221–226. doi: 10.1159/000116271. [DOI] [PubMed] [Google Scholar]
- Garkavi B. L. Vid trikhinelly, vydelennyi ot dikikh khishchnykh. Veterinariia. 1972 Oct;10:90–91. [PubMed] [Google Scholar]
- Hanbury R. D., Doby P. B., Miller H. O., Murrell K. D. Trichinosis in a herd of swine: cannibalism as a major mode of transmission. J Am Vet Med Assoc. 1986 May 15;188(10):1155–1159. [PubMed] [Google Scholar]
- Harms G., Binz P., Feldmeier H., Zwingenberger K., Schleehauf D., Dewes W., Kress-Hermesdorf I., Klindworth C., Bienzle U. Trichinosis: a prospective controlled study of patients ten years after acute infection. Clin Infect Dis. 1993 Oct;17(4):637–643. doi: 10.1093/clinids/17.4.637. [DOI] [PubMed] [Google Scholar]
- Hernández M., Ramos-Martínez E., Casco-Sánchez E. J., Morales-Gómez J. M., Pérez-Matos E. M. Triquinosis aguda. Epidemia de 166 casos en Ciudad Delicias, Chih. Diagnóstico por compresión tisular y tinción. Gac Med Mex. 1992 Jan-Feb;128(1):45–50. [PubMed] [Google Scholar]
- Hinz E. Trichinellosis and trichinellosis control in Germany. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):329–333. [PubMed] [Google Scholar]
- Ivanoska D., Cuperlović K., Gamble H. R., Murrell K. D. Comparative efficacy of antigen and antibody detection tests for human trichinellosis. J Parasitol. 1989 Feb;75(1):38–41. [PubMed] [Google Scholar]
- Juranovic L. R., Park D. L. Foodborne toxins of marine origin: ciguatera. Rev Environ Contam Toxicol. 1991;117:51–94. doi: 10.1007/978-1-4612-3054-0_2. [DOI] [PubMed] [Google Scholar]
- Kamel A. M. Trichinosis in camels. J Egypt Soc Parasitol. 1991 Aug;21(2):589–590. [PubMed] [Google Scholar]
- Kefenie H., Bero G. Trichinosis from wild boar meat in Gojjam, north-west Ethiopia. Trop Geogr Med. 1992 Jul;44(3):278–280. [PubMed] [Google Scholar]
- Khamboonruang C. The present status of trichinellosis in Thailand. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):312–315. [PubMed] [Google Scholar]
- Kim C. W. The significance of changing trends in trichinellosis. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):316–320. [PubMed] [Google Scholar]
- Komaroff A. L., Buchwald D. Symptoms and signs of chronic fatigue syndrome. Rev Infect Dis. 1991 Jan-Feb;13 (Suppl 1):S8–11. doi: 10.1093/clinids/13.supplement_1.s8. [DOI] [PubMed] [Google Scholar]
- Kozek W. J. The molting pattern in Trichinella spiralis. I. A light microscope study. J Parasitol. 1971 Oct;57(5):1015–1028. [PubMed] [Google Scholar]
- Landry S. M., Kiser D., Overby T., Mays B., Caplen C. W. Trichinosis: common source outbreak related to commercial pork. South Med J. 1992 Apr;85(4):428–429. doi: 10.1097/00007611-199204000-00022. [DOI] [PubMed] [Google Scholar]
- Lange W. R. Ciguatera fish poisoning. Am Fam Physician. 1994 Sep 1;50(3):579–584. [PubMed] [Google Scholar]
- Leiby D. A., Duffy C. H., Murrell K. D., Schad G. A. Trichinella spiralis in an agricultural ecosystem: transmission in the rat population. J Parasitol. 1990 Jun;76(3):360–364. [PubMed] [Google Scholar]
- Li X. Food-borne parasitic zoonoses in the People's Republic of China. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):31–35. [PubMed] [Google Scholar]
- Lopez-Lozano J. J., Garcia Merino J. A., Liaño H. Bilateral facial paralysis secondary to trichinosis. Acta Neurol Scand. 1988 Sep;78(3):194–197. doi: 10.1111/j.1600-0404.1988.tb03645.x. [DOI] [PubMed] [Google Scholar]
- Louthrenoo W., Mahanuphab P., Sanguanmitra P., Thamprasert K. Trichinosis mimicking polymyositis in a patient with human immunodeficiency virus infection. Br J Rheumatol. 1993 Nov;32(11):1025–1026. doi: 10.1093/rheumatology/32.11.1025. [DOI] [PubMed] [Google Scholar]
- MacLean J. D., Viallet J., Law C., Staudt M. Trichinosis in the Canadian Arctic: report of five outbreaks and a new clinical syndrome. J Infect Dis. 1989 Sep;160(3):513–520. doi: 10.1093/infdis/160.3.513. [DOI] [PubMed] [Google Scholar]
- McAuley J. B., Michelson M. K., Hightower A. W., Engeran S., Wintermeyer L. A., Schantz P. M. A trichinosis outbreak among Southeast Asian refugees. Am J Epidemiol. 1992 Jun 15;135(12):1404–1410. doi: 10.1093/oxfordjournals.aje.a116251. [DOI] [PubMed] [Google Scholar]
- McAuley J. B., Michelson M. K., Schantz P. M. Trichinella infection in travelers. J Infect Dis. 1991 Nov;164(5):1013–1016. doi: 10.1093/infdis/164.5.1013. [DOI] [PubMed] [Google Scholar]
- Morakote N., Sukhavat K., Khamboonruang C., Siriprasert V., Suphawitayanukul S., Thamasonthi W. Persistence of IgG, IgM, and IgE antibodies in human trichinosis. Trop Med Parasitol. 1992 Sep;43(3):167–169. [PubMed] [Google Scholar]
- Murrell K. D., Bruschi F. Clinical trichinellosis. Prog Clin Parasitol. 1994;4:117–150. [PubMed] [Google Scholar]
- Nishiyama T., Araki T., Mizuno N., Wada T., Ide T., Yamaguchi T. Detection of circulating antigens in human trichinellosis. Trans R Soc Trop Med Hyg. 1992 May-Jun;86(3):292–293. doi: 10.1016/0035-9203(92)90316-5. [DOI] [PubMed] [Google Scholar]
- Olaison L., Ljungström I. An outbreak of trichinosis in Lebanon. Trans R Soc Trop Med Hyg. 1992 Nov-Dec;86(6):658–660. doi: 10.1016/0035-9203(92)90178-f. [DOI] [PubMed] [Google Scholar]
- Pozio E., La Rosa G. General introduction and epidemiology of trichinellosis. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):291–294. [PubMed] [Google Scholar]
- Pozio E., La Rosa G., Murrell K. D., Lichtenfels J. R. Taxonomic revision of the genus Trichinella. J Parasitol. 1992 Aug;78(4):654–659. [PubMed] [Google Scholar]
- Pozio E., La Rosa G., Rossi P., Murrell K. D. Biological characterization of Trichinella isolates from various host species and geographical regions. J Parasitol. 1992 Aug;78(4):647–653. [PubMed] [Google Scholar]
- Pozio E., Varese P., Morales M. A., Croppo G. P., Pelliccia D., Bruschi F. Comparison of human trichinellosis caused by Trichinella spiralis and by Trichinella britovi. Am J Trop Med Hyg. 1993 Apr;48(4):568–575. doi: 10.4269/ajtmh.1993.48.568. [DOI] [PubMed] [Google Scholar]
- Roberts T., Murrell K. D., Marks S. Economic losses caused by foodborne parasitic diseases. Parasitol Today. 1994 Nov;10(11):419–423. doi: 10.1016/0169-4758(94)90171-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rénier J. F., Goeau-Brissonnière O., Vercken J. B., Tavakoli R., de Cervens T., Lesur G., Raphaël J. C., Patel J. C. L'entérite aiguë nécrosante: une complication rare de la trichinose. Gastroenterol Clin Biol. 1990;14(4):408–409. [PubMed] [Google Scholar]
- Sandoval L., Pérez S., Contreras M. C. La reacción de hemaglutinación indirecta en el diagnóstico de la triquinosis. Bol Chil Parasitol. 1990 Jul-Dec;45(3-4):80–83. [PubMed] [Google Scholar]
- Schad G. A., Duffy C. H., Leiby D. A., Murrell K. D., Zirkle E. W. Trichinella spiralis in an agricultural ecosystem: transmission under natural and experimentally modified on-farm conditions. J Parasitol. 1987 Feb;73(1):95–102. [PubMed] [Google Scholar]
- Schantz P. M., McAuley J. Current status of food-borne parasitic zoonoses in the United States. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):65–71. [PubMed] [Google Scholar]
- Schmitt N., Saville J. M., Greenway J. A., Stovell P. L., Friis L., Hole L. Sylvatic trichinosis in British Columbia: potential threat to human health from an independent cycle. Public Health Rep. 1978 Mar-Apr;93(2):189–193. [PMC free article] [PubMed] [Google Scholar]
- Singh M., Hian Y. E., Lay-Hoon C. Current status of food-borne parasitic zoonoses in Singapore. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):27–30. [PubMed] [Google Scholar]
- Soh C. T. Current status of food-borne parasitic zoonoses in Korea. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):54–55. [PubMed] [Google Scholar]
- Spry C. J., Davies J., Tai P. C., Olsen E. G., Oakley C. M., Goodwin J. F. Clinical features of fifteen patients with the hypereosinophilic syndrome. Q J Med. 1983 Winter;52(205):1–22. [PubMed] [Google Scholar]
- Wheeldon E. B., Dick T. A., Schulz T. A. First report of Trichinella spiralis var. pseudospiralis in North America. J Parasitol. 1983 Aug;69(4):781–782. [PubMed] [Google Scholar]
- Wright K. A., Weidman E., Hong H. The distribution of cells killed by Trichinella spiralis in the mucosal epithelium of two strains of mice. J Parasitol. 1987 Oct;73(5):935–939. [PubMed] [Google Scholar]
- Yamaguchi T. Present status of trichinellosis in Japan. Southeast Asian J Trop Med Public Health. 1991 Dec;22 (Suppl):295–301. [PubMed] [Google Scholar]
- Zamora-Chávez A., de la O-Cavazos M. E., Bernal-Redondo R. M., Berrones-Espericueta D., Vázquez-Antona C. Triquinosis aguda en niños. Brote epidémico intrafamiliar en la ciudad de México. Bol Med Hosp Infant Mex. 1990 Jun;47(6):395–400. [PubMed] [Google Scholar]
- el Koussa S., Chemaly R., Fabre-Bou Abboud V., Tamraz J., Haddad N. Trichinose et occlusions sino-veineuses cérébrales. Rev Neurol (Paris) 1994 Jun-Jul;150(6-7):464–466. [PubMed] [Google Scholar]
