Table 4.

Recommended topics for inclusion in a Trichinella testing training program.

Topic	Objectives	Key points
History	Demonstrate the importance of human cases both historically and at present	Trichinella is a public health hazard, worldwide. Analysts must be attentive to the possibility of finding Trichinella in any sample.
Life cycle of Trichinella	Describe the basic life history of the parasite, reproductive capacity index	The entire life cycle occurs in one host; infective larvae are found in nurse cells, which are modified muscle cells. Digestion frees the larvae from the capsule and that is what is observed in the test.
Phylogeny of Trichinella	Describe the species and genotypes relative to differences such as freeze resistance	It is not possible to differentiate species in the digestion test. If larvae are recovered, they need to be appropriately preserved for genotyping and traceback.
Trichinella morphology	Provide a detailed description of the anatomical structure of the parasite including the stichosome and the cuticle	This section must be sufficiently detailed so that analysts are able to accurately identify Trichinella and distinguish from artifacts and other nematode larvae. Discuss the use of microscopes – what is visible at the appropriate magnification – and the size of Trichinella relative to other nematodes. Photos of larvae in various shapes (coiled, moving, dead) should be used and the details from this part of the training should be reinforced during the practical sessions.
Epidemiology	Describe the domestic and wildlife cycles and the species and hosts involved; geographical distribution	Focus should be on at- risk species in the area to be covered by the testing. Differences should be described amongst pigs reared in biosecure (Trichinella-free) housing versus backyard and free-ranging pigs (at risk for Trichinella infection)
Clinical disease	Describe the clinical disease resulting from human exposure to infected meat and susceptibility to all genotypes of Trichinella	This section should include a discussion of the enteral and parenteral phases, the most common symptoms, diagnostic methods, and the treatment and outcome of infections. Some details of outbreaks should be given.
Detection in animals	Describe direct and indirect tests to detect infection – benefits and drawbacks to use; predilection sites in host species; note that Trichinella-infected animals do not show any signs of disease	The only tests currently suitable for protecting public health are direct tests – artificial digestion methods. Indirect tests may be used for surveillance. Provide some theory of the digestion method, including why Trichinella resist digestion when alive and the problems with recovering larvae following digestion if larvae are dead.
Prevention	Describe current programs to prevent infection in domestic pigs	Analysts should be made aware of national programs that are designed to prevent infection in food animals. Also, they should understand that free-range and outdoor pigs as well as wildlife are at risk and are much more likely to yield positive results.
Prophylaxis	Describe processes (cooking, freezing, curing) used to kill Trichinella in prepared meats	Specific guidelines are available for the commercial cooking, freezing and curing of pork products, when meat has not been otherwise proven free from Trichinella. Home cooking guidelines are also available. Curing may be insufficient to kill larvae if not done properly.
Laboratory safety	Describe requirements for biocontainment when working with infectious material	Biocontainment applies specifically to handling of proficiency samples, but trainees should be informed that any piece of meat might harbor Trichinella larvae until tested and determined free.