User:CFCF/Trichinosis

Trichinosis, trichinellosis or trichiniasis is a parasitic disease caused by roundworms of the genus Trichinella. Several subspecies cause human disease, but T. spiralis is the classic cause. Light infection may have no symptoms. Intestinal invasion may cause diarrhea, abdominal pain or vomiting. Larval migration into muscle tissues (one week after infection) can cause facial edema and around the eyes, conjunctivitis, fever, muscle pains, splinter hemorrhage s, rash es, and peripheral eosinophilia. Life-threatening cases include myocarditis, central nervous system involvement, and pneumonitis. Larval encystment in the muscles causes pain and and muscle weakness, followed by slow progression of symptoms.

Trichinellosis is primarily caused by the ingestion of undercooked meat containing encysted larvae Trichinella. In the stomach the larvae are exposed to stomache acid and pepsin and are released from their cysts and will start invading the lining of the small intestine, where they develop into adult worms. Females are 2.2 mm in length; males 1.2 mm. The life span in the small bowel is about four weeks. After 1 week, the females release larvae that migrate to voluntarily controlled muscles where they encyst. Diagnosis is usually made based on clinical symptoms, and is confirmed by serology or identification of encysted or non-encysted larvae in biopsy or autopsy specimens.

The best way to prevent trichinellosis is to cook meat to safe temperatures. A food thermometer should be used to measure the internal temperature of cooked meat. Meat should not be samples until it is cooked. Treatment with antiparasitic drugs such as albendazole or mebendazole should be stared promptly. This may help kill adult worms and stop further release of larvae. Once the larvae have become established in skeletal muscle cells, usually by 3 to 4 weeks after infection, treatment may not completely eliminate the infection or associated symptoms. Both drugs are considered relativetly safe but have been associated with side effects such as bone marrow suppression. Patients on longer courses should be monitored by continuous complete blood count s to detect adverse effects quickly and then discontinue treatment. Both medicines should be treated with caution during pregnancy or children under the age of 2 years, but the WHO weighs the benefits of treatment higher than the risks. In addition to antiparasitic medication, treatment with steroids is sometimes required in severe cases.

Unites States
Historically, pork products were thought to have the most risk of infecting humans with Trichinella spiralis. However, a Trichinellosis surveillance conducted between 1997-2001 showed a higher percentage of cases caused by consumption of wild game. This is thought to be due to the Federal Swine Health Protection Act (Public Law 96-468) that was passed by congress in 1980. Before this act swine were fed garbage that could potentially be infected by Trichinella spiralis. This act was put in place to prevent contaminated food from being given to swine. Additionally, other regulations were put in place such as rodent control, limiting commercial swines contact with wildlife, maintaining good hygiene, and removing dead pigs from pens immediately.

Between 2002 and 2007, 11 cases were reported to CDC each year on average in the United States; these were mostly the result of eating undercooked game, bear meat, or home-reared pigs. It is common in developing countries where meat fed to pigs is raw or undercooked, but many cases also come from developed countries in Europe and North America, where raw or undercooked pork and wild game may be consumed as delicacies.