TRICHINOSIS

Synonyms
• In humans: Raw pork disease
• In animals: Trichinellosis

Etiology
• Caused by Trichinella spiralis, which is an intestinal nematode it is also called as
garbage worm or trichina worm.
• Female worms are ovo-viviparous (eggs hatch in the uterus itself) and one female can
lay 500 to 1500 larvae at a time.
• Location of the parasite:
– Adult worm in the small intestine.
– Larvae in the striated muscles (diaphragm, tongue, intercostal and
mandibular muscle)

Reservoir and incidence

• Distributed worldwide most commonly seen in Europe and US.
• All mammals can get affected with this parasite.
• Mostly pigs, rats, dogs, cats and many wild animals are affected with this parasite.
• In Sylvatic cycle disease circulates in wild animals like jackals and wild boars by
cannibalism, predating or eating of infected carcass.
• Synanthropic cycle involves wild and domestic cycles.
• Pigs are the major source of infection to humans.

Transmission and life cycle

• Pigs generally become infected by feeding on garbage, uncooked scraps and by eating
infected dead rats.
• In humans, infection occurs by eating raw or under cooked pork.
• Humans eating pork with more than one larva / gm would cause asymptomatic
infection if more than 100/gm cause symptoms and more than 1000/gm cause severe
infection.
Clinical symptoms in humans
• In the initial phase after 2 to 3 days of infection infected humans shows symptoms
like vomition, nausea and fever are predominant.
• Later patients suffer with headache, muscular pains, dyspnoea, cough and edema of
face.
• Nervous symptoms like neuritis, loss of vision and delirium also seen.
• Other symptoms like myocarditis, meningitis, encephalitis are observed in some
cases.
• Still births are obserevd in pregnant women.
• Lastly, death due to myocardial and respiratory failure.
Diagnosis
• Meat inspection.
• Larval examination by Baermann's apparatus.
• Muscle biopsy and trichinoscopic examination.
• Immunological tests like CFT, IHA, AGPT, FAT, ELISA and larval precipitation test.
• Recently tests to detect for T. spiralis antigens in urine and blood of man have been
developed for diagnosis.
Treatment
• Infected persons recover spontaneously.
• Supportive treatment should be given.
• Anthelmintics like mebendazole, thiabendazole or albendazole can be given.
Prevention and control
• Cooking of pork at 77°C or above destroys the parasite.
• Freezing of pork at -10°C for about 30 days or -20°C for about 10 days destroys
the parasite.
• Gamma irradiation (30,000R) destroys the parasite.
• Humans should not eat raw and/or insufficiently cooked Trichinella infested pork /
meat.
• Regular meat inspection.
• Prevent the availability of garbage to pigs by proper disposal of garbage.