Triquinosis: el impacto sanitario de una patología emergente / Trichinosis: the health impact of an emerging pathology

La triquinosis es una zoonosis que afecta a los animales y al hombre, y es ocasionada por la ingestión de la larva Trichinella spiralis que habita en el músculo de los animales hospedadores y, tras ser ingerida por el hombre, pasa a la pared intestinal de éste donde se multiplica y sus embriones emigran a los músculos. De 1990 a 1999 se reportaron 5.217 casos y en otro posterior de 2014 a 2018 fueron 5.211 casos. Con un promedio anual de 579 casos y de 1302 casos. Como resultado del cambio climático, la triquinosis se traslada de climas fríos a templados, lo que la torna una enfermedad emergente. El cuadro clínico puede presentarse en forma benigna o aguda, y su evolución abarca un período de un año; en ocasiones provoca la muerte por complicaciones. El hombre es responsable de la crianza, la alimentación y el control sanitario del cerdo y de sus productos para consumo. Consideramos a esta zoonosis, un indicador del desarrollo de los pueblos. Con educación, cambios de conducta y cumplimiento de las normas sanitarias, se actuará en beneficio de la salud y el bienestar de la población. (AU)

Trichinosis is a zoonosis that affects animals and humans. It is caused by the ingestion of a larva called Trichinella spiralis which lives in the muscle of host animals. After being ingested by humans, the larva passes to the intestinal wall where it multiplies, and its embryos migrate to the muscles. From 1990 to 1999, 5.217 cases were reported, and in a later period from 2014 to 2018, there were 5.211 cases. With an annual average of 579 cases and 1.302 cases, respectively. As a result of climate change, trichinosis moves from cold to temperate climates making it an emerging disease. The clinical presentation can range from benign to acute, with an evolution period of 1 year; and sometimes it causes death due to complications. Humans are responsible for raising, feeding, and ensuring sanitary control of pigs and their products for consumption. We consider this zoonosis an indicator of the development of communities. Through education, behavioral changes, and compliance with sanitary regulations, actions can be taken to promote the health and welfare of the population. (AU)

Punica granatum and amygdalin extracts plus cobalamin combined with albendazole reduce larval burden and myositis in experimental trichinosis / Extratos de Punica granatum e amígdalina mais cobalamina combinado com albendazol reduzem a carga larvar e a miosite na triquinose experimental

Abstract Trichinellosis is a zoonosis results from eating raw or semi-cooked meat of infected animals. Medicinal plants have been used lately as alternatives and/or combined therapies to resolve some drawbacks of the current regimens. This work analyzed the effect of albendazole monotherapy on Trichinella spiralis experimental infection (group A), in comparison to P. granatum and amygdalin extracts +cobalamin (group B), plus its combination with albendazole (group C). The study revealed that the extracts alone or combined with albendazole had an inferior effect to albendazole monotherapy regarding number of adult worms (40.83 ±3.82, 18.67 ±1.86 and 16.83 ±2.32, respectively). However, their effect was more obvious in muscle phase combined with albendazole, achieving the lower number of larvae/mL tissue homogenate (22.33 ±3.27 in comparison to 39.67 ±2.58 achieved by albendazole monotherapy). The extracts exerted a significant immunomodulatory effect by reducing the local CD4+ expression in the intestine as well as in muscle phase (1.15 ±0.25 and 3.80 ±0.65 in comparison to 4.97 ±0.37 and 12.20 ±0.87 with albendazole monotherapy, respectively). So, these extracts improved the therapeutic efficacy of albendazole, specifically in muscle phase and counteracted the inflammatory reaction caused by albendazole monotherapy, thus extensively alleviating the resulting myositis.

Resumo Trichinellosis é uma zoonose resultante da ingestão de carne crua ou semicozida de animais infectados. As plantas medicinais têm sido usadas, ultimamente, como alternativas e/ou terapias combinadas, para resolver algumas desvantagens dos regimes atuais. Este trabalho analisou o efeito da monoterapia albendazole na infecção experimental por Trichinella spiralis (grupo A), em comparação com extratos de P. granatum e amígdalina +cobalamina (grupo B), além de sua combinação com albendazol (grupo C). O estudo revelou que os extratos sozinho ou combinado com albendazol teve efeito inferior à monoterapia albendazol em relação ao número de vermes adultos (40,83 ±3,82, 18,67 ±1,86 e 16,83 ±2,32, respectivamente). No entanto, seu efeito foi mais óbvio na fase muscular combinado com o albendazol, alcançando o menor número de larvas/mL homogeneizado de tecido (22,33 ±3,27 em comparação com 39,67 ±2,58 obtidos pela monoterapia albendazol). Os extratos exerceram um efeito imunomodulatório significativo, ao reduzir a expressão local CD4+ no intestino, bem como na fase muscular (1,15 ±0,25 e 3,80 ±0,65 em comparação com 4,97 ±0,37 e 12,20 ±0,87 com monoterapia albendazol, respectivamente). Assim, esses extratos melhoraram a eficácia terapêutica do albendazol, especificamente na fase muscular e neutralizaram a reação inflamatória causada pela monoterapia albendazol, aliviando extensivamente a miosite resultante.

A cien años del inicio de la Gran Guerra: brote de triquinosis en marinos del Dresden en Chile: Crónica de una infección anunciada / A hundred years since the beginning of the Great War: trichinosis outbreak in Dresden marine in Chile: Chronicle of an announced infection

In commemoration of one hundred years of the beginning of World War I, the occurrence of an outbreak of trichinosis in the crew of the SMS Dresden, a German ship that participated in that world conflagration, is re-viewed. In September 1915, while the sailors of SMS Dresden were forcibly detained on Isla Quiriquina, Bío Bío Region, Chile, 60 individuals became ill. The cause of the outbreak was the consumption of sausages made from pork infected with the parasite Trichinella spiralis. There was a fatal case. The review of the epidemiological aspects that facilitated the presentation and spread of human trichinosis at that time allows to conclude that, pork breeded in poor hygienic conditions, meat and its by-products clandestinely sold without sanitary inspection and the language barrier were determinant in the occurrence of the epidemic outbreak.

A propósito de la conmemoración de los cien años del inicio de la Primera Guerra Mundial, se revisa la ocurrencia de un brote epidémico de triquinosis en tripulantes del SMS Dresden, buque alemán que participó en esa conflagración mundial. Este suceso, acaecido en septiembre de 1915, ocurrió mientras los marinos se encontraban forzosamente recluidos en la Isla Quiriquina, Región del Bío Bío, Chile. La causa del brote fue el consumo de embutidos fabricados a partir de carne de cerdo infectada con el parásito Trichinella spiralis e involucró a 60 mari-neros, de los cuales hubo un caso fatal. La revisión de los aspectos epidemiológicos que favorecían la presentación de triquinosis humana en la época permite concluir que, la crianza porcina en malas condiciones higiénicas, la venta clandestina de carnes y subproductos sin inspección sanitaria y la barrera idiomática fueron determinantes en la ocurrencia del brote epidémico.

Trichinosis Caused by Ingestion of Raw Soft-Shelled Turtle Meat in Korea

Reptiles, unlike mammals, have been considered to be unsuitable hosts of Trichinella spp., though larvae have been detected in their muscles and human outbreaks related to their consumption have, in fact, occurred. Herein we report 2 Korean cases of trichinosis, possibly transmitted via consumption of reptile meat. Both patients suffered from myalgia, headache, and facial edema. Laboratory examinations revealed leukocytosis with eosinophilia (54% and 39%, respectively) and elevated creatinine phosphokinase. ELISA was performed under the suspicion of trichinosis, showing positivity at the 29th and 60th day post-infection. Since they had consumed raw soft-shelled turtle meat, turtle was strongly suggested to be an infection source of trichinosis in Korea next to the wild boar and badger.

The Fifth Outbreak of Trichinosis in Korea

Trichinosis is a food-borne zoonotic disease caused by the nematode, Trichinella spp., and had been reported several times in Korea. Recently, there was an additional outbreak, involving 5 patients, the findings from which are reported herein. On 30 November 2010, 8 persons ate sashimi of the meat of a wild boar. Then, 2-3 weeks later, they complained of myalgia and fever. Unfortunately, muscle biopsy was not performed, but ELISA was performed using their sera. Two people among 8 were positive for Trichinella on the 34th day post-infection (PI), and 3 patients who initially revealed negative ELISA were additionally proved to be positive for trichinosis on the 42nd day PI. Hence, the confirmed patients of trichinosis were 5 in total in the present outbreak. They were treated with albendazole and discharged uneventfully. This was the fifth outbreak of trichinosis in Korea.

Human trichinosis in remotes of Uttarakhand, India.

Trichinosis is a parasitic zoonosis caused by ingestion of infected meat containing larvae of Trichinella, more prevalent in developing countries. Although infection with Trichinella is globally distributed, it has been documented only rarely in India. The reports are available where Trichinella larvae were found from animals in India but, to our knowledge, only one human case has been reported from India (Punjab), so far. This is the first report of small multiple outbreaks of human trichinosis in India (2009-2011). Epidemiological, clinical, and laboratory findings of trichinosis patients belonging to remote areas of Uttarakhand were analyzed retrospectively and prospectively. Patients belonged to remote areas of Garhwal, Uttarakhand, 77.78% were male, and 22.22% were female. The age of patients ranged from 9-55 yrs. History of eating meat of wild boar was given by all (100%). The signs and symptoms of the patients varied even after intake of same diet, and included generalized weakness/malaise, myalgia, fever, gastrointestinal symptoms, facial/periorbital edema, subconjunctival hemorrhages, retinal hemorrhages, muscle atrophy, and dyspnea. Laboratory investigations revealed eosinophilia, leukocytosis, creatine phosphokinase (CPK) and serum glutamic oxaloacetic transaminase (SGOT) elevation in 100%, 88.89%, 50% and 16.67%, respectively. Muscle biopsies revealed larvae in 27.78%. One patient expired while others improved. The prevalence of trichinosis is likely to be underestimated. The aim of this study is to emphasize on the magnitude of the problem, to educate people, especially in the affected areas about this health hazard and help implementation of epidemiological studies and preventive measures.

Family Outbreak of Trichinosis After Eating a Raw Meat of Wild Swine / 감염과화학요법

Trichinosis is a worldwide parasitic infection caused by ingesting an uncooked raw meat containing viable larvae of nematode Trichinella. Although most cases have been reported in Western countries, the incidence has decreased due to strict control of meat handlings and improved hygiene in these countries. In Korea, the first case of Trichinella spiralis was reported in a patient who ingested an uncooked badger. We have also experienced four cases of Trichinella spiralis infestation among family members who showed typical clinical manifestations and laboratory findings after ingesting raw wild swine meat, and herein report the finding.

Family Outbreak of Trichinosis After Eating a Raw Meat of Wild Swine / 감염과화학요법

Trichinosis is a worldwide parasitic infection caused by ingesting an uncooked raw meat containing viable larvae of nematode Trichinella. Although most cases have been reported in Western countries, the incidence has decreased due to strict control of meat handlings and improved hygiene in these countries. In Korea, the first case of Trichinella spiralis was reported in a patient who ingested an uncooked badger. We have also experienced four cases of Trichinella spiralis infestation among family members who showed typical clinical manifestations and laboratory findings after ingesting raw wild swine meat, and herein report the finding.

A Case of Trichinosis caused by eating a wild badger / 대한내과학회지

Trichinosis is a worldwide parasitic infection developed after the ingestion of uncooked meat containing viable larvae of the nematode Trichinella spiralis. Fever, myalgia, periorbital edema and eosinophilia are characteristic features and most infections are mild and asymptomatic, but a few cases have a severe clinical course due to cardiac or cerebral complications. This parasitic infection is spread in nature among a large number of carnivorous animals, human being an incidental host. While the highest prevalence is in North America and Europe, some outbreaks of trichinosis have been reported in the areas of Southeast Asia, China and Japan recently, but it has not been reported in Korea yet. We experienced a case of trichinosis with typical clinical features and laboratory findings of trichinosis after eating a raw liver and blood of wild badger which was poached in Chi-ri mountain.

Triquinosis esporádica / Sporadic trichnosis

En el presente trabajo se analizan retrospectivamente las características clínicas y de laboratorio detectadas en 13 casos de triquinosis aguda esporádica, estudiados en el Instituto Nacional de Nutrición "Salvador Zubirán" (INNSZ) de 1977 a 1986. El número de casos por año fue de uno a dos con aumento a cinco en 1986; ningún paciente mostró correlación entre el tipo de dieta o sitio específico en la ciudad. La sintomatología fue similar a la descrita para la forma epidémica; en 69.1 por ciento de los casos se sospechó el diagnóstico en base clínicas y el 84.6 por ciento mostró eosinofilia. El motivo de la biópsia muscular fueron los síntomas musculares (92.3%) y corroboró la parasitosis en el 100 por ciento de los pacientes. El tratamiento fue tiabendazol y/o prednisona con mejoría en la mayoría de los pacientes durante su seguimiento (x: 7 meses). Se discute la utilidad de la biopsia muscular, las posibilidades de tratamiento y se enfatiza en los síntomas, signos y hallazgos de laboratorio de la triquinosis esporádica para sospechar dicha zoonosis ante un cuadro clínico de enfermedad inflamatoria multisistémica con síntomas musculares predominantes

Preliminary Study of Immunodiagnosis of Trichinosis by ELISA Using Urea Soluble Antigen of Trichinella spiralis / 第三军医大学学报

Urea soluble antigens of Trichinella spiralis infective larva were prepared and the efficiency of the antigens in diagnosis of trichinosis by ELISA are studied. Specific IgG antibodies are detected by ELISA using urea soluble antigens in 91.67%(22/24) of 24 sera and 91.67% (ll/12)of 12 blood spots of filter paper of patients of trichinosis. Specific IgM antibodies are seen in 95.24% (20/21) of 21 sera of patients using the antigens. Sera of patients infected with Schistosoma japonicum have some cross reactions on the antigens. Sera from mice infected with - Schistosoma japonicum, Ancyclostoma caninum larva, and Plasmodium yoelii are negative. The urea soluble antigen has a relatively high sensitivity, specificity and good reproducibility in diagnosis of trichinoisis by ELISA, and has a practical and economic value.