Caracterización y evolución temporal de la mortalidad por zoonosis bajo declaración obligatoria, entre los años 1997 y 2018 / Characterization and temporal evolution of mortality due to zoonoses under mandatory declaration, between the years 1997 and 2018

INTRODUCCIÓN: Las zoonosis son enfermedades transmitidas desde un hospedador animal al ser humano o viceversa. En Chile, las zoonosis de Notificación Obligatoria (NO) son: brucelosis, carbunco, triquinosis, hidatidosis, leptospirosis, dengue, enfermedad de Chagas, hantavirosis y rabia. OBJETIVO: Evaluar la tendencia y caracterizar la mortalidad por zoonosis de NO en Chile entre 1997-2018. METODOLOGÍA: Estudio ecológico de la mortalidad por zoonosis de NO. Se utilizaron bases de mortalidad y población oficiales. Se describió la mortalidad relativa, general y específica, según variables sociodemográficas. Se calcularon tasas de mortalidad anuales brutas (TMb) y ajustadas (TMa, método directo). Se evaluó la tendencia temporal con modelos de regresión de Prais-Winsten. Resultados: Entre 1997 y 2018 la mortalidad por zoonosis de NO correspondió al 0,12% (2.359 muertes) de la mortalidad total, siendo las principales causas la enfermedad de Chagas (59,8%), hidatidosis (23,9%) y hantavirosis (13,8%). La TMa general disminuyó significativamente (B: -0,017; IC95%: -0,024; -0,009) al igual que hidatidosis (B: -0,011; IC95%: -0,013; -0,008), sólo hantavirosis mostró un aumento (no significativo). CONCLUSIÓN: La mortalidad por zoonosis de NO disminuyó durante el período estudiado; solo la hantavirosis mostró un aumento en su tendencia. Se sugiere enfocar estrategias para prevenir la transmisibilidad y mortalidad por hanta, así como mejorar el acceso a tratamiento para las otras zoonosis.

BACKGROUND: Zoonoses are diseases transmitted from an animal host to humans or vice versa. In Chile, the zoonoses of mandatory notification are brucellosis, anthrax, trichinosis, hydatidosis, leptospirosis, dengue, Chagas disease, hantavirosis and rabies. AIM: To assess the trend and characterize the mortality from zoonoses of mandatory notification in Chile between 1997-2018. METHODS: An official mortality and population data were used. Relative, general and specific mortality rates were described according to sociodemographic variables. Crude and adjusted annual mortality rates (direct method) were calculated. Temporal trend was evaluated with the Prais-Winsten regression model. RESULTS: Between 1997 and 2018, the mortality rate due to zoonosis of mandatory notification corresponded to 0.13% (2152 deaths) of the total mortality, being Chagas disease (59.2%), hydatidosis (24.6%) and hantavirosis (13.5%) the main causes. The general adjusted mortality rate decreased significantly (B: -0.017; IC95%: -0.024; -0.009) as did hydatidosis (B: -0.011; IC95%: -0.013; -0.008), and only hantavirosis showed an increase trend (not significant). CONCLUSION: Mortality due to zoonoses decreased during the period; only hantavirosis showed an increasing trend. It is suggested to focus on strategies to prevent contagion and mortality by hantavirosis, as well as to improve access to treatment for the other zoonoses.

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.

Trichinella spiralis in a cougar (Puma concolor) hunted by poachers in Chile / Trichinella spiralis em um puma (Puma concolor) caçado por caçadores furtivos no Chile

Abstract Trichinellosis is a zoonosis caused by nematodes of the Trichinella genus, of which 10 species have been described. Species identification when larvae is found is only possible using molecular tools. Meat from pigs and game animals not subjected to veterinary inspection are the main sources of human infections. The hunting of native carnivores is prohibited in Chile due to conservation issues and the fact that those animals favor pest control. The illegal hunting of a cougar (Puma concolor) occurred in September 2020. Herein, the molecular identification of Trichinella larvae, by analyzing nuclear (expansion segment V) and mitochondrial (cytochrome C oxidase subunit I) sequences are described. Both the amplification of the expansion segment V region and the phylogenetic analysis of a segment of a fragment of the cytochrome c-oxidase subunit I sequence confirmed that the larvae belonged to T. spiralis. The case described herein represents the first evidence of illegal hunting of a protected mammal infected with Trichinella in Chile, highlighting the 'One Health' perspective to face this disease in the rural-sylvatic interphase.

Resumo A triquinelose é uma doença causada por nematoides do gênero Trichinella. Dez espécies foram descritas. A identificação das espécies a partir das larvas só foi possível com ferramentas moleculares. O abate doméstico de suínos e o consumo de animais de caça, sem inspeção veterinária, são as principais fontes de infecção humana. A caça de carnívoros nativos é proibida no Chile por questões de conservação e pelo fato de que esses animais favorecem o controle de pragas. A caça ilegal de um puma (Puma concolor) aconteceu em setembro de 2020. No Chile, a identificação molecular de larvas de Trichinella, obtida pelo exame de sequências nucleares (segmento de expansão V) e mitocondriais (citocromo C oxidase subunidade I) são descritas. Tanto a amplificação da região do segmento de expansão V quanto a análise filogenética de um segmento de um fragmento da sequência da subunidade I da Citocromo c-oxidase, confirmaram que as larvas pertenciam a T. spiralis. O caso aqui descrito representa a primeira evidência de caça ilegal de um mamífero protegido infectado com Trichinella no Chile, destacando a perspectiva de "Saúde Única" para enfrentar esta doença na interfase rural-silvestre.

Statistical approach to Trichinella infection in horses handled by rural slaughterhouses across five distinctive socioeconomic regions in Mexico

Abstract This work aimed to investigate the prevalence of Trichinella infection in horses (Equus ferus caballus) handled by rural slaughterhouses across five distinctive socioeconomic regions in Mexico. Serum samples were obtained by non-probabilistic convenience sampling in the Eastern, Southern Central and Western regions (100 samples of each). Additionally, muscle tissue samples were collected from the East (n = 45), Southeastern (n = 88), Southern Central (n = 39) and Southwestern (n = 11) regions. Antibodies were determined by Western blot and the muscle tissue was examined by artificial digestion. A global antibody prevalence of 2% was obtained. Regionally, a prevalence of 5% was observed in the East and 1% in the Southern Central region. No antibodies were detected in the West region and no larvae were found in the muscle tissue samples. These findings support the low presence of Trichinella in Mexican horses, which can positively impact the Mexican horse meat trade.

Resumen Se investigó la prevalencia de Trichinella en caballos (Equus ferus caballus) demataderos rurales en cinco regiones socioeconómicas de México. Los sueros se obtuvieron por Trichinella muestreo de conveniencia no probabilístico en las regiones Este, Centrosur y Oeste (100 muestras de cada una). Además se colectaron muestras de tejido muscular de animales de las regionesEste (n = 45), Centro Sur (n = 39), Sudeste (n = 88) y Sudoeste (n = 11). Los anticuerpos se determinaron por Western blot y el tejido muscular se examinó por digestión artificial. Se obtuvo una prevalencia global de anticuerpos del 2%. A nivel regional se observó una prevalencia del 5% enel Este y del 1% en el Centrosur. No se detectaron anticuerpos en el Oeste y no se encontraron larvas en el tejido muscular. Los datos respaldan la baja presencia de Trichinella en caballos mexicanos, lo que puede impactar positivamente en su comercio.

Compromiso neurológicoy cardiovascularen pacientes con triquinosis / Neurological and cardiovascular involventin patients with trichinosis

Introducción: La triquinosis es una infección parasitaria causada por nematodos del género Trichinella. El compromiso cardíaco no es habitual, pero representa la causa más frecuente de muerte por triquinosis, mientras que la afectación neurológica ocurre principalmente en pacientes severamente enfermos. Se sabe que a mayor cantidad de larvas ingeridas menor es el tiempo de incubación y mayor es la severidad de la enfermedad. Se presentan dos pacientes con compromiso del sistema nervioso central, uno de ellos cardiovascular, ambos pertenecientes a un brote de triquinosis ocurrido en la ciudad de Bahía Blanca.

Background: Trichinosis is a parasitic infection caused by nematodes of the genus Trichinella. Cardiac involvement is not usual but represents the most frequent cause of death by trichinosis, while neurological affectation occurs mainly in severely ill patients. A greater number of larvae ingested, the shorter the incubation time and the greater the severity of the disease. We present two patients with compromise of the central nervous system and one of them cardiovascular, both belonging to an outbreak of trichinosis in the city of Bahía Blanca

Conocimientos y prácticas asociadas a transmisión de triquinelosis, hanta y equinococosis quística / Knowledge and practices associated with transmission of trichinellosis, hanta and cystic equinococcosis

RESUMEN Objetivo: Asociar el nivel de conocimiento y prácticas (hábitos y costumbres) responsables de la transmisión de Triquinelosis, Síndrome Cardiopulmonar por Hantavirus y Equinococosis quística (Hidatidosis), en habitantes de los sectores rurales. Material y método: Estudio descriptivo correlacional de corte transversal en el que se aplicó una encuesta a 149 habitantes residentes en el área rural de las localidades de Curacautín, Lonquimay y Melipeuco, a través de muestreo no probabilístico por conveniencia, durante los meses de diciembre 2013 a enero 2014. Resultados: La población posee mejores conocimientos de Triquinelosis y Hanta que Hidatidosis, 64,9, 72,8 y 39,3%, respectivamente; los hábitos y costumbres para Hanta e Hidatidosis alcanzan mejores prácticas (84% cada una) que para Triquinelosis (69,5%); la población reconoce correctamente reservorio, fuente de infección y mecanismos de transmisión en Triquinelosis y Hanta, pero en menor grado Hidatidosis; respecto de los hábitos y costumbres, aun desconociendo los fundamentos teóricos, reportan buenas prácticas, aunque mantienen algunas que favorecen la transmisión de infecciones predominantemente en Triquinelosis. Conclusión: El nivel de conocimiento no asegura buenas prácticas, además los conocimientos y prácticas siguen un patrón empírico más que cognitivo, respaldados por aspectos culturales y del entorno. Esto sugiere mayor participación de los equipos interdisciplinarios en comunidades aisladas para fortalecer la promoción, educación y refuerzo de las buenas prácticas de acuerdo con sus condiciones sociales e incentivar la adherencia a conductas que reduzcan el riesgo de la transmisión de zoonosis.

ABSTRACT Objective: To associate the level of knowledge and practices (habits and customs) responsible for the transmission of trichinellosis, Hanta and cystic echinococcosis (hydatidosis), among rural population. Material and method: Cross-sectional correlational descriptive study in which 149 residents of the rural areas of Curacautín, Lonquimay and Melipeuco were surveyed, using non-probability convenience sampling from December 2013 to January 2014. Results: The population has better knowledge of trichinellosis and Hanta than hydatidosis, 64.9%, 72.8 and 39.3% respectively; they also have better practices regarding Hanta and hydatidosis (84% each) than regarding trichinellosis (69.5%). The population recognizes correctly the reservoir, source of infection and transmission mechanisms of trichinellosis and Hanta, and to a lesser degree hydatidosis; they report good practices regarding habits and customs, even ignoring theoretical foundations, but maintain some practices that favor the transmission of infections related to trichinellosis. Conclusion: The level of knowledge does not ensure good practices. Additionally, knowledge and practices follow an empirical rather than cognitive pattern, rooted on cultural and environmental aspects. This suggests greater participation of interdisciplinary teams in isolated communities to strengthen the promotion, education and reinforcement of good practices in accordance with their social conditions and to encourage adherence to behaviors that reduce the risk of the transmission of zoonoses.

Análisis proteómico de los productos de excreción-secreción de cuatro aislados de Trichinella spiralis obtenidos de hospederos accidentales / Proteomic analysis of the excretion-secretion products of four Trichinella spiralis isolates obtained from accidental hosts

Resumen: Introducción: Trichinella spiralis es un nemátodo tisular que se aloja en el músculo esquelético de humanos y otros mamíferos y causa una serie de alteraciones fisiológicas. Las proteínas de los productos de excreción-secreción de T. spiralis juegan un papel importante en la aparición y regulación de estas alteraciones. Sin embargo, aún no se conoce el efecto de estos productos en la infección e invasión del parásito al hospedero. Métodos: Mediante un análisis electroforético en una dimensión, Western blot y espectrometría de masas, se evaluaron las diferencias y similitudes entre proteínas antigénicas y de superficie de cuatro aislados de T. spiralis obtenidos de hospederos accidentales (perros) y la cepa de referencia aislada de cerdos (MSUS/MEX/91/CM). Resultados: Utilizando ontología de genes, se encontraron cinco proteínas exclusivas de los hospederos accidentales. Después del análisis, se encontró que estas proteínas forman parte de la matriz extracelular del parásito, cuentan con actividad catalítica y están implicadas en la adhesión a las células del hospedero. La actividad antigénica de las cuatro cepas aisladas de hospederos accidentales es idéntica a la reportada para T. spiralis, visualizándose el triplete antigénico característico de 43, 45 y 47 kDa. Conclusiones: Las proteínas exclusivas de los hospederos accidentales proveen información para entender el mecanismo de acción de este parásito para penetrar el músculo y evadir la respuesta inmune en el hospedero.

Abstract: Background: Trichinella spiralis is an intestinal and tissue nematode specific for mammalian skeletal muscle, causing a series of physiological alterations. T. spiralis excretory-secretion products play an important role in the appearance and regulation of these alterations. However, the effect of these products on the infection and invasion of the parasite to the host is unknown. Methods: Differences and similarities between antigenic proteins and surface proteins of four accidental hosts isolates (dogs) of T. spiralis and the reference strain isolated from pigs (MSUS/MEX/91/CM) were assessed by electrophoresis, western blot and mass spectrometry. Results: Using gene ontology, five proteins exclusive to the accidental hosts were analyzed. The results showed that these proteins are part of the extracellular matrix of the parasite, present catalytic activity, and bind to host cells. The antigenic activity the four strains showed the antigenic triplet characteristic of T. spiralis of 43, 45 and 47 kDa. Conclusions: Five proteins exclusive to dog isolates provided information to understand the mechanism of action of this parasite to penetrate the muscle and evade the immune response in the host.

Avaliação da presença de Trichinella spiralis em equinos abatidos em Araguari, MG / Evaluation of the presence of Trichinella spiralis in horses slaughtered in Araguari, MG

A larva do nematódeo Trichinella spiralis é responsável por infectar animais como porcos, javalis e cavalos e por causar grave doença em seres humanos. Surtos devido ao consumo da carne de cavalo são mais comuns na Europa, principalmente na França e Itália, onde existe a cultura de ingeri-la crua. Apesar de no Brasil não ter relatos sobre a infecção desse parasita em animais e seres humanos, os abatedouros exportadores para alguns mercados, como Europa e Estados Unidos, são obrigados a pesquisar o parasita. No presente estudo, a presença de larvas de Trichinella spiralis foi avaliada em 14.852 cavalos abatidos entre dezembro de 2014 a julho de 2016 em um frigorífico de Araguari sob inspeção federal. Os animais eram procedentes dos estados de Minas Gerais, Goiás e Bahia. A técnica empregada foi a de digestão artificial, em que se utilizou o músculo masseter, seguindo as legislações da União Europeia: Diretiva 91/497/CEE, Diretiva 77/96/CEE, Regulamento (CE) N° 2075/2005 e suas alterações. A larva não foi encontrada em nenhuma amostra analisada.

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.

Therapeutic Effects of Resiniferatoxin Related with Immunological Responses for Intestinal Inflammation in Trichinellosis

The immune response against Trichinella spiralis at the intestinal level depends on the CD4⁺ T cells, which can both suppress or promote the inflammatory response through the synthesis of diverse cytokines. During the intestinal phase, the immune response is mixed (Th1/Th2) with the initial predominance of the Th1 response and the subsequent domination of Th2 response, which favor the development of intestinal pathology. In this context, the glucocorticoids (GC) are the pharmacotherapy for the intestinal inflammatory response in trichinellosis. However, its therapeutic use is limited, since studies have shown that treatment with GC suppresses the host immune system, favoring T. spiralis infection. In the search for novel pharmacological strategies that inhibit the Th1 immune response (proinflammatory) and assist the host against T. spiralis infection, recent studies showed that resiniferatoxin (RTX) had anti-inflammatory activity, which decreased the serum levels of IL-12, INF-γ, IL-1β, TNF-α, NO, and PGE₂, as well the number of eosinophils in the blood, associated with decreased intestinal pathology and muscle parasite burden. These researches demonstrate that RTX is capable to inhibit the production of Th1 cytokines, contributing to the defense against T. spiralis infection, which places it as a new potential drug modulator of the immune response.

Conocimientos y prácticas sobre hidatidosis y triquinosis en usuarios y acompañantes del Hospital Comunitario de Salud Familiar El Carmen, Región del Biobío, Chile / Knowledge and practices regarding cystic echinococcosis and trichinellosis in users and companions of users of the Hospital Comunitario de Salud Familiar El Carmen, Biobio Region, Chile

We surveyed users of the Hospital Comunitario de Salud Familiar El Carmen and their companions to analyze knowledge and practices regarding cystic echinococcosis and trichinellosis. Most people recognized risky practices. Previous attendance at talks and working in agricultural-livestock enhanced the knowledge. Age, sex and formal education were not associated with the knowledge. Knowledge was not associated with practices.

Introducción: La comuna de El Carmen, Región del Biobío, presenta factores de riesgo para la hidatidosis y la triquinosis, como un alto índice de pobreza, actividad principalmente agropecuaria y carencia de plantas faenadoras de animales. Método: Se analizó, a través de una encuesta a los usuarios y acompañantes del hospital de El Carmen, el conocimiento y las prácticas relacionadas con esas enfermedades. Resultados: La mayoría de los encuestados reconoció conductas de riesgo. La asistencia previa a charlas y el trabajo en actividades agropecuarias se asoció a mayor conocimiento de la hidatidosis y triquinosis, respectivamente. No hubo asociación entre edad, género o nivel educacional con el conocimiento de las enfermedades. Tampoco hubo asociación entre el conocimiento y las prácticas. Conclusiones: Los resultados sugieren la necesidad de mejoras educacionales, así como también intervenciones públicas, especialmente en sectores más lejanos.

Neoplasia asociada a Trichinella spiralis / Triquinella spiralis associated with neoplasia

La patología del cuello y su abordaje quirúrgico es una práctica clínica habitual para el cirujano de cabeza y cuello. El planteamiento de la cirugía será en base al diagnóstico de sospecha, con las pruebas de imagen y citología por punción de la tumoración cervical. En algunos casos el diagnóstico definitivo solo nos lo dará el estudio anatomopatológico de la pieza quirúrgica. Se presenta el caso de una tumoración cervical, de tórpida y rápida evolución, en la cual el agente Trichinella spiralis, pudo tener un papel en la etiología del cuadro.

Neck masses and their surgical approach form part of standard practice for the head and neck surgeon. The approach of the surgery will be based on the diagnosis of suspicion, with imaging and cytology by puncture of the cervical tumor. Sometimes the definitive diagnosis will only be established during surgery or, in particular, after pathological analysis. We present a case of a patient with cervical tumor, showing a rapid and fatal progression. In this patient, triquinella spiralis might play a role in cancer development.

Estudio de la cinética de captación de ácido siálico por larvas musculares de Trichinella spiralis / Study of kinetics of sialic acid capture by muscle larvae of Trichinella spiralis / Estudo da cinética de captaçao de ácido siálico por larvas musculares da Trichinella spiralis

Se ha comunicado que los eritrocitos (GR) incubados con larvas infectantes de Trichinella spiralis presentan mayor agregación que los GR Controles incubados con solución salina, lo cual indica que el parásito capta el ácido siálico globular. El objetivo fue estudiar la cinética de captación de ácido siálico por larvas musculares de T. spiralis aplicando Análisis Digital de Imágenes. Se trabajó con concentrados larvales de T. spiralis incubados en partes iguales con GR Grupo O, en medio salino y enzimático (GR Tratados), durante 120 minutos a intervalos de 15 minutos. Los Controles fueron incubados con igual volumen de solución salina. Se aplicó Análisis Digital de Imágenes y se calculó el valor del Coeficiente de células aisladas (CCA). Para analizar el efecto del tiempo de incubación en los valores de CCA, se utilizó un análisis de la variancia para un diseño en bloques completos aleatorizados. Los resultados mostraron que el valor promedio de CCA, en ambos medios, varió significativamente con el tiempo de incubación, lo que evidencia que el aumento del contacto de las larvas con los GR produce una disminución del ácido siálico que se refleja en mayores valores de CCA. La experiencia realizada sugeriría que durante su permanencia y viabilidad en el quiste, las larvas de T. spiralis podrían ir captando ácido siálico de la célula muscular con el objeto de interferiry /o evadir la respuesta inmune del hospedador...

Toll-Like Receptor Gene Expression during Trichinella spiralis Infection

In Trichinella spiralis infection, type 2 helper T (Th2) cell-related and regulatory T (T(reg)) cell-related immune responses are the most important immune events. In order to clarify which Toll-like receptors (TLRs) are closely associated with these responses, we analyzed the expression of mouse TLR genes in the small intestine and muscle tissue during T. spiralis infection. In addition, the expression of several chemokine- and cytokine-encoding genes, which are related to Th2 and T(reg) cell mediated immune responses, were analyzed in mouse embryonic fibroblasts (MEFs) isolated from myeloid differentiation factor 88 (MyD88)/TIR-associated proteins (TIRAP) and Toll receptor-associated activator of interferons (TRIF) adapter protein deficient and wild type (WT) mice. The results showed significantly increased TLR4 and TLR9 gene expression in the small intestine after 2 weeks of T. spiralis infection. In the muscle, TLR1, TLR2, TLR5, and TLR9 gene expression significantly increased after 4 weeks of infection. Only the expression of the TLR4 and TLR9 genes was significantly elevated in WT MEF cells after treatment with excretory-secretory (ES) proteins. Gene expression for Th2 chemokine genes were highly enhanced by ES proteins in WT MEF cells, while this elevation was slightly reduced in MyD88/TIRAP-/- MEF cells, and quite substantially decreased in TRIF-/- MEF cells. In contrast, IL-10 and TGF-beta expression levels were not elevated in MyD88/TIRAP-/- MEF cells. In conclusion, we suggest that TLR4 and TLR9 might be closely linked to Th2 cell and T(reg) cell mediated immune responses, although additional data are needed to convincingly prove this observation.

An Outbreak of Trichinellosis by Consumption of Raw Soft-Shelled Turtle Meat in Korea

Trichinellosis transmission to humans via the consumption of reptile meat is rare worldwide. In Korea, however, 2 such outbreaks, possibly via consumption of soft-shelled turtle meat, have occurred in 2 successive years. In 17 August 2014, 6 patients were admitted to Wonju Severance Christian Hospital complaining of myalgia, fever, and headache. Eosinophilia was the indication of the initial laboratory results, and they were eventually diagnosed as trichinellosis by ELISA. All of the patients worked at the same company and had eaten raw soft-shelled turtle meat at a company dinner 10 days prior to their admission. They were treated with albendazole for 2 weeks, upon which all of their symptoms disappeared. This is the 8th report on human trichinellosis in Korea, and the second implicating raw soft-shelled turtle meat.

Cardiac Parasitic Infection in Trichinellosis Associated with Right Ventricle Outflow Tract Obstruction

Here, we present a rare case of cardiac parasitic infection found in an adult female patient who had the symptoms of dyspnea upon exertion. She was diagnosed with a double-chambered right ventricle due to infundibular hypertrophy confirmed by transthoracic echocardiography and cardiac computed tomography. We performed surgery of infundibulectomy around the pulmonary valve. In the end, histopathological findings of the resected infundibular muscle demonstrated trichinellosis, a type of roundworm infection.

Determinantes de infestación durante un brote de trichinellosis en el sudoeste de la provincia de Buenos Aires / Determinants of infestation during an outbreak of trichinellosis in southwest Buenos Aires province / Determinantes da infecçâo durante um surto de triquinose no sudoeste da provincia de Buenos Aires

Se estudió la asociación entre infestación, parámetros de laboratorio y signos clínicos en personas expuestas a infestación por Trichinella spiralis durante un brote de trichinellosis en el sudoeste de la provincia de Buenos Aires, Argentina. Asimismo, se investigó el grado de concordancia entre las pruebas inmunoserológicas más comúnmente utilizadas en el diagnóstico de trichinellosis humana. En las personas expuestas, la presencia de síntomas clínicos y los niveles elevados de la enzima creatina fosfoquinasa al día 7 post-exposición se asociaron significativamente con la infestación al día 30 post-exposición. Por el contrario, la eosinofilia (>7%) a los siete días postexposición no se asoció al estado de infestación a los 30 días post-exposición. El mayor grado de concordancia entre pruebas inmunoserológicas se dio entre el par ELISA-Western Blot tanto al día 7 como 30 post-exposición.

The association between infestation, laboratory parameters and clinical signs was investigated in human patients exposed to Trichinella spiralis during an outbreak of human trichinellosis in southwest Buenos Aires province, Argentina. The degree of agreement between immunoserological tests commonly used for diagnosis of human trichinellosis was determined. Among exposed individuals, the presence of clinical symptoms and high concentration of the creatine phosphoquinase enzyme 7 days post-exposure was significantly associated with infestation by day 30 post-exposure. Contrarily, Randazzo V et al. a high level of eosinophils (>7%) 7 days post-exposure was not associated with infestation by day 30 post-exposure. Test agreement was highest between ELISA and Western Blot both by days 7 and 30 post-exposure.

Foi estudada a associagáo entre a infestagáo, parámetros laboratoriais e sinais clínicos em pessoas expostas à infestagáo por Trichinella spiralis durante um surto de triquinose, no sudoeste da provincia de Buenos Aires, Argentina. Também se pesquisou o grau de concordáncia entre os testes imunosorológicos mais comumente utilizados no diagnóstico de triquinose humana. Em pessoas expostas, a presenga de sintomas clínicos e os níveis elevados da enzima creatina fosfoquinase no dia 7 pós-exposigáo foram associados significativamente à infestagáo no dia 30 pós-exposigáo. Em contraste, a eosinofilia (> 7%) aos sete dias pós-exposigáo náo foi associada ao estado de infestagáo aos 30 dias pós-exposigáo. O maior grau de concordáncia entre testes imunoserológicos ocorreu entre o par de ELISA-Western Blot tanto no dia 7 quanto no dia 30 pós-exposigáo.

Estudio epidemiológico de los casos de triquinelosis registrados en la provincia de Santa Fe, Argentina, 1998-2009 / Epidemiological study of recorded trichinosis cases in Santa Fe Province, Argentina, 1998-2009

OBJETIVO: Caracterizar desde los puntos de vista epidemiológico, clínico y de laboratorio los casos y brotes de triquinelosis que se registraron en la provincia de Santa Fe, Argentina, entre 1998 y 2009. MÉTODOS: Se analizaron 1 519 fichas epidemiológicas de personas que presentaron síntomas y signos compatibles con triquinelosis en la provincia de Santa Fe en el período 1998-2009. Se realizó el análisis estadístico descriptivo de la información contenida en las fichas epidemiológicas y los resultados clínicos y de laboratorio; se aplicó el análisis bifactorial para determinar las posibles asociaciones con factores epidemiológicos y ambientales. RESULTADOS: Se encontraron síntomas de triquinelosis en 1 276 casos; 372 cumplían la definición de caso clínico y 224 muestras resultaron positivas por inmunofluorescencia indirecta, independientemente de su clasificación como caso clínico. Se identificaron 27 brotes que involucraron a 1 157 casos en ocho departamentos, con mayor frecuencia en el centro y el sur de la provincia. La distribución anual de los casos asociados epidemiológicamente entre sí fue heterogénea, con una mayor frecuencia en el período 2000-2003 y en los meses de agosto a octubre. Hubo mayor probabilidad de enfermar cuando se consumieron productos de fuentes informales (OR = 3,69; P = 0,014) y en las áreas rurales (OR = 1,799; P = 0,011). El período de incubación de la enfermedad (mediana) fue de 12 días. Las personas que consumieron carne de cerdo o sus derivados tuvieron 2,06 veces más riesgo de enfermar que las que no la consumieron. CONCLUSIONES: El mayor número de brotes ocurrió en los departamentos más poblados y con mayor producción porcina. Se deben diseñar acciones específicas de prevención y control de la enfermedad en esos departamentos. Se debe considerar el análisis epidemiológico de riesgos al evaluar, gestionar y comunicar los riesgos sanitarios de triquinelosis.

OBJECTIVE: To characterize recorded trichinosis cases and outbreaks in Santa Fe Province, Argentina, from 1998 to 2009 from epidemiological, clinical, and laboratory viewpoints. METHODS: An analysis was conducted of 1 519 epidemiological records of persons who had signs and symptoms compatible with trichinosis in Santa Fe Province in the period 1998-2009. A descriptive statistical analysis of information in epidemiological records and of clinical and laboratory results, as well as a bifactorial analysis of possible associations with epidemiological and environmental factors were also carried out. RESULTS: Trichinosis symptoms were found in 1 276 cases; 372 met the clinical case definition and 224 samples were positive by indirect immunofluorescence, independent of their clinical case classification. There were 27 outbreaks that involved 1 157 cases identified in eight departments, with greater frequency in the province's center and south. Annual distribution of epidemiologically associated cases was heterogeneous, with greater frequency in the period 2000-2003 and in the months of August to October. Probability of becoming sick was greater with consumption of products from informal sources (OR = 3.69; P = 0.014) and in rural areas (OR = 1.799; P = 0.011). Disease incubation period (median) was 12 days. The risk of becoming sick was 2.06 times greater in persons who ate meat or ate pork by-products than in those who did not. CONCLUSIONS: The greatest number of outbreaks occurred in departments that were more populous and where pork production was greater. Specific actions should be designed for prevention and control of the disease in those departments. Epidemiological risk analysis should be considered in evaluating, managing, and communicating trichinosis health risks.

Analysis of distribution and pathological characteristics of 9 fatal trichinosis cases in Yunnan / 法医学杂志

OBJECTIVE@#To explore forensic pathology features of the fatal trichinosis cases and to summarize the population distribution characteristics of trichinosis in Yunnan.@*METHODS@#Nine recent fatal trichinosis cases were collected from the Forensic Science Identification Center of Kunming Forensic Hospital. Pathological and epidemiological characteristics of trichinosis were analyzed.@*RESULTS@#The nine cases were all died in heart failure due to myocarditis. Among them, 1 case was complicated by encephalitis and 3 cases were complicated by pneumonia. The population mainly involved Bai and Dai nationalities. The geographic distribution was concentrated in Dali, Dehong, Lincang, Xishuangbanna, etc. The cases commonly appeared in winter and spring.@*CONCLUSION@#The cause of trichinosis is closely due to the habit of eating raw pork. It can be diagnosis through the pathological changes of the muscle system in the death cases.

Effect of Trichinella spiralis infection on expression and distribution of colonic epithelial E-cadherin in mice and its mechanism / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the effect of Trichinella spiralis (T.spiralis) infection on the expression and distribution of colonic epithelial E-cadherin in mice and its mechanism.</p><p><b>METHODS</b>BALB/c mice and STAT6-/- mice were infected with T.spiralis, and mice without infection were used as control. Seven days later, the horseradish peroxidase (HRP) was infused by rectal enema. Serum HRP was detected in the subsequent 0, 60 and 120 minutes. Then the mice were sacrificed and colon was taken out. The distribution of E-cadherin in colon was detected by immunofluorescence staining, and the expression of E-cadherin was detected by Western blot. The expression of interleukin-4 (IL-4) in mesenteric lymph nodes was detected by ELISA.</p><p><b>RESULTS</b>Serum HRP level in infected BALB/c mice was significantly higher than that in control mice (P<0.05), while it was not significantly different between infected STAT6-/- mice and controls (P>0.05). In infected BALB/c mice, E-cadherin located in cytoplasm of colonic epithelial cells, while in controls, it located in cellular membrane. E-cadherin expression down-regulated significantly in infected BALB/c mice as compared to controls. E-cadherin expression and distribution did not change obviously in infected STAT6-/- and control mice. IL-4 level in mesenteric lymph nodes of infected BALB/c mice [(193.0±12.5) μg/L] was significantly higher as compared to control BALB/c and infected STAT6-/- mice [(21.0±2.3) μg/L and (15.0±3.1) μg/L, all P<0.05].</p><p><b>CONCLUSION</b>T.spiralis infection can increase colonic epithelial permeability of mice, which may be associated with induction of Th2 cytokine secretion.</p>