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.

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.

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.

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.

An Outbreak of Trichinellosis with Detection of Trichinella Larvae in Leftover Wild Boar Meat

The clinical diagnosis of trichinellosis can be difficult due to lack of pathognomonic signs or symptoms. In Korea, since the first report of human infection by Trichinella spiralis in 1997 following the consumption of raw badger meat, there have been occasional trichinellosis outbreaks. We describe an outbreak of 12 cases of trichinellosis in Korea and implicate raw wild boar meat as the culprit. A total of 27 larvae of Trichinella (0.54 larvae per gram of meat) were recovered from the leftover raw wild boar meat.

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.

Serología para triquinosis en dadores de sangre en área no endémica de la Argentina / Trichinellosis serology in blood-donors from a non-endemic area of Argentina

El presente estudio tuvo como objetivo determinar la presencia de triquinosis humana en un área considerada históricamente libre de esta parasitosis en la Argentina. Se evaluó la parasitosis mediante técnicas inmunoserológicas y su relación con los hábitos alimenticios de riesgo mediante un cuestionario realizado a 150 donantes de sangre. Las encuestas revelaron que el 98.0% (n=147) de los individuos consumía carne de cerdo y/o derivados con elevada frecuencia. Los principales productos porcinos incorporados a la alimentación habitual fueron los chacinados. El 80.3% (n=118) de los individuos adquirían los productos en carnicerías, el 38.1% (n=56) en faenas domiciliarias y el 34.0% (n=50) en supermercados. Las técnicas inmunoserológicas utilizadas para el diagnóstico de triquinosis fueron: enzimoinmunoanálisis, inmunofluorescencia indirecta y/o inmunoelectrotransferencia. En el 8.0% (n=12) de los sueros de los individuos se detectaron anticuerpos anti-Trichinella por más de una de las técnicas realizadas, considerándose este resultado diagnóstico confirmatorio de triquinosis. Los estudios realizados demuestran la existencia de triquinosis humana en un área considerada libre de esta parasitosis y sugieren su relación con la ingesta de carne porcina y/o sus subproductos, hábito alimenticio de riesgo. Estos resultados indican que la falta de denuncia de casos de la enfermedad no debe ser el único criterio a tener en cuenta para considerar a una región área libre de triquinosis. El conocimiento de la presencia del parásito en un área determinada favorece la instauración de medidas de control y prevención evitando la diseminación de la parasitosis.

The aim of the present study was to determine the presence of human trichinellosis in an area of Argentina historically regarded as free of this parasitic disease. This parasitosis was assessed on 150 blood donors by means of immunoserological tests, and their relation with risk alimentary habits by a questionnaire. The questionnaires showed that 98.0% (n=147) of the individuals consumed pork and pork products at a high frequency. The main pork products incorporated to the habitual diet were the stuffed ones. A 80.3% (n=118) of the individuals had acquired such products at butchers, a 38.1% (n=56) at home slaughters and a 34.0% (n=50) at supermarkets. The immunoserological techniques employed were: enzyme immunoanalysis, indirect immunofluorescence and/or immunoelectrotransfer blot assay. Anti-Trichinella antibodies were detected in 8.0% (n=12) of the serum samples by more than one of the methodologies employed, considering these results as confirmatory of trichinellosis. The studies carried out herein demonstrate the existence of human trichinellosis in an area historically regarded as free of this parasitic disease and suggest its relationship with the ingestion of pork or pork products as a risk factor. These results indicate that the lack of reports should not be the only criterion for an area to be considered as Trichinella-free. The awareness of the existence of the parasite in a region will favor the establishment of control and prevention strategies which is of fundamental importance to avoid the spread of the disease.

Application of Giemsa stain for easy detection of Trichinella spiralis muscle larvae

The application of Giemsa technique to stain compressed diaphragm samples obtained from rodents experimentally infected with Trichinella spiralis is described. Diaphragm samples from rats heavily infected with 20 muscle larvae per gram of body weight (20 ML/gbw) were cut into several pieces and stained with Giemsa; on the other hand, whole diaphragms from slightly infected mice (1 ML/gbw) were also stained with Giemsa. Besides, muscle samples were also stained with Giemsa. Observation at 10 x magnification revealed that both ML and nurse cells (NC) look as bluish structures clearly contrasting with the pinkish color of the non-infected muscle fibers. NC in the diaphragms of mice could be easily observed at naked eye as blue points contrasting with the pink surrounding areas formed by the non-infected muscle fibers. Among NC observed in the diaphragms of rats infected with 20 ML/gbw, 4.4% was multiple infection. These findings were confirmed in sectioned and hematoxylin-eosin stained specimens. This data could be usefulness for a rapid diagnosis of trichinellosis in post-mortem mammals without magnification procedures.

Application of Giemsa stain for easy detection of Trichinella spiralis muscle larvae

The application of Giemsa technique to stain compressed diaphragm samples obtained from rodents experimentally infected with Trichinella spiralis is described. Diaphragm samples from rats heavily infected with 20 muscle larvae per gram of body weight (20 ML/gbw) were cut into several pieces and stained with Giemsa; on the other hand, whole diaphragms from slightly infected mice (1 ML/gbw) were also stained with Giemsa. Besides, muscle samples were also stained with Giemsa. Observation at 10 x magnification revealed that both ML and nurse cells (NC) look as bluish structures clearly contrasting with the pinkish color of the non-infected muscle fibers. NC in the diaphragms of mice could be easily observed at naked eye as blue points contrasting with the pink surrounding areas formed by the non-infected muscle fibers. Among NC observed in the diaphragms of rats infected with 20 ML/gbw, 4.4% was multiple infection. These findings were confirmed in sectioned and hematoxylin-eosin stained specimens. This data could be usefulness for a rapid diagnosis of trichinellosis in post-mortem mammals without magnification procedures.

Seroprevalence of Trichinella in slaughter pigs in Kathmandu Valley, Nepal.

The aim of the present study was to determine the Trichinella seroprevalence in slaughter pigs in Kathmandu Valley, Nepal. Serum samples were obtained from 400 pigs at 4 major slaughterhouses and tested for Trichinella antibodies by ELISA using larval excretory-secretory (E/S) antigen. Four were positive and one was equivocal, giving a Trichinella seroprevalence of 1% (95% CI: 0.27 - 2.54). On titration, all positive and equivocal samples had titers greater than 1:80. Upon re-examination the equivocal sample failed to give a positive ELISA result. The pigs were from four major areas of Nepal, Kathmandu Valley, eastern Nepal, Terai and adjoining areas of the valley. Positive results were found from only Kathmandu Valley and adjoining areas. There was no significant difference in the prevalence between areas (p = 0.43). All four positive samples were from indoor managed pigs. The Trichinella seroprevalence determined in this study deserves a direct demonstration of the parasites for proof of the presence of Trichinella in Nepal and to discover the species and infection sources.

First record of human trichinosis in Chile associated with consumption of wild boar (Sus scrofa)

The first South American case of human trichinosis, resulting from the consumption of roast wild boar (Sus scrofa) is reported in Chile. The patient presented fever, diarrhea, myalgias, facial edema, sub-conjunctival reddening, photophobia, eosinophilia, and elevated glutamic oxalacetic transaminase. The diagnosis was confirmed by two immunoenzymatic tests (ELISA) using somatic and excretion-secretion antigens.

Aspectos clinicos, serologicos y parasitologicos de un brote de triquinelosis humana en villa mercedes, san luis, argentina las fases aguda y cronica de la infeccion / Clinical, serological and parasitological aspects of an outbreak of human trichinellosis in Villa Mercedes, San Luis, Argentina: the acute and chronic phases of the infection

Se describen las características clínicas y serológicas de individuos cursando las fases aguda (n: 54) y crónica (n: 32) de triquinelosis, de un brote epidémico ocurrido en una zona endémica de Argentina, originado por el consumo de productos de cerdo de origen comercial. Se evaluaron los datos epidemiológicos, signos y síntomas de la parasitosis y estudios de laboratorio. Se realizaron estudios parasitológicos en pacientes y en chacinados. Los resultados mostraron que: a) la carga parasitaria de los productos de cerdo fue de 200.0±18.3 larvas/g; b) se demostró la presencia de larvas musculares en 10 de 11 pacientes estudiados; c) durante la fase aguda se observó fiebre (94%), eosinofilia (90%), mialgias (85%), cefalea (81%), edema facial (54%), diarrea (52%) y anticuerpos anti-Trichinella (64%); d) el 15% de los pacientes debió ser hospitalizado presentando el 7% de ellos complicaciones; e) durante la fase crónica se observó mialgia (72%), alteraciones visuales (22%), desórdenes gastrointestinales (31%) y la persistencia de anticuerpos (77%). Este estudio evidencia el impacto socioeconómico de la triquinelosis debido a las características clínicas de la fase aguda y a la presencia de síntomas en la fase crónica. .

Serological diagnosis of trichinealla spiralis in experimentally infected mice

ELISA and IFA tests were used to detect IgG levels in sera of experimentally infected mice with Trichinella spiralis during a period of 12 weeks post infection. A crude saline extract of muscle larvae was used for application of ELISA technique, while the intact T. spiralis muscle larvae were used as an antigen for IFAT. In both tests, T spiralis IgG antibodies could be detected one week post infection in sera of all infected mice. ELISA test showed a sensitivity of 100% during the whole period of the experiment, while its specificity was 93.3%. Meanwhile, IFA test revealed a sensitivity of 100% and a specificity of 85%

Identification and diagnostec evaluation of cross-reactive antigen between hydatid cyst fluid of echinococcusgranulosus and trichinella spiralis larval extract

A cross reactive fraction was isolated from hydatid cyst fluid antigen of E. granulosus using CNBr Sepharose 4B affinity chromatography in which anti-T. spiralis antibodies were coupled with the column. Biochemical characterization of the isolated fraction included the use of SDS-PAGE, isoelectric focusing and amino acid analysis. The fraction showed 5 polypeptides of 165, 95.5, 63.5, 30.6 and 24 KDa. The isoelectric points of these polypeptides were 7.8, 7.2, 6.7, 6.2 and 5.7. The fraction exhibited 17 amino acids and was rich in tyrosine [20.81] and glutamic [15.28] micro gram/100 mg. The fraction proved higher potency in the diagnosis of experimental trichinellosis in rats than echinococcosis in dogs by ELISA. All experimentally infected animals reacted positively, recording 100% diagnostic sensitivity. Collectively, the present study proved that the hydatid cyst fluid cross-reactive fraction could be used in the diagnosis of trichinellosis at different intervals of infection and as early as 1 week post infection

Cystatin capture-dot-enzyme-linked immunosorbent assay for immunodiagnosis and assessment of cure of experimental trichinellosis in mice

Cystatin capture-dot-enzyme-linked immunosorbent assay [CC-dot ELISA] was evaluated as a new version of ELISA for the diagnosis of trichinellosis by the detection of anti-Trichinella spiralis cysteine proteinase [CyP] IgG using nitrocellulose membrane sensitized with cystatin as a capture reagent for CyP from T. Spiralis muscle larvae excretory secretary products [ESP] without purification compared with the detection of anti-T. spiralis IgG by conventional [conv.] ELISA using whole ESP. Experimentally infected mice with light [100 larvae/mouse] and heavy [300 larvae/mouse] infections by T. spirals larvae at 7, 14, 21 and 56 days post-infection and after flubendazole treatment were examined

Trichinosis of psoas muscle.

There are isolated case reports of Trichinella spiralis infestation in animals from India. We report the first case in man from India. The nematode was discovered incidentally during drainage of psoas abscess.