From wildlife to humans: The global distribution of Trichinella species and genotypes in wildlife and wildlife-associated human trichinellosis.

Zoonotic nematodes of the genus Trichinella are foodborne parasites that have a global distribution in wild carnivores and omnivores, with spillover and spillback into domestic livestock and people, with concomitant trade and health consequences. Historically, most human cases were linked to domestic pigs infected with Trichinella spiralis, but under current high biosecurity swine production in many countries, wildlife have become a more important source of human trichinellosis. The aim of this review is to update the global distribution of Trichinella species and genotypes reported in wildlife, as well as reported human outbreaks from the consumption of wildlife. Using several online databases and by "snowballing" references, hundreds of reports of Trichinella spp. in wildlife published between January 1991 and December 2023 provide an important update to the host and geographic range for each of the recognized 13 species/genotypes, grouped by continent. Surveillance effort was highest in Europe and North America, while Africa, Asia, Central and South America have had limited surveillance, in some instances with human cases serving as sentinels of transmission in a region. Dozens of human outbreaks are described, with wild boars (Sus scrofa) being the most frequently implicated wildlife species in human outbreaks globally. Bears are an important source of infection in North America, for wildlife tourism, and importation of bear meat has also been implicated in multicountry outbreaks. The largest study limitation was the dearth of molecular identification of larvae in both wildlife surveillance studies and human outbreaks, particulary in under-studied regions. We highlight the need for enhanced molecular epidemiological approaches to outbreaks of this important foodborne parasite, and emphasize the need for a One Health approach to manage Trichinella spp. which transmit among terrestrial and marine wildlife (including migratory birds), pigs, horses, and people, often across large geographic scales and borders.

New Geographic Records for Trichinella nativa and Echinococcus canadensis in Coyotes (Canis latrans) from Insular Newfoundland, Canada.

Coyotes (Canis latrans) rapidly expanded across North America during the 20th century and in 1987 colonized insular Newfoundland, Canada. Their arrival brought the potential for new predator-prey interactions and the potential for transmission of parasites to naïve populations. Trichinella spp. and Echinococcus spp. are zoonotic parasites not previously reported from the island of Newfoundland, Canada. Muscle samples (diaphragm and tongue) from 153 coyotes and feces from 35/153 coyotes were collected. Larvae of Trichinella spp. were recovered by muscle digestion from 6/153 coyotes (3.9%) and identified using multiplex PCR and Sanger sequencing as T. nativa. Fecal samples were screened for DNA of Echinococcus spp. using qPCR, and intestines from positive animals were examined for adult cestodes. No fecal samples were positive for DNA of E. multilocularis, and 2/35 (5.7%) samples were positive for E. canadensis, of which one was successfully genotyped as the G10 cervid strain. Echinococcus canadensis has not previously been reported on the island of Newfoundland, historically the only region of Canada where Echinococcus spp. was not known to occur. No species of Trichinella have previously been reported on the island. Both parasites are zoonotic, and hunters, trappers, dog owners, and the general public should be aware of these new risks for public health.

A Rapid Review on the Efficacy and Safety of Pharmacological Treatments for Chagas Disease.

Chagas disease remains a neglected tropical disease, causing significant burden in the Americas and countries that receive immigrants from endemic nations. Current pharmaceutical treatments are suboptimal, not only varying drastically in efficacy, depending on the stage of disease, but also presenting significant risk of adverse events. The objective of this review is to provide a timely update on the efficacy and safety of current trypanocidals. Eligible studies published from January 2015 to December 2020 were retrieved by one reviewer from six electronic databases. Ana-lysis was done with review management software and risk of bias was assessed using tools appropriate for the type of study (i.e., experimental or observational). Thirteen studies (10 observational and three RCTs) were included in the analysis. All 13 studies tested Benznidazole (BNZ) or Nifurtimox (NFX), and two studies also tested Posaconazole (POS) or E1224 (Ravucanazole). BNZ was found to be the most efficacious trypanocidal drug compared to Nifurtimox, POS, and E1224; it also resulted in the highest percentage of adverse effects (AEs) and treatment discontinuation due to its toxicity. Adults experienced higher frequency of neurological AEs while taking BNZ or NFX compared to children. Children had a higher frequency of general AEs compared to adults while taking BNZ. Overall, BNZ is still the most efficacious, but development of new, less toxic drugs is paramount for the quality of life of patients. Studies testing combination therapies and shorter regimens are needed, as is the devising of better clinical parameters and laboratory biomarkers to evaluate treatment efficacy. Considering the variability in methodology and reporting of the studies included in the present analysis, we offer some recommendations for the improvement and replicability of clinical studies investigating pharmacological treatment of Chagas disease. These include full disclosure of methodology, standardization of outcome measures, and always collecting and reporting data on both the efficacy of trypanocidals and on safety outcomes.