[Outbreak of trichinellosis in the region of la Vera (Carceres, Spain) caused by Trichinella britovi]. / Brote de triquinosis en la comarca de la Vera (Cáceres) causado por Trichinella britovi.

OBJECTIVE: To describe the clinical and epidemiological aspects of a trichinellosis outbreak in the region of La Vera that took place during January and February 2002, related to the consumption of pork meat infected with Trichinella britovi. MATERIAL AND METHODS: When the first suspected case was discovered, the presumed infected meat was checked and all the people who might have eaten it were examined. An epidemiological interview and a clinic evaluation were carried out in each patient. RESULTS: We found 52 exposed people that had eaten the presumptive infected meat, 35 males and 17 females, with an age ranging from 2 to 86 years old. A confirmed positive diagnosis was established in 16 patients. The most frequent symptoms were: diarrhea (present in all the cases), fever, myalgia and facial edema. Eosinophilia was an early and characteristic analytic sign. All diagnosed cases were found to have positive serology, although this was not a required criterion to start medical treatment. Treatment was started once the clinical suspicion of trichinellosis was determined, based on compatible clinical signs and eosinophilia. There were no complications and none of the patients required hospitalization. The meat sample was claimed by the Health Authorities and destroyed, thus avoiding further extension of the outbreak. CONCLUSIONS: Sporadic outbreaks of trichinellosis have been described in Spain. In the present paper an outbreak caused by Trichinella britovi has been studied. Early diagnosis suspicion and its communication to the Health Authorities allowed the control of the outbreak and the identification of the contaminated meat. Treatment must be started after clinical suspicion and eosinophilia.

Brote de triquinosis en la comarca de la Vera (Cáceres) causado por Trichinella britovi / An outbreak of trichinellosis in the region of la Vera (Cáceres, Apain) caused by Trichinella britovi

Objetivo: Descripción de los aspectos epidemiológicos y clínicos de un brote de Triquinosis (TQ) en la comarca de La Vera (provincia de Cáceres) durante los meses de enero y febrero del 2002, en relación con el consumo de carne de cerdo infectada por Trichinella britovi. Material y métodos: Al efectuarse el primer diagnostico de sospecha de TQ se localizó la pieza cárnica infectada y todas las personas expuestas a su consumo. Se realizó encuesta epidemiológica y valoración clínica (en urgencias o consulta programada) con los siguientes exámenes complementarios: hemograma completo, urea, creatinina, iones, CPK, LDH, mioglobina y serología de Trichinella. Resultados: Se localizaron 52 personas expuestas de las cuales 35 eran varones y 17 mujeres, con edades comprendidas entre los 2 y 86 años. El diagnóstico definitivo de TQ se estableció en 16 expuestos. Los síntomas mas frecuentes fueron: diarrea (en todos los casos), fiebre, mialgias y edema facial. La eosinofilia fue el dato analítico precoz y característico. Todos los casos diagnosticados positivizaron la serología aunque este dato no fue determinante para el inicio del tratamiento, que se comenzó ante la sospecha basada en clínica compatible y eosinofilia.No hubo complicaciones y ningún paciente requirió ingreso hospitalario.La pieza cárnica fue bloqueada lográndose interrumpir la propagación del brote. Conclusiones: Se siguen describiendo esporádicamente brotes de TQ en España, en este caso producido por Trichinella britovi. La sospecha diagnóstica precoz y su comunicación a las autoridades sanitarias logra bloquear la carne infectada e interrumpe la propagación del brote. El tratamiento se debe indicar ante cuadro clínico compatible y la presencia de eosinofilia (AU)

Outbreak of trichinellosis in Cáceres, Spain, December 2001-February 2002.

An outbreak of trichinellosis by T. britovi occured in Cáceres, Spain, between 18 December 2001 and 11 February 2002, following the consumption of insufficiently cooked meat from a domestic pig. Among the 56 people exposed, 26 cases of trichinellosis were diagnosed, of which 17 serologically confirmed. The mean incubation period was 23.5 days (3-45). Among the foodstuffs suspected, salami-type sausages were associated with an attack rate of 93.3% (14/15), and a dose-response relationship was observed. Trichinella britovi is essentially a sylvatic species, but this study suggests a change in the epidemiology of trichinellosis.