Worldwide Occurrence and Impact of Human Trichinellosis, 1986–2009

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Abstract

To assess the global incidence and clinical effects of human trichinellosis, we analyzed outbreak report data for 1986–2009. Searches of 6 international databases yielded 494 reports. After applying strict criteria for relevance and reliability, we selected 261 reports for data extraction. From 1986 through 2009, there were 65,818 cases and 42 deaths reported from 41 countries. The World Health Organization European Region accounted for 87% of cases; 50% of those occurred in Romania, mainly during 1990–1999. Incidence in the region ranged from 1.1 to 8.5 cases per 100,000 population. Trichinellosis affected primarily adults (median age 33.1 years) and about equally affected men (51%) and women. Major clinical effects, according to 5,377 well-described cases, were myalgia, diarrhea, fever, facial edema, and headaches. Pork was the major source of infection; wild game sources were also frequently reported. These data will be valuable for estimating the illness worldwide.

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Most cited references 26

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The increased population of the Wild Boar (Sus scrofa L.) in Europe

C. SáAEZ-ROYUELA, J. TELLERÍIA (1986)

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Molecular taxonomy, phylogeny and biogeography of nematodes belonging to the Trichinella genus.

Edoardo Pozio, Eric Hoberg, Giuseppe La Rosa … (2009)

Studying parasites of the genus Trichinella provides scientists of today many advantages. This is a group of zoonotic nematodes that circulates freely among wildlife hosts with one in particular, Trichinella spiralis that is exceptionally well adapted to domestic swine. Recent reports suggest that human infections from hunted animals are on the rise worldwide and numerous countries still experience problems with T. spiralis in their domestic food supplies. Trichinella is a genus whose members are easily propagated in the laboratories, have been used as models to investigate host-parasite relationships and parasitism among clade I organisms, and represent a poorly investigated link between the phylum Nematoda and other Metazoans. The importance of T. spiralis in better understanding the tree of life was so recognized that in 2004, its genome was carefully selected as one of only nine key non-mammalian organisms to be sequenced to completion. Since it was first discovered in 1835, this genus has expanded from being monospecific to eight species including four other genotypes of undetermined taxonomic rank. Inasmuch as discriminating morphological data have been scant, our understanding of the genus has been relegated to a compilation of molecular, biochemical and biological data. Herein, we provide a collection of information and up-to-date interpretations on the taxonomy, diagnostics, systematics, micro- and macroevolution, and the biogeographical and biohistorical reconstruction of the genus Trichinella.

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Towards a standardised surveillance for Trichinella in the European Union.

L Alban, E Pozio, J. Boes … (2011)

Each year, more than 167 million pigs in the European Union (EU) are tested for Trichinella spp. under the current meat hygiene regulations. This imposes large economic costs on countries, yet the vast majority of these pigs test negative and the public health risk in many countries is therefore considered very low. This work reviewed the current Trichinella status across the EU as well as the national level of monitoring and reporting. It also reviewed which animal species were affected by Trichinella and in which species it should be surveyed. This information was used to design a cost-effective surveillance programme that enables a standardised monitoring approach within the EU. The proposed surveillance programme relies on identifying sub-populations of animals with a distinct risk. Low-risk pigs are finisher pigs that originate from so-called controlled housing. All other pigs are considered high-risk pigs. Controlled housing is identified by the application of a specific list of management and husbandry practices. We suggest that member states (MS) be categorised into three classes based on the confidence that Trichinella can be considered absent, in the specified sub-population of pigs above a specified design prevalence which we set to 1 per million pigs. A simple and transparent method is proposed to estimate this confidence, based on the sensitivity of the surveillance system, taking into account the sensitivity of testing and the design prevalence. The probability of detecting a positive case, if present, must be high (>95 or >99%) to ensure that there is a low or negligible risk of transmission to humans through the food chain. In MS where the probability of a positive pig is demonstrated to be negligible, testing of fattening pigs from a sub-population consisting of pigs from controlled housing can be considered unnecessary. Furthermore, reduced testing of finishers from the sub-population consisting of pigs from non-controlled housing might even be considered, if conducted in conjunction with a proportionate sampling scheme and a risk-based wildlife surveillance programme where applicable. The proposed surveillance programme specifies the required number of samples to be taken and found negative, in a MS. A MS with no data or positive findings will initially be allocated to class 1, in which all pigs should be tested. When a MS is able to demonstrate a 95% or 99% confidence that Trichinella is absent, the MS will be allocated to class 2 or 3, in which the testing requirement is lower than in class 1. Copyright © 2011 Elsevier B.V. All rights reserved.

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Journal

Journal ID (nlm-ta): Emerg Infect Dis

Journal ID (iso-abbrev): Emerging Infect. Dis

Journal ID (publisher-id): EID

Title: Emerging Infectious Diseases

Publisher: Centers for Disease Control and Prevention

ISSN (Print): 1080-6040

ISSN (Electronic): 1080-6059

Publication date (Print): December 2011

Volume: 17

Issue: 12

Pages: 2194-2202

Affiliations

[-1-1]Author affiliations: University of Copenhagen, Copenhagen, Denmark (K.D. Murrell);

[-1-2]Istituto Superiore di Sanità, Rome, Italy (E. Pozio)

[-2-1]Author affiliations: University of Copenhagen, Copenhagen, Denmark (K.D. Murrell);

[-2-2]Istituto Superiore di Sanità, Rome, Italy (E. Pozio)

[-3-1]Author affiliations: University of Copenhagen, Copenhagen, Denmark (K.D. Murrell);

[-3-2]Istituto Superiore di Sanità, Rome, Italy (E. Pozio)

Author notes

Address for correspondence: K. Darwin Murrell, 5126 Russett Rd, Rockville, MD 20853, USA; email: kdmurrell@ 123456comcast.net

Article

Publisher ID: 11-0896

DOI: 10.3201/eid1712.110896

PMC ID: 3311199

PubMed ID: 22172230

SO-VID: 939d848d-15af-4ff4-af97-bb552e42ece4

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Worldwide Occurrence and Impact of Human Trichinellosis, 1986–2009

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Most cited references 26

The increased population of the Wild Boar (Sus scrofa L.) in Europe

Molecular taxonomy, phylogeny and biogeography of nematodes belonging to the Trichinella genus.

Towards a standardised surveillance for Trichinella in the European Union.

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