Trichinosis Follow-up

  • Author: Clinton Murray, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Jan 4, 2010
 

Further Inpatient Care

  • Inpatient care is rarely needed.
  • Consider trichinosis in cases of heavy infection with evidence of shock, encephalitis, myocarditis, or pneumonitis.
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Further Outpatient Care

  • Patients need continued monitoring because clinical improvement is slow.
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Inpatient & Outpatient Medications

  • Analgesics
  • Antipyretics
  • Anthelmintic medication for severe infections
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Transfer

  • Transfer to another level of care is rarely needed unless the diagnosis is in question or severe sequelae are present.
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Complications

  • Long-term sequelae of the CNS include decreased mental power, numbness of hands and feet, decreased stress tolerance, loss of initiative, and depression.
  • Usually, full recovery occurs after cardiac or pulmonary involvement.
  • Prolonged weakness and myalgias may occur.
  • Adrenal gland insufficiency may occur.
  • Obstruction of blood vessels may occur.
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Prognosis

  • Severe disease develops in only 5%-20% of patients during epidemics.
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Patient Education

  • Adequate cooking and freezing methods prevent infections.
  • The most effective measure to eradicate Trichinella species is by adequate cooking to kill the parasite.
    • The current recommendation for heating is 160°F (71°C) for all food-borne disease. Trichinella species can typically be killed by adequate cooking to 140°F (60°C) for 2 minutes or 131°F (55°C) for 6 minutes
    • If no trace of pink in fluid or flesh is found, these temperatures have been reached.
  • Freezing is also an effective method for killing most species of Trichinella. For a 6-inch piece of meat, the recommended temperatures to kill larvae are as follows:
    • 5°F (-15°C) for 20 days
    • -10°F (-23°C) for 10 days
    • -20°F (-29°C) for 6 days
  • Salting, smoking, or drying the meat does not kill cysts.
  • Excellent patient education resources regarding the esophagus, stomach, and intestine are available at eMedicine's Esophagus, Stomach, and Intestine Center. Patient education material specific to diarrhea is found in the article Diarrhea. Patient education material specific to vomiting and nausea is found in the article Vomiting and Nausea.
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Contributor Information and Disclosures
Author

Clinton Murray, MD  Program Director, Infectious Disease Fellowship, San Antonio Uniformed Services Health Education Consortium

Clinton Murray, MD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Association of Military Surgeons of the US, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Pranatharthi Haran Chandrasekar, MBBS, MD  Professor, Department of Internal Medicine, Director of Infectious Disease Fellowship, Harper Hospital, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

John L Brusch, MD, FACP  Assistant Professor of Medicine, Harvard Medical School; Consulting Staff, Department of Medicine and Infectious Disease Service, Cambridge Health Alliance

John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

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Trichinosis. Life cycle of Trichinella species parasite. (Image courtesy of the CDC)
Table. Important Characteristics of Trichinella Species
Species Distribution Major Host Reservoir Infectivity Resistance to Freezing
T spiralis (T1)CosmopolitanSwine, wild boar, bear, horse, foxHighNone
Trichinella nativa (T2)ArcticBear, horseHighHigh
Trichinella britovi (T3)TemperateWild boar, horseModerateNone
Trichinella pseudospiralis (T4)CosmopolitanBirds, omnivorous mammalsModerateNone
Trichinella murrelli (T5)Temperate, near arcticBearLowLow
Trichinella nelsoni (T7)TropicalWarthogHighNone
Trichinella papuae (T10)Papua New GuineaWarthogModerateNone
Trichinella zimbabwensis (T11)Central AfricaCrocodilesUnknownNone
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