Trichinellosis/Trichinosis Treatment & Management

  • Author: L Kristian Arnold, MD; Chief Editor: Rick Kulkarni, MD   more...
 
Updated: Dec 7, 2010
 

Prehospital Care

Institute appropriate supportive therapy for patients who present with symptoms of neurologic or cardiac involvement.

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Emergency Department Care

Patients with mild cases require no special care.

Patients with more severe cases of muscle involvement may need basic supportive therapy (eg, oxygen, intravenous fluids).

Cardiac monitoring is suggested for patients who present early. Cardiac findings are unlikely to develop late in the course (ie, after peripheral muscle invasion has started).

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Consultations

  • Infectious disease/tropical medicine/travel medicine specialists
  • Surgeons (for muscle biopsy)
  • Cardiologists
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Contributor Information and Disclosures
Author

L Kristian Arnold, MD  Chief Medical Officer, ArLac Global Health Services, Lexington, MA, Medical Director, Boston Police Department, Assistant Professor (retired), Emergency Medicine, Boston University School of Medicine

L Kristian Arnold, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Occupational and Environmental Medicine, and Massachusetts Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Theodore J Gaeta, DO, MPH, FACEP  Clinical Associate Professor, Department of Emergency Medicine, Weill Cornell Medical College; Vice Chairman and Program Director of Emergency Medicine Residency Program, Department of Emergency Medicine, New York Methodist Hospital; Academic Chair, Adjunct Professor, Department of Emergency Medicine, St George's University School of Medicine

Theodore J Gaeta, DO, MPH, FACEP is a member of the following medical societies: Alliance for Clinical Education, American College of Emergency Physicians, Clerkship Directors in Emergency Medicine, Council of Emergency Medicine Residency Directors, New York Academy of Medicine, and Society for Academic Emergency Medicine

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: eMedicine Salary Employment

Mark L Plaster, MD, JD  Executive Editor, Emergency Physicians Monthly

Mark L Plaster, MD, JD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians

Disclosure: M L Plaster Publishing Co LLC Ownership interest Management position

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD 

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

References
  1. Zarlenga DS, Rosenthal BM, La Rosa G, Pozio E, Hoberg EP. Post-Miocene expansion, colonization, and host switching drove speciation among extant nematodes of the archaic genus Trichinella. Proc Natl Acad Sci U S A. May 9 2006;103(19):7354-9. [Medline].

  2. Despommier D. The history of Trichinella. The Trichinella Page. Available at http://www.trichinella.org/index.htm. Accessed November 2, 2007.

  3. Cook GC. Outbreak of trichinosis (trichiniasis)-contracted in London in 1879. Postgrad Med J. Jan 2001;77(903):62-3. [Medline].

  4. Pozio E, Zarlenga DS. Recent advances on the taxonomy, systematics and epidemiology of Trichinella. Int J Parasitol. Oct 2005;35(11-12):1191-204. [Medline].

  5. Pozio E. Factors affecting the flow among domestic, synanthropic and sylvatic cycles of Trichinella. Vet Parasitol. Dec 1 2000;93(3-4):241-62. [Medline].

  6. Despommier D. Biology of the Nurse Cell — Parasite Complex. The Trichinella Page. Available at http://www.trichinella.org/bio_nursecell.htm. Accessed 3 November, 2007.

  7. Pozio E, Bruschi F. The importance of correct terminology in describing the muscular stage of Trichinella infection. Trends Parasitol. Aug 2001;17(8):362. [Medline].

  8. Fourestie V, Douceron H, Brugieres P, Ancelle T, Lejonc JL, Gherardi RK. Neurotrichinosis. A cerebrovascular disease associated with myocardial injury and hypereosinophilia. Brain. Jun 1993;116 (Pt 3):603-16. [Medline].

  9. van Knapen F. Control of trichinellosis by inspection and farm management practices. Vet Parasitol. Dec 1 2000;93(3-4):385-92. [Medline].

  10. Roy SL, Lopez AS, Schantz PM. Trichinellosis surveillance--United States, 1997-2001. MMWR Surveill Summ. Jul 25 2003;52(6):1-8. [Medline].

  11. Graves T, Harkess J, Crutcher JM. Case report: locally acquired trichinosis in an immigrant from Southeast Asia. J Okla State Med Assoc. Nov 1996;89(11):402-4. [Medline].

  12. Gamble HR, Brady RC, Bulaga LL, et al. Prevalence and risk association for Trichinella infection in domestic pigs in the northeastern United States. Vet Parasitol. Mar 22 1999;82(1):59-69. [Medline].

  13. Prescribed treatment of pork and products containing pork to destroy trichinae. In: United States Code of Federal Regulations. 9 CFR 318.10 (Rev 1/1/2007). Accessed November 2, 2007: [Full Text].

  14. Centers for Disease Control and Prevention. Trichinellosis associated with bear meat--New York and Tennessee, 2003. MMWR Morb Mortal Wkly Rep. Jul 16 2004;53(27):606-10. [Medline].

  15. Murrell KD, Pozio E. Trichinellosis: the zoonosis that won't go quietly. Int J Parasitol. Nov 2000;30(12-13):1339-49. [Medline].

  16. Dupouy-Camet J. Trichinellosis: a worldwide zoonosis. Vet Parasitol. Dec 1 2000;93(3-4):191-200. [Medline].

  17. Pozio E. New patterns of Trichinella infection. Vet Parasitol. Jul 12 2001;98(1-3):133-48. [Medline].

  18. Gajadhar AA, Gamble HR. Historical perspectives and current global challenges of Trichinella and trichinellosis. Vet Parasitol. Dec 1 2000;93(3-4):183-9. [Medline].

  19. Gamble HR, Bessonov AS, Cuperlovic K, et al. International Commission on Trichinellosis: recommendations on methods for the control of Trichinella in domestic and wild animals intended for human consumption. Vet Parasitol. Dec 1 2000;93(3-4):393-408. [Medline].

  20. Watt G, Saisorn S, Jongsakul K, Sakolvaree Y, Chaicumpa W. Blinded, placebo-controlled trial of antiparasitic drugs for trichinosis myositis. J Infect Dis. Jul 2000;182(1):371-4. [Medline].

  21. Kurup A, Yew WS, San LM, Ang B, Lim S, Tai GK. Outbreak of suspected trichinosis among travelers returning from a neighboring island. J Travel Med. Jul-Aug 2000;7(4):189-93. [Medline].

  22. Centers for Disease Control and Prevention. Trichinellosis outbreaks--Northrhine-Westfalia, Germany, 1998-1999. MMWR Morb Mortal Wkly Rep. Jun 18 1999;48(23):488-92. [Medline]. [Full Text].

  23. Kramme S, Schmiedel S. Trichinellosis imported to Germany from Poland, cardiac complications. International Commission on Trichinellosis News Postings. 2007 Accessed: 15 August, 2007. [Full Text].

  24. World Health Organization. Imported human outbreak of trichinellosis, Italy. Wkly Epidemiol Rec. Mar 30 2001;76(13):97-8. [Medline]. [Full Text].

  25. Samuelsson S, ed. Outbreak of trichinosis. Epi-News. 2004; 14. Staten Serum Institute. Available at http://www.ssi.dk/sw10275.asp. Accessed 15 October, 2007.

  26. Dupouy-Camet J. Trichinellosis: still a concern for Europe. Euro Surveill. 2006;11(1):5. [Medline]. [Full Text].

  27. Boireau P, Vallee I, Roman T, et al. Trichinella in horses: a low frequency infection with high human risk. Vet Parasitol. Dec 1 2000;93(3-4):309-20. [Medline].

  28. Liu M, Boireau P. Trichinellosis in China: epidemiology and control. Trends Parasitol. Dec 2002;18(12):553-6. [Medline].

  29. Takahashi Y, Mingyuan L, Waikagul J. Epidemiology of trichinellosis in Asia and the Pacific Rim. Vet Parasitol. Dec 1 2000;93(3-4):227-39. [Medline].

  30. Cui J, Wang ZQ, Kennedy MW. The re-emergence of trichinellosis in China?. Trends Parasitol. Feb 2006;22(2):54-5. [Medline].

  31. Proulx JF, MacLean JD, Gyorkos TW, et al. Novel prevention program for trichinellosis in inuit communities. Clin Infect Dis. Jun 1 2002;34(11):1508-14. [Medline].

  32. O'Brien F. Environmental health in the Canadian arctic of Nunavut: Our People - Our Land. Environment and Health International [serial online]. 6(1):6-10. Accessed 3 November, 2007. Available at http://www.ifeh.org/magazine/ifeh-magazine-2004_v6_n1.pdf.

  33. Gallardo MT, Mateos L, Artieda J, et al. Outbreak of trichinellosis in Spain and Sweden due to consumption of wild boar meat contaminated with Trichinella britovi. Euro Surveill. Mar 15 2007;12(3):E070315.1. [Medline].

  34. Pozio E, Darwin Murrell K. Systematics and epidemiology of trichinella. Adv Parasitol. 2006;63:367-439. [Medline].

  35. Gebreyes WA, Bahnson PB, Funk JA, McKean J, Patchanee P. Seroprevalence of Trichinella, Toxoplasma, and Salmonella in antimicrobial-free and conventional swine production systems. Foodborne Pathog Dis. Apr 2008;5(2):199-203. [Medline].

  36. van der Giessen J, Fonville M, Bouwknegt M, Langelaar M, Vollema A. Seroprevalence of Trichinella spiralis and Toxoplasma gondii in pigs from different housing systems in The Netherlands. Vet Parasitol. Sep 30 2007;148(3-4):371-4. [Medline].

  37. Owen IL, Pozio E, Tamburrini A, et al. Focus of human trichinellosis in Papua New Guinea. Am J Trop Med Hyg. Nov 2001;65(5):553-7. [Medline].

  38. Nuñez GG, Costantino SN, Gentile T, Venturiello SM. Immunoparasitological evaluation of Trichinella spiralis infection during human pregnancy: a small case series. Trans R Soc Trop Med Hyg. Jul 2008;102(7):662-8. [Medline].

  39. Webster P, Kapel CM. Studies on vertical transmission of Trichinella spp. in experimentally infected ferrets (Mustela putorius furo), foxes (Vulpes vulpes), pigs, guinea pigs and mice. Vet Parasitol. Jun 30 2005;130(3-4):255-62. [Medline].

  40. Dubinsky P, Boor A, Kincekova J, Tomasovicova O, Reiterova K, Bielik P. Congenital trichinellosis? Case report. Parasite. Jun 2001;8(2 Suppl):S180-2. [Medline].

  41. Akar S, Gurler O, Pozio E, Onen F, Sari I, Gerceker E, et al. Frequency and severity of musculoskeletal symptoms in humans during an outbreak of trichinellosis caused by Trichinella britovi. J Parasitol. Apr 2007;93(2):341-4. [Medline].

  42. Nikolic S, Vujosevic M, Sasic M, et al. [Neurologic manifestations in trichinosis]. Srp Arh Celok Lek. May-Jun 1998;126(5-6):209-13. [Medline].

  43. Walsh DS, Jongsakul K, Watt G. Hand rash in trichinosis. Clin Exp Dermatol. May 2001;26(3):272-3. [Medline].

  44. Astudillo LM, Arlet PM. Images in clinical medicine. The chemosis of trichinosis. N Engl J Med. Jul 29 2004;351(5):487. [Medline].

  45. Bruschi F, Murrell KD. New aspects of human trichinellosis: the impact of new Trichinella species. Postgrad Med J. Jan 2002;78(915):15-22. [Medline].

  46. Pozio E, Foggin CM, Gelanew T, et al. Trichinella zimbabwensis in wild reptiles of Zimbabwe and Mozambique and farmed reptiles of Ethiopia. Vet Parasitol. Feb 28 2007;143(3-4):305-10. [Medline].

  47. Pozio E, Foggin CM, Gelanew T, Marucci G, Hailu A, Rossi P, et al. Trichinella zimbabwensis in wild reptiles of Zimbabwe and Mozambique and farmed reptiles of Ethiopia. Vet Parasitol. Feb 28 2007;143(3-4):305-10. [Medline].

  48. Gelal F, Kumral E, Vidinli BD, Erdogan D, Yucel K, Erdogan N. Diffusion-weighted and conventional MR imaging in neurotrichinosis. Acta Radiol. Apr 2005;46(2):196-9. [Medline].

  49. Yera H, Andiva S, Perret C, Limonne D, Boireau P, Dupouy-Camet J. Development and evaluation of a Western blot kit for diagnosis of human trichinellosis. Clin Diagn Lab Immunol. Sep 2003;10(5):793-6. [Medline].

  50. Robert F, Weil B, Kassis N, Dupouy-Camet J. Investigation of immunofluorescence cross-reactions against Trichinella spiralis by western blot (immunoblot) analysis. Clin Diagn Lab Immunol. Sep 1996;3(5):575-7. [Medline]. [Full Text].

  51. Astudillo LM, Arlet PM. Images in clinical medicine. The chemosis of trichinosis. N Engl J Med. Jul 29 2004;351(5):487. [Medline].

  52. Watt G, Silachamroon U. Areas of uncertainty in the management of human trichinellosis: a clinical perspective. Expert Rev Anti Infect Ther. Aug 2004;2(4):649-52. [Medline].

  53. Pozio E, Sacchini D, Sacchi L, Tamburrini A, Alberici F. Failure of mebendazole in the treatment of humans with Trichinella spiralis infection at the stage of encapsulating larvae. Clin Infect Dis. Feb 15 2001;32(4):638-42. [Medline].

  54. Caner A, Doskaya M, Degirmenci A, Can H, Baykan S, Uner A, et al. Comparison of the effects of Artemisia vulgaris and Artemisia absinthium growing in western Anatolia against trichinellosis (Trichinella spiralis) in rats. Exp Parasitol. May 2008;119(1):173-9. [Medline].

  55. Cosoroaba I, Orjanu N. Congenital trichinellosis in the rat. Vet Parasitol. Jun 15 1998;77(2-3):147-51. [Medline].

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Trichinosis. Life cycle of Trichinella species parasite. Image courtesy of the Centers for Disease Control and Prevention.
Photomicrograph depicting numbers of Trichinella spiralis cysts seen embedded in a muscle tissue specimen, in a case of trichinellosis. Image courtesy of the Centers for Disease Control and Prevention.
 
 
 
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