Medical Care

Attention to basic and advanced life support is mandatory in patients who present with severe cardiopulmonary or neurologic compromise.

Surgical Care

Surgery is unnecessary unless a biopsy of a tender skeletal muscle is required.

Consultations

Consultation with an infectious diseases specialist is often helpful. Consultation with a neurologist or cardiologist may be appropriate for patients who present with corresponding organ involvement.

Diet

Avoidance of under-cooked meat is preventative. Cooking thoroughly pork or bear meat until an adequate internal temperature is reached. Storing pork at – 15 ° C for almost 3 weeks is also effective in killing Trichinella larvae. See Deterrence/Prevention section.

Activity

Patient tolerance determines activity restrictions; myalgias are most common in association with activity during the acute parenteral stage.

Medication

Markell EK, Voge M, John DT. Medical Parasitology, 6th ed. Philadelphia, PA: WB Saunders Company; 1986. 270-74.
Knopp S, Steinmann P, Keiser J, Utzinger J. Nematode infections: soil-transmitted helminths and trichinella. Infect Dis Clin North Am. 2012 Jun. 26(2):341-58. [QxMD MEDLINE Link].
Oski FA, et al. Tissue nematodes Trichinella spiralis. In Principles and Practices of Pediatrics 2nd edition. Philadelphia, PA: JB Lippincott; 1994. 1413-14.
Moorhead A, Grunenwald PE, Dietz VJ, Schantz PM. Trichinellosis in the United States, 1991-1996: declining but not gone. Am J Trop Med Hyg. 1999 Jan. 60(1):66-9. [QxMD MEDLINE Link]. [Full Text].
Kennedy ED, Hall RL, Montgomery SP, Pyburn DG, Jones JL. Trichinellosis surveillance - United States, 2002-2007. MMWR Surveill Summ. 2009 Dec 4. 58(9):1-7. [QxMD MEDLINE Link].
American Academy of Pediatrics. Trichinellosis (Trichinella spiralis). Red Book: 2009 Report of the Committee on Infectious Diseases. 28th. Elk Grove Village, IL: American Academy of Pediatrics; 2009. 673-4.
Hall RL, Lindsay A, Hammond C, Montgomery SP, Wilkins PP, da Silva AJ, et al. Outbreak of human trichinellosis in Northern California caused by Trichinella murrelli. Am J Trop Med Hyg. 2012 Aug. 87(2):297-302. [QxMD MEDLINE Link]. [Full Text].
Murrell KD, Pozio E. Worldwide occurrence and impact of human trichinellosis, 1986-2009. Emerg Infect Dis. 2011 Dec. 17(12):2194-202. [QxMD MEDLINE Link].
Cui J, Wang ZQ, Xu BL. The epidemiology of human trichinellosis in China during 2004-2009. Acta Trop. 2011 Apr. 118(1):1-5. [QxMD MEDLINE Link].
Pannwitz G, Mayer-Scholl A, Balicka-Ramisz A, Nockler K. Increased Prevalence of Trichinella spp., Northeastern Germany, 2008. Emerg Infect Dis. 2010 Jun. 16(6):936-42. [QxMD MEDLINE Link].
Neghina R, Neghina AM, Marincu I, Iacobiciu I. Trichinellosis in children and adults: a 10-year comparative study in Western Romania. Pediatr Infect Dis J. 2011 May. 30(5):392-5. [QxMD MEDLINE Link].
Moller LN, Koch A, Petersen E, et al. Trichinella infection in a hunting community in East Greenland. Epidemiol Infect. 2010 Sep. 138(9):1252-6. [QxMD MEDLINE Link].
Capo V, Despommier DD. Clinical aspects of infection with Trichinella spp. Clin Microbiol Rev. 1996 Jan. 9(1):47-54. [QxMD MEDLINE Link]. [Full Text].
Cabie A, Bouchaud O, Houze S, et al. Albendazole versus thiabendazole as therapy for trichinosis: a retrospective study. Clin Infect Dis. 1996 Jun. 22(6):1033-5. [QxMD MEDLINE Link].
Messiaen P, Forier A, Vanderschueren S, Theunissen C, Nijs J, Van Esbroeck M, et al. Outbreak of trichinellosis related to eating imported wild boar meat, Belgium, 2014. Euro Surveill. 2016 Sep 15. 21 (37):[QxMD MEDLINE Link]. [Full Text].
Lo YC, Hung CC, Lai CS, Wu Z, Nagano I, Maeda T. Human trichinosis after consumption of soft-shelled turtles, taiwan. Emerg Infect Dis. 2009 Dec. 15(12):2056-8. [QxMD MEDLINE Link].
Kusolsuk T, Kamonrattanakun S, Wesanonthawech A, et al. The second outbreak of trichinellosis caused by Trichinella papuae in Thailand. Trans R Soc Trop Med Hyg. 2010 Jun. 104(6):433-7. [QxMD MEDLINE Link].
Intapan PM, Chotmongkol V, Tantrawatpan C, Sanpool O, Morakote N, Maleewong W. Molecular identification of Trichinella papuae from a Thai patient with imported trichinellosis. Am J Trop Med Hyg. 2011 Jun. 84(6):994-7. [QxMD MEDLINE Link]. [Full Text].
Rosenblatt JE. Laboratory diagnosis of infections due to blood and tissue parasites. Clin Infect Dis. 2009 Oct 1. 49(7):1103-8. [QxMD MEDLINE Link].
Yang Y, Cai YN, Tong MW, Sun N, Xuan YH, Kang YJ, et al. Serological tools for detection of Trichinella infection in animals and humans. One Health. 2016 Dec. 2:25-30. [QxMD MEDLINE Link]. [Full Text].
Centers for Disease Control and Prevention. Laboratory Identification of Parasitic Diseases of Public Health Concern. CDC. Available at http://www.cdc.gov/dpdx/trichinellosis/dx.html. Accessed: November 29, 2013.
Escalante M, Romaris F, Rodriguez M, et al. Evaluation of Trichinella spiralis larva group 1 antigens for serodiagnosis of human trichinellosis. J Clin Microbiol. 2004 Sep. 42(9):4060-6. [QxMD MEDLINE Link]. [Full Text].
Wang ZQ, Shi YL, Liu RD, Jiang P, Guan YY, Chen YD, et al. New insights on serodiagnosis of trichinellosis during window period: early diagnostic antigens from Trichinella spiralis intestinal worms. Infect Dis Poverty. 2017 Feb 20. 6 (1):41. [QxMD MEDLINE Link]. [Full Text].
Morakote N, Sukhavat K, Khamboonruang C, Siriprasert V, Suphawitayanukul S, Thamasonthi W. Persistence of IgG, IgM, and IgE antibodies in human trichinosis. Trop Med Parasitol. 1992 Sep. 43(3):167-9. [QxMD MEDLINE Link].
Watt G, Saisorn S, Jongsakul K, et al. Blinded, placebo-controlled trial of antiparasitic drugs for trichinosis myositis. J Infect Dis. 2000 Jul. 182(1):371-4. [QxMD MEDLINE Link].
Centers for Disease Control and Prevention. Parasites – Trichinellosis (also known as Trichinosis), Prevention and Control. CDC. Available at http://www.cdc.gov/parasites/trichinellosis/prevent.html. Accessed: December 13, 2013.
Neghina R, Iacobiciu I, Neghina AM, Marincu I. Trichinellosis, another helminthiasis affecting the central nervous system. Parasitol Int. 2011 Jun. 60(2):230. [QxMD MEDLINE Link].
Aronson SM. A tale of an inconsequential worm. Med Health R I. 1999 Oct. 82(10):347. [QxMD MEDLINE Link].
Astudillo LM, Arlet PM. Images in clinical medicine. The chemosis of trichinosis. N Engl J Med. 2004 Jul 29. 351(5):487. [QxMD MEDLINE Link].
Barennes H, Sayasone S, Odermatt P, De Bruyne A, Hongsakhone S, Newton PN, et al. A major trichinellosis outbreak suggesting a high endemicity of Trichinella infection in northern Laos. Am J Trop Med Hyg. 2008 Jan. 78(1):40-4. [QxMD MEDLINE Link].
Bruschi F. Trichinellosis in developing countries: is it neglected?. J Infect Dev Ctries. 2012 Mar 12. 6(3):216-22. [QxMD MEDLINE Link].
Bruschi F, Chiumiento L. Trichinella inflammatory myopathy: host or parasite strategy?. Parasit Vectors. 2011 Mar 23. 4:42. [QxMD MEDLINE Link]. [Full Text].
Bruschi F, Korenaga M, Watanabe N. Eosinophils and Trichinella infection: toxic for the parasite and the host?. Trends Parasitol. 2008 Oct. 24(10):462-7. [QxMD MEDLINE Link].
CDC. Trichinellosis associated with bear meat--New York and Tennessee, 2003. MMWR Morb Mortal Wkly Rep. 2004 Jul 16. 53(27):606-10. [QxMD MEDLINE Link].
De Bruyne A, Ancelle T, Vallee I, Boireau P, Dupouy-Camet J. Human trichinellosis acquired from wild boar meat: a continuing parasitic risk in France. Euro Surveill. 2006. 11(9):E060914.5. [QxMD MEDLINE Link].
Dubey ML, Khurana S, Singhal L, Dogra S, Singh S. Atypical trichinellosis without eosinophilia associated with osteomyelitis. Trop Doct. 2011 Oct. 41(4):244-6. [QxMD MEDLINE Link].
Dupouy-Camet J, Lecam S, Talabani H, Ancelle T. Trichinellosis acquired in Senegal from warthog ham, March 2009. Euro Surveill. 2009 May 28. 14(21):[QxMD MEDLINE Link].
Feigin RD, Cherry JD. Parasitic myocarditis. Textbook of Pediatric Infectious Diseases. Philadelphia, Pa: WB Saunders Co; 2004. 407-9.
Gamble HR, Pozio E, Bruschi F, et al. International Commission on Trichinellosis: recommendations on the use of serological tests for the detection of Trichinella infection in animals and man. Parasite. 2004 Mar. 11(1):3-13. [QxMD MEDLINE Link].
Golab E, Szulc M, Wnukowska N, Rozej W, Fell G, Sadkowska-Todys M. Outbreak of trichinellosis in North-Western Poland--update and exported cases, June-July 2007. Euro Surveill. 2007 Jul. 12(7):E070719.2. [QxMD MEDLINE Link].
Gomez-Morales MA, Ludovisi A, Amati M, Cherchi S, Pezzotti P, Pozio E. Validation of an enzyme-linked immunosorbent assay for diagnosis of human trichinellosis. Clin Vaccine Immunol. 2008 Nov. 15(11):1723-9. [QxMD MEDLINE Link].
Gotistein B, Piarroux R. Current trends in tissue-affecting helminths. Parasite. 2008 Sep. 15(3):291-8. [QxMD MEDLINE Link].
Gottstein B, Pozio E, Nöckler K. Epidemiology, diagnosis, treatment, and control of trichinellosis. Clin Microbiol Rev. 2009 Jan. 22(1):127-45, Table of Contents. [QxMD MEDLINE Link]. [Full Text].
Hall RL, Lindsay A, Hammond C, Montgomery SP, Wilkins PP, da Silva AJ. Outbreak of human trichinellosis in Northern California caused by Trichinella murrelli. Am J Trop Med Hyg. 2012 Aug. 87(2):297-302. [QxMD MEDLINE Link].
Hidron A, Vogenthaler N, Santos-Preciado JI, Rodriguez-Morales AJ, Franco-Paredes C, Rassi A Jr. Cardiac involvement with parasitic infections. Clin Microbiol Rev. 2010 Apr. 23(2):324-49. [QxMD MEDLINE Link].
Ilic N, Gruden-Movsesijan A, Sofronic-Milosavljevic L. Trichinella spiralis: shaping the immune response. Immunol Res. 2012 Apr. 52(1-2):111-9. [QxMD MEDLINE Link].
Jansen A, Schoneberg I, Stark K, Nockler K. Epidemiology of trichinellosis in Germany, 1996-2006. Vector Borne Zoonotic Dis. 2008 Apr. 8(2):189-96. [QxMD MEDLINE Link].
Kaewpitoon N, Kaewpitoon SJ, Philasri C, et al. Trichinosis: epidemiology in Thailand. World J Gastroenterol. 2006 Oct 28. 12(40):6440-5. [QxMD MEDLINE Link].
Kociecka W. Trichinellosis: human disease, diagnosis and treatment. Vet Parasitol. 2000 Dec 1. 93(3-4):365-83. [QxMD MEDLINE Link].
Lazarevic AM, Neskovic AN, Goronja M, et al. Low incidence of cardiac abnormalities in treated trichinosis: a prospective study of 62 patients from a single-source outbreak. Am J Med. 1999 Jul. 107(1):18-23. [QxMD MEDLINE Link].
Lindh J, Ljungstrom I. Trichinella spp. Akuffo H, Linder E, Ljungstrom I, Wahlgren M. Parasites of the Colder Climates. London and New York: Taylor & Francis; 2003. 195-204.
Long SS, Pickering LK, Prober CG. Trichinella spiralis. Pediatric Infectious Diseases. 2003. 1344-46.
Madariaga MG, Cachay ER, Zarlenga DS. A probable case of human neurotrichinellosis in the United States. Am J Trop Med Hyg. 2007 Aug. 77(2):347-9. [QxMD MEDLINE Link].
Mandell GL, Bennett JE, Dolin RD. Tissue nematodes, including trichinosis, dracunculiasis, and the filariases. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Philadelphia, Pa: Churchill Livingstone; 2005. 3267-76.
Marva E, Markovics A, Gdalevich M, et al. Trichinellosis outbreak. Emerg Infect Dis. 2005 Dec. 11(12):1979-81. [QxMD MEDLINE Link].
McIntyre L, Pollock SL, Fyfe M, Gajadhar A, Isaac-Renton J, Fung J. Trichinellosis from consumption of wild game meat. CMAJ. 2007 Feb 13. 176(4):449-51. [QxMD MEDLINE Link].
Mitreva M, Jasmer DP. Biology and genome of Trichinella spiralis. WormBook. 2006 Nov 23. 1-21. [QxMD MEDLINE Link].
Murrell KD, Bruschi F. Clinical trichinellosis. Prog Clin Parasitol. 1994. 4:117-50. [QxMD MEDLINE Link].
Neghina R, Moldovan R, Marincu I, Calma CL, Neghina AM. The roots of evil: the amazing history of trichinellosis and Trichinella parasites. Parasitol Res. 2011 Oct 8. [QxMD MEDLINE Link].
Neghina R, Neghina AM. Reviews on trichinellosis (IV): hepatic involvement. Foodborne Pathog Dis. 2011 Sep. 8(9):943-8. [QxMD MEDLINE Link].
Outbreak of trichinellosis in French hunters who ate Canadian black bear meat. Can Commun Dis Rep. 2006 May 1. 32(9):109-12. [QxMD MEDLINE Link].
Ozdemir D, Ozkan H, Akkoc N, et al. Acute trichinellosis in children compared with adults. Pediatr Infect Dis J. 2005 Oct. 24(10):897-900. [QxMD MEDLINE Link].
Papatsiros VG, Boutsini S, Ntousi D, Stougiou D, Mintza D, Bisias A. Detection and zoonotic potential of Trichinella spp. from free-range pig farming in Greece. Foodborne Pathog Dis. 2012 Jun. 9(6):536-40. [QxMD MEDLINE Link].
PDR. Physician's Desk Reference. Montvale, NJ: Thomson Healthcare; 2000.
Pozio E, Darwin Murrell K. Systematics and epidemiology of trichinella. Adv Parasitol. 2006. 63:367-439. [QxMD MEDLINE Link].
Pozio E, Gomez Morales MA, Dupouy-Camet J. Clinical aspects, diagnosis and treatment of trichinellosis. Expert Rev Anti Infect Ther. 2003 Oct. 1(3):471-82. [QxMD MEDLINE Link].
Pozio E, Hoberg E, La Rosa G, Zarlenga DS. Molecular taxonomy, phylogeny and biogeography of nematodes belonging to the Trichinella genus. Infect Genet Evol. 2009 Jul. 9(4):606-16. [QxMD MEDLINE Link].
Taratuto AL, Venturiello SM. Trichinosis. Brain Pathol. 1997 Jan. 7(1):663-72. [QxMD MEDLINE Link].
Taylor WR, Tran GV, Nguyen TQ, Dang DV, Nguyen VK, Nguyen CT, et al. Acute Febrile Myalgia in Vietnam due to Trichinellosis following the Consumption of Raw Pork. Clin Infect Dis. 2009 Aug 27. [QxMD MEDLINE Link].
Tint D, Cocuz ME, Ortan OF, Niculescu MD, Radoi M. Cardiac involvement in trichinellosis: a case of left ventricular thrombosis. Am J Trop Med Hyg. 2009 Aug. 81(2):313-6. [QxMD MEDLINE Link].
Turk M, Kaptan F, Turker N, et al. Clinical and laboratory aspects of a trichinellosis outbreak in Izmir, Turkey. Parasite. 2006 Mar. 13(1):65-70. [QxMD MEDLINE Link].
Watt G, Silachamroon U. Areas of uncertainty in the management of human trichinellosis: a clinical perspective. Expert Rev Anti Infect Ther. 2004 Aug. 2(4):649-52. [QxMD MEDLINE Link].
Youn H. Review of zoonotic parasites in medical and veterinary fields in the Republic of Korea. Korean J Parasitol. 2009 Oct. 47 Suppl:S133-41. [QxMD MEDLINE Link]. [Full Text].

Media Gallery

of 0

Author

Germaine L Defendi, MD, MS, FAAP Associate Clinical Professor, Department of Pediatrics, Olive View-UCLA Medical Center

Germaine L Defendi, MD, MS, FAAP is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Russell W Steele, MD Clinical Professor, Tulane University School of Medicine; Staff Physician, Ochsner Clinic Foundation

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, Southern Medical Association

Disclosure: Nothing to disclose.

Additional Contributors

Ashir Kumar, MD, MBBS FAAP, Professor Emeritus, Department of Pediatrics and Human Development, Michigan State University College of Human Medicine

Ashir Kumar, MD, MBBS is a member of the following medical societies: Infectious Diseases Society of America, American Association of Physicians of Indian Origin

Disclosure: Nothing to disclose.

Acknowledgements

Basim Asmar, MD Director, Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Michigan; Professor, Department of Pediatrics, Wayne State University School of Medicine

Basim Asmar, MD is a member of the following medical societies: American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Leslie L Barton, MD Professor Emerita of Pediatrics, University of Arizona College of Medicine

Leslie L Barton, MD is a member of the following medical societies: American Academy of Pediatrics, Association of Pediatric Program Directors, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Swati Garekar, MBBS Staff Physician, Department of Pediatrics, Children's Hospital of Michigan

Swati Garekar, MBBS is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

Sections Pediatric Trichinosis
Overview
Presentation
- History
- Physical
- Causes
- Show All
DDx
Workup
Treatment
Medication
Follow-up
References

Pediatric Trichinosis Treatment & Management

Medical Care

Surgical Care

Consultations

Diet

Activity

References

Tables

Contributor Information and Disclosures

What would you like to print?