Trichinosis (Trichinellosis) Treatment & Management

Updated: May 01, 2018
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: Burke A Cunha, MD  more...
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Treatment

Medical Care

In moderate-to-heavy Trichinella infections, the goal is to stop the larval invasion into the host muscle.

Within 1 week of ingestion of contaminated meat, administer albendazole (5 mg/kg/d for 1 wk) or mebendazole (5 mg/kg/d for 8-14 d). Note that mebendazole is no longer commercially available in the United States but can be obtained from Expert Compound Pharmacy (expertpharmacy.org).

This drug is effective against worms limited to the intestinal lumen.

The goal is to prevent systemic invasion.

Thiabendazole does not affect tissue larvae.

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Surgical Care

A muscle biopsy is necessary only if the diagnosis is unclear after equivocal clinical, laboratory, or serologic testing.

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Consultations

See the list below:

  • Infectious disease specialist

  • Cardiologist, if evidence of cardiac involvement

  • Neurologist, if evidence of neurologic involvement

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Diet

No diet limitations are indicated; however, this is an excellent opportunity to educate patients regarding the avoidance of potentially infected meats and how to properly cook and store foods. For further details, see Prevention.

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Activity

For severe infections, bed rest is recommended. This is especially important upon evidence of myocardial involvement because patients may deteriorate clinically during ambulation.

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Prevention

The following suggestions for prevention and control of trichinosis in humans have been adapted from patient education materials by the Centers for Disease Control and Prevention:

  • Cook meat to safe temperatures, using a food thermometer to measure the internal temperature of the cooked meat.
  • Ensure appropriate temperatures are reached for different types of meat (listed on the CDC website).
  • Wash hands and other food preparation and storage equipment with warm water and soap after handling raw meat.
  • Ensure proper hygiene during preparation, serving, and storage of food.

Trichinella infection in animal populations can be prevented by not allowing domesticated and wild animals to eat uncooked meat of any animals that may be infected with Trichinella.

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Long-Term Monitoring

Patients need continued monitoring because clinical improvement is slow.

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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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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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