Tuesday, January 20, 2015

Trichinellosis Surveillance in the United States, 2008 - 2012 - Summary of CDC Report

CDC issued a surveillance report on cases of Trichinellosis.  This is a quick summary.
 
Trichinellosis is a parasitic disease caused by Trichinella, a nematode. It had been traditionally associated with undercooked pork, but more recently it is more associated with wild game.  [Prior to improvements in pig husbandry in 1940's and 1950's, it was estimated that over 15% of people in the US had been infected by Trichinella.]
 
From the report:
"Trichinella infection in human hosts can be divided into an intestinal (enteral) phase and a muscular (parenteral) phase, with clinical manifestations ranging from asymptomatic infection to fatal disease, depending on the number of larvae ingested. After ingestion, larvae are released into the intestinal mucosa and subsequently migrate to the blood vessels, from which they spread throughout the body before reaching the skeletal muscles."

 During the initial phase, within the first few days of infection, symptoms can range from asymptomatic to severe gastrointestinal distress.  As the parasite migrates to the muscle and embeds itself, the person can have fever, muscle pain, and swelling.  Death can occur in cases where this is inflammation of the heart, brain, or lung tissue as well as due to respiratory failure from a high level of infection of encysted worms in the diaphragm muscle [it gets so many encysted worms that the muscle can't work...tell me that isn't a miserable way to buy the farm].
 
During the reporting period, 2008-2012, there were 84 confirmed cases.
  • 22 cases were linked with pork products, including 10 with commercial pork products, 6 with wild boar, and 1 with home-raised swine, and 5 unspecified.
  • 41 cases were linked to bear meat
  • 2 cases with deer meat
  • 2 with ground meat
  • 17 cases unknown
  • From 51 cases that were further investigated, 24 reported eating raw or undercooked meat [for the other cases, as we know, people hate to admit being stupid...who wants to admit eating bear tartare, or drinking the fresh blood of their hunted bear prey...yeah, you know that guy].
So the number of cases has continued to decline thanks to commercial pork practices and better cooking practices by the consumer, but vigilance is still needed, especially with wild game.  Consumers of pork and game must follow proper cooking or freezing methods to destroy the parasite.

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