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- Trichinosis is an infection caused by an organism called trichinella spiralis. This organism is most often found in pigs. It usually causes Diarrhea, fatigue, Muscle Cramps, and muscle pain.
- Trichinella spiralis is an organism found throughout the world, most often in uncooked meats. Pork products tend to be the most common source of human infection. Once the organism enters the human host, it rapidly multiplies, spreading throughout the body, causing such symptoms as Diarrhea, fever, muscle pain, and Muscle Cramps.
The best way to prevent infection is to cook all meats thoroughly. Usually with this infection, supportive care for symptoms and complications is all that is required. In some cases, however, antibiotics will be needed.
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- The symptoms depend upon:
- The amount of the organism consumed (the more organism present, the worse the symptoms)
- The age of the person affected (younger children do better)
- The state of his/her immune system (worse symptoms in those with weak or compromised immune systems)
- The organs of the body that are infected
- Usually, if symptoms develop, they begin 2-7 days after infection.
- The amount and severity of symptoms vary considerably. Some may not have any symptoms at all, others may have mild fever and slight symptoms, and in a few cases, the symptoms may be severe, involving various organs.
- Many will have cramps or pain in the stomach, Diarrhea, fatigue,
nausea, or vomiting during the first week of infection -- while the organism is still in the intestine.
- At the end of the first week, the organism begins to spread to the bloodstream and muscles. During this phase, tend to be much more ill. Symptoms may include fever, muscle pain, Muscle Spasm, swelling (of the eyes, face, or muscles), weakness, trouble swallowing, sensitivity to light, Red Eyes, rashes, sweating, coughing, or trouble breathing. The organism can also spread to other parts of the body, such as the brain, heart, kidneys, lungs, or nerves, causing infection or inflammation in those areas. This phase can last up to 6 weeks.
- After this phase, the patient begins
slowly to improve. However, full recovery may take
several months. Also, not everyone will fully
recover. Muscle aches and pains may last for months to
years.
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- As stated, the organism Trichinella spiralis causes the infection. This organism is found throughout the world.
- There are 3 other types of
trichinella found in humans. Trichinella nativa
occurs mostly in the Arctic and sub-Arctic areas.
Trichinella nelsoni is found in Africa.
Trichinella pseudospiralis is present worldwide, but is quite rare and often causes prolonged infection of the muscle.
- Eating uncooked or undercooked meat usually causes trichinosis. In humans, the most common source is pork products. Ground beef can sometimes be the source if the meat becomes contaminated in a grinder used for pork.
- Pigs often become infected themselves when fed raw or undercooked meat, or if they eat an infected rat.
- Other sources of infection caused by eating raw or undercooked meat include dog, cat, rat, wolf, hyena, jackal, lion, horse, boar, bear, walrus, fox, cougar, and bush pig.
- Once the infected meat is consumed, the organism enters the intestine, spreads to the lymph system and bloodstream, and then to various parts of the body, especially the muscles. In the muscle, it causes inflammation.
- However, the infection can spread to many other parts of the body, including the brain, kidneys, lungs, or heart.
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- Symptoms, history, and physical exam help the doctor arrive at a diagnosis.
- However, the most reliable and usual method is based on blood tests, culture results, or biopsy.
- The best test to detect and diagnose the disease depends on the stage of infection. Initially, blood tests and antibody levels may be helpful. However, after the infection has spread to the muscles, a muscle biopsy may be more definitive.
- Blood tests usually show an increase in the white blood cell count, an increase in the eosinophilia count, an increase in muscle enzymes, and a normal ESR (erythrocyte sedimentation rate).
- Blood tests can be done to detect if the body is producing antibodies to the infection.
- Stool specimens may be examined to look for the organism, but often this test is normal.
- Sometimes, the organism can be found in the blood, stomach fluid, or spinal fluid.
- Muscle biopsy (in which a piece of muscle is removed and examined under a microscope) remains the best way to diagnose the disease, especially if done 3-4 weeks after infection.
- Also, newer blood tests that detect the presence of the organism itself are being tested.
- Sometimes, a spinal tap is advised to establish infection in the brain.
- Chest X-Rays may be used to discover infection in the lungs.
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- Risk factors include inappropriate washing of hands after contact with raw meat.
- Eating meat that has not been properly frozen and/or cooked.
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- Most recover without treatment other than supportive care -- i.e., keeping the patient comfortable and seeing that he is given fluids as needed, and is monitored closely.
- During the initial phase (when the organism is still in the intestine) the patient can be treated with a medicine called Albendazole (400 milligram twice a day for up to 60 days). Other alternatives are Mebendazole (200 to 400 milligrams three times a day for three days, then 400 to 500 milligrams three times a day for 10 days) or Thiabendazole (at a dose of 25 milligrams per kilogram of body weight, twice a day for 3 to 7 days). Steroids should not be taken during this time.
- In the muscle inflammation phase, depending on the severity of the symptoms the patient may require hospitalization, as well as high doses of steroids to decrease inflammation and relieve pain. After 1 to 2 days, steroids can be reduced, but may need to be continued for days to weeks.
- Steroids should only be used when the symptoms are very severe.
- Thiabendazole, Mebendazole, and Albendazole have all been tried during this phase, but their effectiveness is unclear.
- The long-term prognosis in most cases is excellent. Death is rare, but in a few cases, after about 3-6 weeks death may come as a result of complications such as heart failure.
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- If the infection spreads to certain vital organs, potentially life-threatening complications can arise, such as infection and inflammation of the lungs (pneumonitis), brain (encephalitis), and heart failure.
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- Seek medical attention as soon as possible.
- If available, bring a sample of the suspect infected meat to the doctor to have it tested.
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- Prevention is the most important safeguard.
- Properly treating all meats,
especially pork, is essential. Pork should be cooked at 77 degrees Celsius for several minutes, or frozen to -17 degrees Celsius for more than 2 days. The thicker the meat, the longer it needs to be frozen. Freezing usually destroys the organism.
- In game meat, such as bear, boar, walrus, wild pig, etc., the organism is much more resistant to destruction by freezing. Therefore, it is best to cook it properly before consumption. Also, irradiating the meat may destroy the organism.
- Another preventive solution would be to stop feeding uncooked garbage to pigs raised for our consumption. This would eliminate infection in the first place.
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