TRICHINOSIS

also “Trichiniasis, Trichinellosis”

 CAUSATIVE AGENT/ETIOLOGY
▪ Nematodes of the genus Trichinella, i.e. Trichinella spiralis or muscle worm
▪ AlsoT. pseudospiralis, T. britovi, T. native, andT. nelsoni
INCUBATION PERIOD

▪ 2 to 28 days after ingestion of infected pork

▪ 1 to 8 weeks later
▪ An average of about 9 days
 SOURCE OF INFECTION/M.O.T
IN MAN
▪ Consumption of insufficiently cooked animal
meat, principally pork and pork products, that
are infected with T. spiralis.

IN HOGS:
▪ Ingestion of infected rodents such as rats
 PATHOLOGY
▪ After the infected meat is digested, the
released larvae pass into the intestine,
where maturation of the adult worm
occurs.

▪ The female releases from 1000 to 1500

larvae, which penetrate the intestinal
mucosa and eventually enter the
bloodstream.
 PATHOLOGY

▪ The larvae have an affinity for

skeletal muscle tissue, which they
penetrate.

▪ They grow rapidly and become

encysted.

▪ Calcification of the larval cyst may

occur.
 MUSCLES AFFECTED

▪ Greater pectoral

▪ Parts of the deltoid

▪ Gastrocnemius

▪ Biceps
COURSE OF THE DISEASE + CLINICAL
MANIFESTATIONS
ENTERIC STAGE (within the first week of ingestion) - during
which the larvae are being released in the stomach and the
adult worms are maturing and releasing embryonated larvae.

Abdominal Nausea &

Pain Vomiting
COURSE OF THE DISEASE + CLINICAL
MANIFESTATIONS

Anorexia

Diarrhea
COURSE OF THE DISEASE + CLINICAL
MANIFESTATIONS
MIGRATORY STAGE (7 to 10 days after ingestion up to 6 or
more weeks when encapsulation begins) – acute; where one
of the cardinal signs is eosinophilia.

Severe muscle Fever from

pain 101 to 104*F
COURSE OF THE DISEASE + CLINICAL
MANIFESTATIONS

Periorbital edema

Headache
COURSE OF THE DISEASE + CLINICAL
MANIFESTATIONS
Various cutaneous manifestations

Urticaria

Pruritus

Tingling of the skin

Increased perspiration
COURSE OF THE DISEASE + CLINICAL
MANIFESTATIONS

Central Nervous System:

Acute psychosis
Tumors of the brain or spinal cord
Paresis
Polyneuritis
Paraplegia
COURSE OF THE DISEASE + CLINICAL
MANIFESTATIONS
ENCYSTMENT STAGE (14 days after infection up to a year) –
occurs when the larvae reach the muscle tissue and become
encysted, the disease gradually become chronic.

Muscular rheumatic-like pains

DIFFERENTIAL DIAGNOSIS
▪ In early infection
– Influenza
– Acute gastroenteritis
▪ Later considerations include
– Typhoid fever
– Encephalitis
– Myositis
– Tetanus
– Other helminthic infections
COMPLICATIONS

▪ Dysrhythmias 2 to 5 weeks after infection

▪ CHF 4 to 8 weeks after infection
▪ Thromboembolisms
▪ Pericardial effusion
COMPLICATIONS

▪ Meningitis
▪ Meningoencephalitis
▪ Vision disturbances
▪ Hearing impairment
▪ Ataxia
▪ Mental status change
▪ Coma
 DIAGNOSIS

▪ Three Signs
– Muscle pain
– Edema
– Eosinophilia

▪ History of eating
inadequately cooked pork
DIAGNOSIS

▪ Biopsy of muscle tissue

▪ ELISA
▪ Intradermal skin test
▪ Trichinoscopy
▪ Precipitin test
▪ Complement-fixation test
 TREATMENT MODALITIES

▪ There is no therapeutic agent specific for

trichinosis; but steroids have been used.
▪ Anthelmintic agents and repeated doses of
saline cathartics
▪ Broad-spectrum anthelmintic, Thiabendazole
– Daily oral dose of 50 mg. per kilogram of
body weight for 5 to 7 days
– Most will experience nausea, vomiting,
cutaneous rash, and CNS symptoms
 TREATMENT MODALITIES

▪ Other treatment may include:

– Bed rest during the acute stage of

the disease
– Analgesics to relieve muscle pain
– Antihistamines to relieve the allergic
manifestations of the infection
– Sodium restriction with a high
protein diet
 PREVENTION

▪ Sanitary disposal of human excreta

▪ Proper construction of pit privies
▪ Wear protective clothing when
entering a body of water
▪ Use repellents
▪ Avoid going barefooted
▪ Thorough cooking of pork
END~