Trichinellosis in hospitalized patients from Western Romania: A retrospective study

Trichinella spiralis Infecting Wild Boars in West, Southwest, and Northwest of Romania: Evidence of an Underrated Risk

The species of the genus Trichinella are etiological agents distributed all over the world and are able to infect mammals, birds, and reptiles. Trichinella spiralis is the species most adapted to domestic and wild pigs and is also the most important etiological agent of trichinellosis. The wild boar (Sus scrofa) is a nocturnal omnivorous mammal belonging to the Suidae family. S. scrofa has a great appetite and its diet includes a variety of small prey such as mice, rats, and other rodents, as well as carcasses of larger animals. The aim of this study was the identification and the molecular characterization of Trichinella larvae isolated from the muscle tissue of S. scrofa specimens collected in different counties of Romania. The muscle samples were examined by artificial digestion and the larvae identified at the species level by multiplex PCR. T. spiralis, a species that is able to infect a considerable number of different host species including humans, was identified. In Romania, S. scrofa is an important reservoir species for T. spiralis and plays an important role in linking the domestic and the wild cycle of Trichinella, with serious repercussions for human health.

Trichinellosis in Hospitalized Children and Adults from Western Romania: A 11-Year Retrospective Study

Trichinellosis, a serious and sometimes fatal human disease, is a consequence of consuming raw or improperly cooked meat containing the infective larvae of Trichinella spp. The aim of this observational cohort retrospective study is to compare the epidemiological, laboratory, clinical and therapeutic aspects of trichinellosis in children and adults from Western Romania. We investigated the medical records of patients who were diagnosed with trichinellosis and hospitalized between 17 January 2010 and 31 December 2020. One hundred thirty-three patients were identified according to the electronic databases of infectious disease hospitals, located in four counties from Western Romania. A total of 19 patients (14.28%) were children and 114 patients (85.71%) were adults. In children, the most frequent symptoms were digestive in 78.94%, followed by fever in 57.89%, eyelid or facial edema in 57.89% and myalgia in 52.63% of cases, while adults presented mainly myalgia in 87.71%, followed by fever in 77.19%, digestive symptoms in 68.42% and eyelid or facial edema in 66.66% of cases. The source of infection was pork meat products in the majority of patients (89.47%). Our results revealed a general declining trend in infection rates for both children and adults during the studied period. The vast majority of cases were severe and all required hospitalization. Education of the population along with public health strategies should be improved and maintained to fully prevent trichinellosis in Western Romania.

Retrospective Survey of Human Trichinellosis in a Romanian Infectious Diseases Hospital over a Thirty-Year Interval—The Never-Ending Story

Trichinellosis remains a food-safety risk in Romania due to cultural traditions and food behavior. The aim of the present study was to evaluate the epidemiological, clinical and therapeutical data of all human trichinellosis cases in patients admitted to an Infectious Diseases Hospital from northwestern Romania during a thirty-year interval. Between 1 January 1988 and 31 December 2018, a total of 558 patients were hospitalized with the diagnosis of trichinellosis. The number of cases/year varied between 1 and 86. The source of infection was known for 524 patients, represented by domestic pig meat (n = 484; 92.37%) and wild boar (n = 40; 7.63%). Most patients (410; 73.48%) presented were part of family or group outbreaks. Demographical and clinical data of patients will be presented. Antiparasitic therapy was prescribed in 99.46% of cases, and corticosteroids were prescribed in 77.06% of patients. In total, 48 patients (8.6%) presented complications of trichinellosis: 44 for a single complication (neurological, cardiovascular or respiratory); the others multiple complications. Pregnancy was documented in five patients. No fatalities occurred during the study period. Although the number of hospitalized patients has decreased in the last years, trichinellosis still remains an important public health problem in northwestern Romania.

Epidemiological perspective associated with principal risk factors of Trichinella spiralis infection in pigs and humans in Egypt

Background and Aim

In Egypt, there is a scarcity of recent data on trichinellosis in pigs and humans. Therefore, this study aimed to determine the epidemiological profile and risk factors associated with Trichinella spiralis infection as well as to assess the effectiveness of the trichinoscope and digestion technique in diagnosing trichinellosis.

Materials and Methods

Data were collected on 33812 pigs slaughtered during a year at the Al-Basateen abattoir, Cairo Governorate, Egypt. The slaughtered pigs had already been examined by trichinoscope in the abattoir. The diagnostic effectiveness technique was randomly conducted on 170 pork muscle samples, which were examined using the digestion technique. Furthermore, 90 serum samples from high-risk individuals in Qena and Sohag Governorates, Upper Egypt, were analyzed using an enzyme-linked immunosorbent assay.

Results

The investigation revealed that the overall prevalence was 1.06% in pigs by trichinoscope. Of the examined 170 samples, 2.35% and 3.35% were found to harbor Trichinella by trichinoscope and artificial digestion, respectively. Trichinella was identified as T. spiralis using a polymerase chain reaction (PCR) technique. A significant relationship was affirmed between the prevalence of trichinellosis and the sex and age of the examined pigs. Likewise, for the first time, there was a considerable seasonal trend in the prevalence of Trichinella with the maximum infection, which was observed during Autumn (1.18%). The prevalence of trichinellosis in humans was 10%, with a significant association with age.

Conclusion

Our findings are intended to serve as a starting point for developing effective preventive and control measures for trichinellosis (as application of Hazard Analysis Critical Control Points (HACCP) in pig farms, stop feeding pigs on garbage as well as, preventing illegal slaughter of pigs outside the slaughterhouses). It also fortifies the establishment of the digestion technique because of its high specificity and sensitivity, although it is difficult to apply to a large number of samples.

Seroprevalence and Risk Factors of Trichinella spiralis Infection in Blood Donors from Western Romania

Background and Objectives: Trichinellosis, a serious and sometimes fatal human disease, is a foodborne zoonotic disease with worldwide distribution caused by parasitic nematodes of the genus Trichinella. Humans are infected with Trichinella larvae through the ingestion of meat that has not been properly cooked. Romania reported most of the confirmed cases of trichinellosis among the EU countries. The aim of this cross-sectional study was to evaluate, for the first time, the seroprevalence and risk factors of Trichinella infection in blood donors from Western Romania. Materials and Methods: Serum samples of 1347 consecutive blood donors were investigated using an immunoenzymaticassay (ELISA) for the determination of specific IgG class antibodies against T.spiralis. A questionnaire interview was used to obtain information regarding the potential risk factors associated with T. spiralis infection. Mantel–Haenszel chi-squared test or the Fisher exact two-tailed test, as appropriate, were used for comparison between T. spiralis positive and T. spiralis negative blood donors. Student’s t-test was used to evaluate differences between means in studied groups and body mass index was calculated by dividing weight in kilograms by height in meters squared. Statistical analysis was performed using Epi Info Version 7.2 and Stata 16.1. Results: T. spiralis IgG antibodies were detected in 2.00% (27) of 1347 consecutive blood donors. Eating raw and/or undercooked meat, from pigs or wild boars, was found to be the main risk factor (p < 0.001). Strong alcoholic drink consumption was highly associated with T. spiralis infection (p = 0.009). Trichinella seroprevalence was higher among rural residents and males. Subjects identified as Trichinella seropositive were not previously diagnosed and have not been treated for Trichinella infection with any specific therapy. Conclusions: The demonstration of T. spiralis antibodies in healthy blood donors suggests that Trichinella infection may be detected in asymptomatic individuals that were not previously diagnosed with this zoonosis.

Investigation of the Food-Transmitted Parasites Trichinella spp. and Alaria spp. in Wild Boars in Greece by Classical and Molecular Methods and Development of a Novel Real-Time PCR for Alaria spp. Detection

Simple Summary

There are many parasites that may be transmitted to humans via food, and meat is a major source of such infections. Trichinella spp. is one of the most important meat-transmitted parasites, while Alaria spp. may be considered an emerging pathogen, albeit to date rarely reported in humans. Raw and undercooked wild boar meat has been proven as a major source of human infection by both parasites. In the present study, an investigation of the presence of these parasites in wild boar meat was conducted for the first time in Greece. Classical parasitological methods and molecular techniques were implemented for the examination of samples collected from 128 hunted wild boars, and none of them were found positive for Trichinella spp. or Alaria spp. For the detection of Alaria spp., a novel molecular method was developed, offering a powerful complementary diagnostic tool that may be useful for the epizootiological surveillance of the parasite. The epizootiology/epidemiology, clinical implications, and importance of monitoring of these parasitic infections are briefly discussed.

Abstract

Foodborne parasitic diseases represent a major threat to public health. Trichinellosis, caused by the nematode parasite Trichinella spp., is one of the most important foodborne diseases, while alariosis, caused by the trematode parasite Alaria spp., is less common in humans, and rare cases have been reported only in the USA and Canada. Both parasites can infect humans via the consumption of raw or undercooked wild boar meat. In order to investigate the prevalence of these parasites in wild boar meat in Greece, samples from the diaphragm pillars and the region of the mandibular angle from 128 wild boars, hunted in Greece, were collected. The samples were examined by classical parasitological (compression, artificial digestion, and Alaria spp. migration) and by molecular (real-time PCR) methods. For Trichinella spp. an existent real-time PCR detecting all species likely to be present in Greece was applied, while for Alaria spp. a real-time PCR was developed, employing an LNA TaqMan probe targeting the large subunit ribosomal RNA gene. All examined wild boar samples from Greece resulted negative for Trichinella and Alaria species, indicating a low prevalence of infection in the examined population. The novel real-time PCR for Alaria spp. has 81.5% amplification efficiency and is able to detect 0.12 larvae per 50 g of tissue and could be utilized as a complementary to AMT diagnostic tool in surveillance.