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Four outbreaks of human trichinellosis caused by eating pork together had occurred successively in two rural areas and two cities of Henan Province, where the disease is endemic. Of the 110 persons involved, 54 had the onset. All of them had the history of eating pork. In the outbreak of Dengzhou, in those persons who dined together, men were all uninfected and 13 women were infected. The difference found between sexes was suggested to be related with spirit drinking. In these 54 patients, the latent period ranged from 3 to 28 days. The relevant clinical symptoms and signs were fever, edema, myalgia, rash, headache, nausea, abdominal pain and diarrhea. Vomiting was uncommon. Most patients were hospitalized and all cases recovered in two weeks after proper treatment with albendazole.
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PMID:Four outbreaks of human trichinellosis in Henan Province. 858 84

91 patients with trichinosis were treated at the Clinic of Infectious and Dermatovenereology Diseases in Novi Sad during a one-year period. In 64% of patients the onset was intestinal, while in 36% it was invasive. Diarrhea (in 28.89%) and abdominal pain (in 22.22%) are the most common symptoms of the intestinal stage. Nausea, vomiting and opstipation are less common. The main symptoms of the invasive stage are myalgia (65.54%), high temperature and eyelid edema (57.78%). Facial edema (38.89%), general weakness (24.44%), conjunctivitis (15.56%) and rash (8.89%) are somewhat less common. Heavy sweating, headache, nervousness, psychic instability and fast forgetting occur in a small number of treated patients. Myocarditis and encephalitis occurred in 3.33% of patients. There were 43.33% of patients with mild clinical picture, 40% with mild-to-severe and 16.66% with severe clinical picture. 54.44% of patients were males and 45.56% were females, and it can be said that sex did not influence the severeness of the clinical picture. The youngest patient was 5 years of age, the oldest 72. Most patients were 21-50 years of age but we did not establish statistical importance between clinical picture severeness in regard to age. The shortest period of incubation was 5 days, the longest 40 days. Average incubation period was 18.05 days (x = 18.05). Studying period of incubation and severeness of the clinical picture we established the following (x2 = 28.535). The shorter the incubation period, the severer the disease.
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PMID:[Clinical characteristics of trichinosis]. 901 31

52 cases of human trichinellosis were notified from 11 towns in North Rhine-Westphalia from November 1998 to March 1999. After non-typical symptoms in the enteral phase, fever, muscular ache, headache, oedema, disorder of vision and rash occurred in the parenteral phase. Trichinellosis was serologically confirmed by ELISA, IFAT or western blot. Raw sausage and minced meat produced from raw pork could be determined as probable source of infection with 44 and eight notified cases, respectively. Whereas questionable raw sausage was not available for examination, frozen minced meat from the second outbreak could be secured in households of infected people. Larvae were isolated from minced meat and were identified by PCR as Trichinella spiralis. Tracing back to the source of infection was difficult because of the long time between clinical symptoms, laboratory diagnosis and notification as well as complex trade routes for pork and its products. Trichinella cases emphasize the necessity to meet the prescribed slaughter inspection and to guarantee a reliable prove of origin for meat products especially in view of specific consumer habits, i.e. the consumption of raw meat.
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PMID:Aspects of clinical features, diagnosis, notification and tracing back referring to Trichinella outbreaks in north Rhine-Westphalia, Germany, 1998. 1148 50

An outbreak of trichinellosis that occurred in the United Kingdom is described. Members of four households consumed pork salami from northern Serbia, the Federal Republic of Yugoslavia. Eight cases of trichinellosis occurred. Clinical and laboratory features of the cases were typical with myalgia (7 cases), fever (6), headache (5), periorbital oedema (4), non-specific ST/T wave changes on electrocardiogram (3), Trichinella antibodies (6), eosinophilia (7) and raised serum creatine kinase (3). All recovered. Trichinella larvae were detected in the salami. During pre-travel counselling, travellers should be advised about possible risk from cured pork products which have been produced locally in Trichinella endemic areas.
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PMID:Trichinellosis acquired in the United Kingdom. 1169 15

The clinical diagnosis of trichinellosis is difficult because there are no pathogenic signs or symptoms and in diagnosing the infection epidemiological data are of great importance. Trichinellosis usually begins with a sensation of general discomfort and headache, increasing fever, chills and sometimes diarrhoea and/or abdominal pain. Pyrexia, eyelid or facial oedema and myalgia represent the principal syndrome of the acute stage, which can be complicated by myocarditis, thromboembolic disease and encephalitis. High eosinophilia and increased creatine phosphokinase activity are the most frequently observed laboratory features and the parasitological examination of a muscle biopsy and the detection of specific circulating antibodies will confirm the diagnosis. The medical treatment includes anthelmintics (mebendazole or albendazole) and glucocorticosteroids. Mebendazole is usually administered at a daily dose of 5 mg/kg but higher doses (up to 20 - 25 mg/kg/day) are recommended in some countries. Albendazole is used at 800 mg/day (15 mg/kg/day) administered in two doses. These drugs should be taken for 10 - 15 days. The use of mebendazole or albendazole is contraindicated during pregnancy and not recommended in children aged < 2 years. The most commonly used steroid is prednisolone, which may alleviate the general symptoms of the disease. It is administered at a dose of 30 - 60 mg/day for 10 - 15 days.
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PMID:Opinion on the diagnosis and treatment of human trichinellosis. 1215 Jun 91

We describe reference to a family from Bosnia that the diagnosis of Trichinellosis can be difficult despite notice of travel-history and eosinophilia but lack of further epidemiological datas and due to the rarity of this zoonosis. Clinical pattern of trichinellosis are fever, headache, myalgia, periorbital oedema, less frequently diarrhea and abdominal pain. Dreaded complications are myocarditis and encephalitis. High eosinophilia and increased creatine phosphocinase activity are the most frequently observed laboratory features. The detection of specific circulating antibodies or the parasitological examination of a muscle biopsy will confirm the diagnosis. The medical treatment includes albendazol and steroid.
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PMID:[Eosinophilia in a family from Bosnia]. 1472 77

Clinical and serological features of individuals undergoing the acute (n: 54) and chronic (n: 32) phases of trichinellosis belonging to an outbreak originated by the consumption of pork products of a commercial source, arisen in Argentina, are described. Epidemiological data, signs, symptoms, and laboratory studies were assessed. Parasitological studies were performed in patients and pork products. Results showed that: a) the parasite burden of pork products was 200.0 +/- 18.3 larvae/g; b) muscle larvae were demonstrated in 10 out of the 11 patients studied; c) during the acute phase, fever (94%), eosinophilia (90%), myalgia (85%), headache (81%), facial edema (54%), diarrhoea (52%) and anti-Trichinella antibodies (64%) were observed; d) 15% of the patients had to be hospitalized, 7% having complications; e) during the chronic phase, myalgia (72%), sight abnormalities (22%), gastrointestinal disorders (31%) and the persistence of antibodies (77%) were observed. This study highlights the socioeconomical impact of trichinellosis due to the clinical characteristics of the acute phase and the presence of symptoms in the chronic phase.
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PMID:[Clinical, serological and parasitological aspects of an outbreak of human trichinellosis in Villa Mercedes, San Luis, Argentina. The acute and chronic phases of the infection]. 1619 6

Trichinellosis is a worldwide zoonotic disease caused by a nematode Trichinella sp. Cases of Trichinella spiralis infection in Slavonski Brod were investigated. A total of 64 trichinellosis cases were notified to the Institute of Public Health, Brod-Posavska County between October and November 2004. There were 64 patients, 32 of them female, age range 3-67, mean 35 years. The mean incubation period was 3 (range 1-5) weeks. The epidemic started in October and terminated 39 days later. The patients ate smoked sausages. Trichinella spiralis was identified in sausages by artificial digestion. Among 64 people infected, 65% had facial and/or periorbital edema, 56% diarrhea, 53% myalgia, 48% fever, 26% headache, 23% weakness, 6% conjunctivitis, 6% cough and 3% vomitus, 6% of patients were free from symptoms and 17% were hospitalized. Eosinophils were elevated in 92%, creatinine kinase in 60%, and lactate dehydrogenase in 59% of patients; 97% of patients were positive for Trichinella spiralis on indirect immunofluorescence.
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PMID:[An epidemic of trichinellosis in autumn 2004 in Slavonski Brod]. 1758 81

A trichinellosis outbreak occurred in early 2008 in two villages in Timis County, Romania, due to consumption of pork from an infected animal. The infective species, detected by multiplex polymerase chain reaction, was Trichinella spiralis (Isolate Code ISS 1951). This report presents an extensive characterization of the outbreak using the documents of the epidemiological investigation and the medical charts of the hospitalized patients. Fifteen people consumed pork from the same backyard pig, which was slaughtered in the household without veterinary inspection of the meat. Among them, five patients presented clinical forms of the disease and were hospitalized. The analysis within this report includes only the hospitalized cases that were serologically confirmed. The mean age of the patients was 33.4 years. The common symptoms presented by these patients included headache, eyelid and lower limb edema, myalgia, fever, diarrhea, and nausea. Eosinophil counts ranged between 5.5% and 52%. Favorable outcomes were achieved for the patients using antihelminthic therapy. As an important public health concern, trichinellosis outbreaks reinforce the need to urgently implement veterinary and educational programs. Identification of T. spiralis in this case strengthens the supposition that it is one of the most frequently spread species in Romania.
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PMID:Evidence of Trichinella spiralis in Timis County, Romania: a report of a winter trichinellosis outbreak in 2008 due to consumption of contaminated pork. 2037 Apr 32

To assess the global incidence and clinical effects of human trichinellosis, we analyzed outbreak report data for 1986-2009. Searches of 6 international databases yielded 494 reports. After applying strict criteria for relevance and reliability, we selected 261 reports for data extraction. From 1986 through 2009, there were 65,818 cases and 42 deaths reported from 41 countries. The World Health Organization European Region accounted for 87% of cases; 50% of those occurred in Romania, mainly during 1990-1999. Incidence in the region ranged from 1.1 to 8.5 cases per 100,000 population. Trichinellosis affected primarily adults (median age 33.1 years) and about equally affected men (51%) and women. Major clinical effects, according to 5,377 well-described cases, were myalgia, diarrhea, fever, facial edema, and headaches. Pork was the major source of infection; wild game sources were also frequently reported. These data will be valuable for estimating the illness worldwide.
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PMID:Worldwide occurrence and impact of human trichinellosis, 1986-2009. 2217 30


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