Trichinosis

• Alternative Names

  Trichiniasis; Trichinellosis

• Causes, incidence, and risk factors

  Trichinosis is a disease caused by eating undercooked meat containing cysts of Trichinella spiralis. Trichinella spiralis can be found in pork, bear, walrus, fox, rat, horse, and lion meat.

  Wild animals, especially carnivores (meat eaters) or omnivores (animals that eat both meat and plants), should be considered a possible source of roundworm disease. Domestic meat animals raised specifically for eating under USDA guidelines and inspection can be considered safe.

  Trichinosis is a common infection worldwide, but is seldom seen in the United States because of strict rules regarding the feeding of domestic animals and meat-processing inspections.

  When a person eats meat from an infected animal, Trichinella cysts break open in the intestines and grow into adult roundworms.

  The roundworms produce other worms that move through the gut wall and into the bloodstream. These organisms tend to invade muscle tissues, including the heart and diaphragm (the breathing muscle under the lungs). They can also affect the lungs and brain.

  There are approximately 40 cases of trichinosis each year in the U.S.

• Symptoms
  • Abdominal discomfort
  • Cramping
  • Diarrhea
  • Fever
  • Muscle pain (especially muscle pain with breathing, chewing, or using large muscles)
• Signs and tests

  The patient may have a history of having eaten rare or uncooked pork. Tests to diagnose this condition include:

  • Complete blood count (CBC)
  • CPK level (an enzyme found in muscle cells)
  • Muscle biopsy
  • Serology studies
• Treatment

  Mebendazole or albendazole can be used to treat infections in the intestines. There is no specific treatment for trichinosis once the larvae have invaded the muscles. The cysts remain viable for years. Pain killers can help relieve muscle soreness.

• Expectations (prognosis)

  Most people with trichinosis have no symptoms and the infection goes away by itself. More severe infections may be more difficult to treat, especially if the lungs, the heart, or the brain is involved.

• Complications
  • Encephalitis
  • Heart failure
  • Heart rhythm problems (arrhythmias) from heart inflammation (myocarditis)
  • Pneumonia
• Calling your health care provider

  Call your health provider if you have symptoms of trichinosis and recently ate undercooked or raw meat that might have been contaminated.

• Prevention

  Pork and meat from wild animals should be cooked until well done (no traces of pink). Freezing at subzero temperatures (Fahrenheit) for 3 to 4 weeks will kill the organism. Smoking, salting, or drying meat are not reliable methods of killing the organism that causes this infection.

• References
  Kazura JW. Nematode infections. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 378.

Review Date: 12/3/2008

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.