TRICHINOSIS

General Information

DEFINITION--Infection caused by larvae of parasites that live in the intestines of pigs (rarely, meat of bears and some marine animals).

BODY PARTS INVOLVED--Gastrointestinal tract (where larvae enter); lymphatic system and bloodstream (through which they are transported); large muscles of the body, especially the diaphragm (muscle used in breathing that separates the chest from the abdomen); arms and legs (in which they become embedded).

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Early stages (usually begin in 7 to 10 days):

• Appetite loss, nausea, vomiting, diarrhea and abdominal cramps.

Later stages:

• Puffy eyelids and face.
• Muscle pain.
• Itching, burning skin.
• Sweating.
• High fever (102F to 104F or 38.9C to 40C).

Late stages:

• Symptoms subside, but some muscle tissues remain permanently infected with microscopic cysts. In rare cases, these cause heart and central-nervous-system disorders.

CAUSES--Infection with a parasite, Trichinella spiralis, which is transmitted to people when they eat infected animals. Thorough cooking kills the parasite and makes infected meat safe to eat. The parasites pass from animal to animal in contaminated food (usually raw garbage).

RISK INCREASES WITH

• Eating improperly cooked or raw pork.
• Use of immunosuppressive drugs.

HOW TO PREVENT--Don't eat raw or undercooked pork meats (including ready-to-eat pork sausage). Cook all meats thoroughly.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Diagnostic tests for early diagnosis are not available. A muscle biopsy during the 4th week of infection may show larvae or cysts. The parasite is rarely found in blood, stool or cerebrospinal fluid.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Treatment is usually done at home with medication and rest.

POSSIBLE COMPLICATIONS--

Over-whelming infection, which can lead to:

• Congestive heart failure.
• Respiratory failure.
• Permanent damage to central nervous system.
• Kidney damage.
• Sinusitis.

PROBABLE OUTCOME--Usually curable in most persons with antiparasitic drugs and, in severe cases, expert supportive care. Some deaths have been reported, usually due to cardiac failure or pneumonia.

How To Treat

GENERAL MEASURES--

• Reduce high fever with sponge bath or a tepid bath.
• Medical personnel report all cases of trichinosis to the local health department.

MEDICATION--

• Your doctor may prescribe: Antihelmintic drugs (usually thiabendazole) to kill the parasites. Corticosteroids for patients with severe allergic symptoms or with central nervous system involvement.
• You may take non-prescription drugs, such as acetaminophen, to reduce fever and discomfort.

ACTIVITY--Rest in bed until symptoms subside. While confined to bed, move legs frequently to reduce the likelihood of deep-vein blood clots. Resume normal activities gradually.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of trichinosis.
• The following occur during treatment: Fever over 104F (40C). Irregular heartbeat. Shortness of breath. Puffy ankles.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects, especially nausea, vomiting, skin rash or fever.