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Section 3. Summaries of Infectious Diseases
Trichinellosis
(Trichinella spiralis)Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
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CLINICAL MANIFESTATIONS
The clinical spectrum of infection ranges from inapparent to fulminant and fatal illness, but most infections are inapparent. The severity of the disease is proportional to the infective dose. During the first week after ingesting infected meat, a person may be asymptomatic or experience abdominal discomfort, nausea, vomiting, and/or diarrhea. Two to 8 weeks later, as larvae migrate into tissues, fever, myalgia, periorbital edema, urticarial rash, and conjunctival and subungual hemorrhages may develop. Larvae may remain viable in tissues for years; calcification of some larvae in skeletal muscle usually occurs within 6 to 24 months and may be detected on radiographs. In severe infections, myocarditis, neurologic involvement, and pneumonitis can follow in 1 or 2 months.
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ETIOLOGY
Infection is caused by nematodes (roundworms) of the genus Trichinella. At least 5 species capable of infecting only warm-blooded animals have been identified. Worldwide, Trichinella spiralis is the most common cause of human infection.
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EPIDEMIOLOGY
The infection is enzootic worldwide in many carnivores, especially scavengers. Infection occurs as a result of ingestion of raw or insufficiently cooked meat containing encysted larvae of T spiralis. The usual source of
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Red Book 2009 2009: 783-816.