Life cycle and habitat of Trichinella

The life of Trichinella females lasts about a month, but during this time they manage to lay 2-3 thousand larvae. Only those embryos that settle in places actively washed by blood survive.

The human body is a kind of dead end in the life cycle of these helminths.

Trichinella spilaris is a small worm: males do not exceed 2.5 mm in length, and females - 2 mm, but during fertilization they reach 4.5 mm. The name is due to the fact that the structure of adult individuals resembles a spiral. You can see what Trichinella looks like in the photo.

Ways of infection with trichinosis

Animals are able to become infected with trichinosis not only because of eating meat waste, but also insects. Pets - cats and dogs, acquire this disease after eating infected mice and rats.

Routes of infection for humans:

• eating meat that has not undergone sufficient processing;
• consumption of salted or smoked lard that has a meaty streak;
• eating low-quality sausages.

The causative agent of the disease can enter the body only in the process of eating food. Trichinosis is not spread through contact between an infected person and a healthy person. In some cultures, it is considered normal to eat cats or dogs, which is why these animals are included in the list of carriers of the disease.

Your pets may be infected with worms

Phases of development of trichinosis

The larvae, settled in the muscles and grown to adults, are able to live in the human body for up to 25 years.

The development of each phase depends on the initial degree of infection.

How does the disease manifest?

About how trichinosis manifests itself, absolutely every person who eats meat should know. People who do not have sufficient information often confuse it with other types of helminthiasis or simple ailments.
Main symptoms of the disease:

Particular attention should be paid to the distinguishing features that are contained in the second part of this list. The disease in humans develops gradually, so that the intensity of the symptoms will increase over time. The characteristic features of the disease will appear within 2-3 weeks after infection.

In children, the intestinal phase of trichinosis development lasts longer, but due to the fragile body, the main symptoms appear almost immediately.

After infection, physical activity and performance in people decreases several times.

Diagnostics

The initial diagnosis of the disease involves a conversation with a specialist, during which he identifies the presence of distinctive symptoms. The doctor often asks the patient to remember what he ate recently. If possible, leftover meat is taken for examination.

The patient's stool is taken for analysis, as larvae or adult Trichinella may be found in it. The material is examined under a microscope in a laboratory setting. Helminths are easiest to detect at the infestation stage.

Specialists also carry out other diagnostics:

• ELISA (blood test for the presence of specific antibodies);
• FGDS (study of the stomach and esophagus);
• tomography;
• muscle biopsy.

A muscle biopsy can help identify infection

Most often, the exact result becomes known after undergoing any procedure from this list. This is due to the fact that Trichinella worms spread throughout almost the entire body.

How dangerous is trichinosis?

The main danger in most cases is the long life of adults and the ability of Trichinella to actively reproduce. Their development depletes the body and makes a person less resistant to other diseases. In advanced cases, the patient may lose consciousness and be overtaken by attacks of fever and chills.

With trichinosis, general health deteriorates

Trichinosis is a negative source that can cause infectious and inflammatory processes in the respiratory tract and cardiovascular system. The disease hits a person’s nerves, cripples him and puts him out of work. The harm caused is enormous, as it impairs all life activities.

The disease at serious stages of development requires the immediate placement of the patient in a hospital. A similar solution is recommended for the migration phase. At home, you can remove the general symptoms and even kill adults, but you can’t get rid of the larvae without professional intervention.

Pharmacy drugs

Trichinella larvae are resistant to temperature changes. They easily adapt to any environment, which is why treatment sometimes takes a long time. Not every medicine can remove embryos.

Sometimes corticosteroids should be used. This name combines a whole group of hormones that are indicated for pneumonitis, a complication of trichinosis. Medicines from this group such as Lemod and Celeston help.

Folk remedies

Tansy tincture for trichinosis

Another effective remedy is tincture from. To prepare it you will need 200 ml of alcohol and 40 g of plant. The components must be mixed and left in a cool, dry place for 3-4 days. After this, the tincture should be taken 3 times a day after meals.

Tansy will quickly cure trichinosis

Wormwood and pumpkin seeds

A similar tincture can be made from wormwood and pumpkin seeds. Components must be taken in equal proportions. Pour boiled water (for children) or alcohol (for adults). For 100 g of wormwood and 100 g of grains, 400 ml of liquid will be needed. Infuse for 5 days. Drink on an empty stomach.

Wormwood is an effective remedy for trichinosis

Prevention

In order not to get sick with trichinosis, you need to follow strict preventive measures. Especially they need to be observed by people who have already suffered this disease. Prevention includes careful processing of meat. The following animals are at high risk: wild boar, bear, pig.

Fans of exotic meat from wild mammals should eat only in trusted places. You should not buy dubious sausage and smoked lard, as they may also contain helminth larvae.

is a helminthiasis with a naturally focal spread, caused by nematodes of the genus Trichinella, characterized by an acute course with the presence of a specific “tetrad of symptoms”, which can lead to loss of ability to work and even death.

Foci of trichinosis correspond to the distribution of natural reservoirs (bears, wild boars, badgers and others) and are recorded in the USA, Germany, Poland, Ukraine, Belarus, and the Baltic countries. In Russia, the greatest activity is recorded in the Khabarovsk and Krasnoyarsk Territories, the Magadan Region, and the Krasnodar Territory. There are also synanthropic (urban) foci of trichinosis, where the reservoir can be domestic animals - dogs, cats, pigs, as well as rodents.

Trichinosis, scheme of epidemic distribution

The causative agent of trichinosis

Trichinella spiralis(the female Trichinella is 1.5-1.8 mm, and the fertilized one is up to 4.4 mm, the male is about 2 mm). In nature, there are 4 types of Trichinella: T. spiralis, T. nativa, T. nelson, T. pseudospiralis. These are small, even thread-like helminths, have a rounded body and narrowed ends.

Capable of forming capsules around themselves that have good protective functions. Encapsulated larvae are resistant to both high temperatures and freezing. Maintain boiling for about 3 hours. Encapsulated larvae die when meat is cooked at a temperature of at least 80º for about 4 hours. Smoking and salting meat has no effect on encapsulated larvae.

Trichinosis, encapsulated larva

Development cycle Trichinella is quite unique. The same organism is both the main and intermediate host for Trichinella. They enter the human body with the meat of animals infected with muscle trichinella (this is the larval stage). The larvae are released from the capsule and in 1-1.5 days reach the stage of intestinal trichinella (directly on the mucous membrane of the intestinal wall).

After 6 months, calcification of the capsule begins, which lasts about 2 years. At this stage, the development of the helminth ends. In capsules, the larvae remain viable for 25 years or more.

Immunity after suffering from trichinosis, it is lifelong, but non-sterile (there are antibodies in the blood that protect against re-infection, but encapsulated larvae remain in the tissues).

Causes of trichinosis

Mechanism of infection– nutritional, and path- food. A person becomes infected by eating insufficiently heat-treated contaminated meat. Transmission factors can be pork sausages, home-made bacon, lard, ham, bacon, brisket, etc.

Susceptibility to trichinosis is quite high. About 10 grams of contaminated meat is enough to start an invasion. Entire groups or families often fall ill after a feast or hunting meal.
Seasonality for trichinosis is often autumn-winter (when a natural focus is involved, hunting period), in urban outbreaks - autumn (pig slaughter).

Brief description of the development of human trichinosis

1) allergic phase(lasts 2-3 weeks after infection) - sensitization occurs
(allergic restructuring) of the body by waste products and death of helminths. Severe allergic reactions develop with vascular damage and coagulation disorders due to the introduction of Trichinella larvae into the muscles (allergic myositis occurs in the muscles).
A protective granulation shaft is formed in the muscles around the larvae - a capsule is formed that prevents the entry of helminth antigens into the human body. Under the influence of immunosuppressive drugs (for example, hormonal drugs), as well as with excessive activity of the immune system (with massive invasion), this process can be disrupted. Allergic myositis occurs and mass death of larvae in the muscles, as well as in organs - nodular infiltrates are formed from lymphoid elements, plasma cells, and eosinophils.
2) Organ damage phase(from 3-4 weeks after invasion), which is associated with the entry of larvae into
organs and systemic vasculitis that has developed in them.

Clinical forms and symptoms of trichinosis

The incubation period (the period from the moment of infection to the appearance of the first symptoms of the disease) is 10 - 25 days, but can be shortened to a week (with massive infestations) and extended to 45 days (with mild forms).

Trichinosis can be acute and chronic.

According to the severity of the course, acute trichinosis is divided into severe, moderate and mild forms. There may also be atypical (with an unusual clinical picture and symptoms) forms of trichinosis, which include erased and asymptomatic.

Acute trichinosis

During the course of the disease there are:
- acute period, including the phase of allergic manifestations and the phase of organ damage,
- period of convalescence (recovery).

The picture of trichinosis is characterized by a characteristic tetrad of symptoms:
1) fever,
2) edema syndrome
3) muscle pain,
4) high eosinophilia in the blood.

The onset of the disease is acute; a high temperature appears from the first day of illness.
1) Fever is more often of a relapsing or irregular type. For several days the temperature
rises to 40º, stays at the same level for several days, then also decreases lytically. Some patients experience low-grade fever (temperature up to 37º), which can persist for several months. In mild forms, the temperature may not rise. Fever is a manifestation of general intoxication (weakness, chills, headaches, nausea).

2) One of the constant signs of trichinosis are swelling of the eyelids and face in combination with conjunctivitis (because of this symptom, trichinosis is called “puffy”). Appearing on days 1-5 of illness, they can persist for 1-2 weeks. In severe forms, swelling develops more slowly and lasts longer. First, there are swelling of the eyelids, superciliary arches, then the entire face. In severe cases, swelling extends to the neck, torso, upper and lower extremities - this is an unfavorable prognostic sign.

3) From day 3 or more of illness, most patients experience muscle pain in different muscle groups.
First, the muscles of the legs (usually the calf muscles) hurt, then the muscles of the buttocks, back, abdomen, arms, shoulder girdle, neck, tongue, pharynx, oculomotor, and chewing muscles. Muscle pain is often intense, intensifies with movement, and palpation of the muscles is painful. In severe cases, severe myalgia occurs with contractures, sometimes leading to immobilization of the patient. Muscle pain and swelling persist for 1-3 weeks and can periodically recur, accompanied by fever (relapses are milder than the primary disease).

The acute period of trichinosis is also characterized by:
- abdominal syndrome (abdominal pain, dyspeptic disorders),
- allergic manifestations in the form of a polymorphic rash on the skin of the whole body (urticarial, roseolous, macular).

4) Eosinophilia, characteristic of the acute period, reaches a high level (up to 80%), appears with
the first days of the disease with a maximum increase in 2-4 weeks (for a mild form - no more than 30%, for a moderate form - up to 60% or more, for a severe form - the number of eosinophils is not significant, but a sharp increase up to 95% is an unfavorable prognostic sign).

In severe forms, organ lesions appear, developing 3-4 weeks after infection. Organ damage is often the cause of death.
Developing:
1) myocarditis of an allergic nature is the main cause of death (tachycardia, hypotension, symptoms of acute vascular insufficiency, collapse). ECG shows signs of diffuse myocardial damage.
2) damage to the lungs (pneumonia involving the pleura in the pathological process), which are associated with systemic vasculitis.
3) damage to the central nervous system (meningoencephalitis, encephalomyelitis).
4) liver damage.
5) thrombohemorrhagic syndrome (blood coagulation disorder).

The total duration of the disease on average ranges from 1-2 weeks (mild forms) to 5-6 weeks. With timely treatment, these periods are shortened by 3-5 days. In severe cases of trichinosis, the recovery period can take up to 6 months or more. Prolonged convalescence in the form of asthenia (weakness, fatigue, decreased appetite), myalgia can be observed in patients taking immunosuppressive (immune suppressive drugs, for example, hormones) drugs.

Without treatment, damage to vital organs may develop and death may occur. Mortality in trichinosis can reach 5%. However, mild forms cannot always be correctly diagnosed and therapy can be prescribed in a timely manner. There is a possibility that with a mild form of trichinosis, death will not occur, since recovery can occur in an immunocompetent organism (but in a small percentage of cases).

Diagnosis of trichinosis

A preliminary diagnosis is made on the basis of clinical and epidemiological data. When collecting an epidemiological history, attention is drawn to the fact of consumption of insufficiently heat-treated pork and meat of wild animals - wild boar, brown bear, deer; When analyzing complaints, pay attention to the characteristic “tetrad” of clinical symptoms.

The final diagnosis is made on the basis of laboratory tests:
1) detection of Trichinella larvae in the remains of consumed meat;
2) detection of larvae in muscle biopsies (trichinelloscopy) - take the gastrocnemius or delnoid muscle;
3) serological diagnosis (RNGA becomes positive from the 15th day of illness, ELISA method);
4) skin allergy tests (positive from 2 weeks of illness, persist for many years).

Differential diagnosis is carried out with opisthorchiasis, strongyloidiasis, typhoid fever, erysipelas, pseudotuberculosis, yersiniosis.

Treatment of trichinosis

Treatment includes specific (etiotropic) and pathogenetic therapy.

Tasks of etiotropic therapy: destroy intestinal trichinella, stop their production of larvae, disrupt the encapsulation process and increase the death of muscle trichinella.

Apply: mebendazole (vermox) - different schemes for an average of 14 days in a course; mintezol (thiabendazole) - less effective than vermox due to adverse reactions, but is also used in a number of cases; albendazole.

It is most effective to carry out specific (etiotropic) therapy in the incubation period, when it is possible to prevent clinical manifestations, or in the first days of the disease, when intestinal Trichinella is still present. During the muscular stage and encapsulation, its effectiveness decreases and may contribute to the exacerbation of the disease.

Specific treatment must be “covered up” by prescribing antihistamines (Claritin, Zodak, Zyrtec, Cetrin, Erius and others).

Hormonal treatment is indicated for severe forms of trichinosis and for the development of complications (due to the effect on the process of capsule formation around the larvae) - prednisolone is prescribed in medium and high doses and short courses - from 40-80 mg / day for 5-7 days, followed by reducing the dose and discontinuing the drug after 1-1.5 weeks. Since hormones can prolong the period and amount of larval production in the intestines, it is recommended to use anthelmintic drugs during the entire period of their use and for several days after their discontinuation.

The effectiveness of treatment is monitored after 6-12 months (the effectiveness of deworming is 90%).

Pathogenetic therapy includes antipyretics, painkillers, non-steroidal anti-inflammatory drugs.

Prevention of trichinosis

Pay attention to the meat you are about to cook. Any foreign inclusions are a reason not to use it for food. If the invasion is massive, then very small yellowish peas can be seen in the fibers of the striated muscles, but with mild invasion this is not visible. That is why meat sold in stores and markets must undergo universal trichinoscopy.

Infected meat should not simply be thrown away; it may be eaten by stray animals and the disease will continue to spread. Such meat is treated with kerosene and buried in the ground to a depth of at least 1 meter.

And even meat that seems normal in your opinion must be subjected to long-term heat treatment.

Meat from wild animals must also be subjected to trichinoscopy, which is established by current veterinary legislation, and if at least one larva is detected, it must be disposed of. When it is not possible to perform trichinoscopy, heat treatment of meat should last at least 6 hours.

Infectious disease doctor N.I. Bykova

Update: October 2018

The causative agent of trichinosis

How can you get infected?

The mechanism of infection with trichinosis is alimentary, and the route of transmission is oral, through meat infected with trichinosis. The disease belongs to the natural focal, although the foci of infection can be not only natural, but also synanthropic.

In natural foci, helminthiasis is common among wild animals (source of trichinosis):

Synanthropic foci are formed in human habitats after feeding game waste to domestic animals. Helminthiasis is common among pigs, dogs and cats. In this case, human infection with trichinosis occurs by eating infected pigs (in some areas of dogs).

Prevalence of trichinosis

Natural foci of helminthiasis have been recorded in North America, Germany and Poland, Ukraine and Belarus, as well as in the Baltic states. In the Russian Federation, trichinosis is most common in the Khabarovsk and Krasnoyarsk Territories, in the Magadan Region and in the Krasnodar Territory. In total, the disease is fixed everywhere, with the exception of the Australian continent.

Contribute to the spread of helminthiasis:

• the ability of the pathogen to tolerate high and low temperatures, which ensures its survival in any climatic conditions;
• high human susceptibility to trichinosis;
• group outbreaks - collective consumption of contaminated meat;
• unstable immunity, which provokes repeated cases of infection after the initial infection.

Phases of development of helminthiasis

The development of helminthiasis occurs in several stages:

• Enzymatic-toxic

The initial phase of the disease takes 7–14 days after infection. Invasive larvae enter the intestinal mucosa, where they develop to adult Trichinella, which in the process of life form enzymes and metabolites, which causes inflammation of the intestine.

• Allergic

• Immunopathological

Develops by 5–6 weeks after invasion. Systemic vasculitis and associated severe organ damage occur. There are such complications of trichinosis as meningoencephalitis, myocarditis, focal pneumonia and others.

Classification

Depending on the severity of the disease, the disease proceeds in mild, moderate and severe forms. Typical and atypical forms of helminthiasis are also distinguished. Atypical include erased and asymptomatic trichinosis. There are acute and chronic trichinosis.

Clinical picture

Manifestations of mild and moderate forms

The disease includes 2 periods:

• acute (allergic reactions and damage to internal organs);
• recovery period.

The tetrad of symptoms of trichinosis in humans includes:

• fever;
• edema syndrome;
• pain syndrome (in muscles);
• high level of eosinophils in the blood.

Clinical manifestations:

• Fever

The temperature rises to 40 degrees for several days, then sharply decreases to 37, which lasts 7 - 10 days. In some cases, low-grade fever persists for several months. A mild course of the disease may not be accompanied by hyperthermia. Against the background of high temperature, signs of general intoxication appear: weakness, chills, sweating and nausea, headache.

• Facial swelling

A characteristic sign of helminthiasis is the appearance of swelling of the eyelids and face as a whole, which is often combined with conjunctivitis. As a result, trichinosis is also called “puffiness.” Swelling occurs on the 1st 05th day of the disease and persists for up to two weeks. In cases of severe disease, swelling appears more slowly, but lasts longer. The sequence of appearance of edema: eyelids, brow ridges, entire face. In severe cases, swelling reaches the neck, torso, arms and legs, which is considered an unfavorable prognostic sign.

• Myalgia

Starting from the third day of illness, sometimes later, muscle pain occurs in various muscle groups. First of all, myalgia appears in the muscles of the legs (calf muscles), then spreads to the gluteal muscles, muscles of the back and abdomen, covers the arms and shoulder girdle, rises to the cervical and pharyngeal muscles, muscles of the tongue, chewing and oculomotor muscles. Such pain is very pronounced, intensifies with movement, and palpation of the muscles causes pain. In severe cases, myalgia with contractures develops, which leads to immobilization of the patient. Both myalgia and edema persist for up to 1–3 weeks and periodically recur, which is accompanied by an increase in temperature.

The acute phase of the disease is accompanied by abdominal syndrome (pain, nausea, vomiting, diarrhea) and allergic manifestations - rash (rosacea - pink blisters that turn pale when pressed, urticaria - spots merging with each other, urticarial - blisters raised above the skin).

• Eosinophilia

The level of eosinophils increases to 80%, which appears with the first symptoms of helminthiasis. The maximum increase in eosinophils is observed at 2–4 weeks of illness (mild up to 30%, moderate up to 60%). An unfavorable prognostic sign is an increase in eosinophils to 95%.

Severe course

A severe form of the disease is accompanied by the development of organ lesions that appear 3 to 4 weeks after infection. It is organ damage that often becomes the cause of death of the patient.

The following complications arise:

• allergic myocarditis is the leading cause of death of the patient (increased heart rate, decreased blood pressure, signs of acute vascular insufficiency, ECG symptoms of diffuse myocarditis);
• lung damage - the development of pneumonia in combination with pleurisy, which is caused by systemic vasculitis;
• brain damage (encephalomyelitis, encephalitis, meningitis);
• liver damage - hepatitis;
• thrombohemorrhagic syndrome (blood clotting disorder);
• kidney damage - nephritis.

The duration of the disease in the case of a mild course ranges from 7 – 14 days to 35 – 42. If treatment is started on time, the duration of each period is reduced by 3 – 5 days. The recovery period in case of severe helminthiasis is delayed to half a day or more. Prolonged muscle pain occurs in patients taking immunosuppressive drugs (glucocorticoids).

Symptoms depending on the stage of the disease

Stage of invasion

Dissemination stage

At this stage, the functions of the affected organs are restored (15–20 days), muscle pain persists for up to 2 months, and eosinophilia for up to 3 months.

Diagnostics

Diagnosis of trichinosis is difficult, since in the early stages of the disease it is often confused with influenza, colds and allergies of unknown origin. A thorough medical history plays an important role in diagnosis; the doctor should be alert to the patient’s consumption of game. At the same time, all participants in the feast are required to be examined.

Also, suspicion of trichinosis should be caused by a characteristic set of symptoms: periorbital edema, high fever and muscle pain.

Laboratory research methods:

UAC

Serological diagnosis

• RNGA;
• RIF and others.

Skin allergy test

Muscle biopsy

To carry out trichinoscopy - identifying larvae in the muscles, the deltoid and gastrocnemius muscles are examined. The material is obtained by puncture of the muscle, and then studied under a microscope.

meat check

Veterinary laboratories available in the markets and the laboratory of the sanitary and epidemiological station are engaged in checks for this helminthiasis. Sampling is done from the entire carcass. The sampling of small pieces of meat (about 5 grams) is carried out from the intercostal muscles, diaphragm, tongue and chewing muscles. If at least one larva is detected, the meat is considered infected and destroyed. For destruction, they dig a hole at least one meter deep, douse the meat with kerosene and bury it. Or clean meat is covered with quicklime and buried.

• Mebendazole (Vermox)

• Albendazole

• Tibendazole

The effectiveness of the drug is lower due to severe adverse reactions. Dosage: 25 mg per kg of patient weight. The course lasts 3–5 days, the medicine is taken twice a day. If necessary, repeated treatment is carried out (after 7 days).

In severe cases, with the development of organ pathology, glucocorticoids are included in the treatment regimen. Glucocorticoids suppress the immune system, thereby reducing allergic manifestations.

The effectiveness of treatment is assessed after six months to a year.

In case of immobilization of the patient and the development of muscle contractures, massage, physiotherapy and special gymnastics are prescribed.

In parallel with the main treatment, the patient is prescribed hepatoprotectors and multivitamins, as well as drugs to improve microcirculation.

Question answer

Question:
Is it possible to cure trichinosis using traditional methods?

Question:
How should you cook meat suspected of helminthiasis?

Suspicious meat should be subjected to prolonged heat treatment. When cooking, cut the meat into pieces no larger than 8 cm and boil for at least 3 hours. Frying suspicious meat should be done in small pieces (up to 2.5 cm), and after frying the meat should be simmered for at least 1.5 hours. It is prohibited to use lard for salting/smoking, and use it only after heating.

Question:
Is it possible to disinfect suspicious meat by freezing?

Yes, this method is quite effective, but subject to certain conditions. Meat should be kept for 20 days at a temperature of -15 degrees or three days at a temperature of -20 degrees.

Question:
Is it possible to become infected with trichinosis by eating salted or smoked lard?

In addition to animals and people, there are many different organisms in nature. Moreover, they live precisely thanks to their “owners” - people and animals. They poison organisms with their waste products and also cause terrible pathologies, which are not always possible to cope with.

You can verify this by looking at a photo of the symptoms of trichinosis in humans.

Symptoms of trichinosis in humans

Worms live everywhere, in every corner of the world. The exception is Australia, and most of all in the north. Areas with large natural foci are also characterized by a high degree of morbidity among the population.

You can get infected from both domestic and wild animals.

How infection occurs

It is enough to eat 10 grams of meat to reward yourself with this disease. Not everyone understands this. Moreover, most people are not aware that they are at risk of becoming infected almost every day. This category of people includes lovers of poorly fried meat with blood.

In addition to meat products, lard can also become a source of disease. Infection is often epidemiological in nature. For example, whole groups of people get sick; if they were relaxing together at a barbecue, then the whole company will get sick, if they went hiking as a whole group, the whole group will get sick, and so on.

Trichinella

It is important to know that only 80 degrees kill larvae. Therefore, the smoking and salting technique will not affect the vital activity of helminths in any way.

Clinical manifestations of trichinosis

A person will not have symptoms if Trichinella affects him for the first time in his life. But the important thing is that symptoms of trichinosis will be absent only at the initial stage. However, the following phenomena may still make themselves felt:

• digestive problems;
• soreness in the abdomen;
• weakness;
• dyspeptic disorders.

But in most cases, people do not pay attention to these manifestations and mistake the signs of trichinosis in humans for ordinary poisoning or pathologies of the digestive system.

However, at the next stage of development of the disease, the larva will reach the muscles and then the symptoms of trichinosis, as in the photo above, will make themselves felt in all their glory, namely:

• severe muscle pain will occur;
• body temperature will rise;
• redden eyes;
• the face will become swollen;
• the patient will be sensitive to light;
• severe headaches will begin to bother you;
• the person will feel a constant loss of strength;
• may cause systemic body itching.

Severe headache is one of the symptoms of trichinosis

When the larvae turn into capsules, the disease reaches its final stage of development. At this stage, symptoms become less pronounced.

Damages to the body caused by helminths can be fatal for a person, therefore it is very important to establish the correct diagnosis and begin treatment on time.

What are the consequences of the disease

Such a serious disease as trichinosis cannot be left to chance. It always causes serious harm to the body, especially if the necessary therapeutic measures are not taken. Due to such an ailment as, first of all, the immune system, the central nervous system, the cardiovascular system, the gastrointestinal tract, the respiratory system, etc., suffer.

Even with timely treatment, the disease causes serious damage to the defenses. As a result, myocarditis, pneumonia, etc. may develop. Possible deaths.

Diagnostic measures

Unfortunately, this disease has not yet been fully studied. When making a diagnosis, doctors do not always follow the correct diagnostic tactics, which is why time is wasted.

It is important to go through the following diagnostic steps:

Inexperienced and unscrupulous doctors may mistakenly, due to the similarity of symptoms, make a diagnosis such as dysentery, the common cold, and the like.

When contacting a doctor, choose only a competent specialist, perhaps on the recommendation of your loved ones whose opinion you respect. If any doctor is in doubt, go to another one. This disease is very serious, therefore, even if you do not have it, it is very important to exclude it. The specialist should pay special attention to persistent eosinophilia and elevated white blood cells.

Differential diagnosis of trichinosis is very important. It consists in finding the differences between this disease and others.

Therapeutic measures

In order not to reach a critical condition, game hunters and all other meat lovers must know how to test for suitability. You can conduct a rapid test for trichinosis at home, which is very difficult, expensive and uninformative. The best solution is to test for trichinosis in a veterinary examination.

It is impossible to completely remove the helminth from meat, but you can disinfect the source of infection. The sooner the symptoms of trichinosis in a person are identified, the more effective the treatment of the symptoms of trichinosis in a person will be.

Once the diagnosis has been established, the following treatment methods are usually used:

Treatment of severe forms of pathology is carried out in a hospital setting. The doctor warns the patient that muscle soreness may persist for another six months.

How to check meat

To prevent the risk of infection with Trichinella, it makes sense to have meat tested in special laboratories. Professionals recommend not comparing home-grown meat and wild game. In any of these cases it can be dangerous to humans.

Usually meat is tested in a laboratory. Take the entire carcass with you; sections are taken from different parts. For this purpose, parts with the most developed blood supply system are taken: the intercostal part, masticatory muscles, tongue, etc. It is in these parts that the larvae are most numerous.

To test meat at home, you need to purchase a special device. As a rule, experienced hunters know how to use it. Using technology, you can look for the larvae yourself; they have an oval or round shape.

If you see at least one larva, you need to get rid of the entire carcass, as it is unfit for consumption.

Prevention methods

Preventing trichinosis is much easier than fighting it, so special attention should be paid to prevention. Choose the meat you cook wisely and process it properly before eating.

Careless game lovers who like to feast on meat right next to a fire in the forest should get rid of this habit. Be sure to carry out sanitary control of pets.

Other preventive measures are as follows:

It must be remembered that any meat, both wild boar and chicken, can cause trichinosis, so it does not matter where the meat comes from: homemade or brought from hunting. Remember that worm larvae live for another three days at the lowest temperature of minus 23 degrees.

You need to freeze products for at least seven days and make sure that the temperature is constantly minus 23. This is the only way to protect yourself. Your health is in your hands and danger often finds us where we don’t expect it, so you should always be very attentive to what you eat.

In contact with

In Russia, since 1995, the incidence of trichinosis has noticeably decreased, which was facilitated by the intensive implementation of preventive and anti-epidemic measures. In 2014, the incidence rate throughout the Russian Federation was 0.06 per 100,000 population. The maximum incidence is recorded in the Far Eastern District (0.37 per 100,000 population) and the Siberian District (0.16 per 100,000 population). These two counties account for 60% of all cases. The incidence rate of trichinosis in the Amur region exceeded the federal average by 30 times.

Rice. 1. Dynamics of the incidence of trichinosis in the population of the Russian Federation per 100 thousand population.

Pathogenesis of trichinosis

During the development of trichinosis, intestinal, migratory and muscular stages are distinguished, each of which corresponds to a specific clinical picture.

Intestinal stage

In places of localization of Trichinella, under the influence of metabolites and enzymes, a local inflammatory reaction develops. Trichinosis at this stage occurs secretly, unnoticed by the patient.

Rice. 2. The photo shows a female and a male Trichinella.

Generalized (migration) stage

The mass death of larvae in the migratory stage leads to the development of allergic reactions, which become even more rapid during the formation of specific immunity. At this moment, a large number of antigens with high sensitizing activity appear in the blood. Vascular permeability increases sharply, and tissue edema develops. The allergic phase develops from 3 to 4 weeks from the moment of infection.

Next comes the immunopathological phase of trichinosis, characterized by the development of systemic vasculitis and severe organ damage. The lungs, heart, central nervous system, gastrointestinal tract, etc. are affected.

Allergic manifestations come in varying degrees of severity. With massive invasion, meningoencephalitis, hepatitis, myocarditis and pneumonia with a malignant course develop. High body temperature, muscle pain, skin rashes, widespread swelling are the main symptoms of trichinosis during this period. At 5-6 weeks after infection, degenerative processes develop in the parenchymal organs.

Upon recovery, all infiltrative changes disappear without leaving a trace. Dystrophic changes recover more slowly - within 6 - 12 months.

Rice. 3. Trichinella larva (photo on the left). Larva in capsule (photo on the right).

Muscular stage

In muscle tissue, Trichinella larvae penetrate under the sarcolemma of muscle cells, where after 2 weeks they spiral and encapsulate after 3-9 weeks. Gradually, new larvae stop entering the bloodstream. The capsule protects the larva from the effects of negative environmental factors and performs the function of nutrition and disposal of metabolic products. Then, after 6–18 months, it begins to become saturated with calcium salts and calcify. The larvae in such a capsule remain viable for up to 25 years or more.

Signs and symptoms of trichinosis in humans

The clinical picture of trichinosis is characterized by the presence of 4 signs:

• Fever.
• Edema syndrome.
• Myalgia (muscle pain).
• Eosinophilia.

Depending on the massiveness of the infection, trichinosis can occur in mild, mild, moderate and severe forms. Atypical include asymptomatic and erased forms of trichinosis. The erased course of trichinosis is recorded during outbreaks in 20 - 30% of cases, mild and moderate - in 50 - 60% of patients, severe - in 10 - 30% of patients.

During the course of the disease, an acute period and a period of recovery (convalescence) are distinguished.

Incubation period of trichinosis

The incubation period of trichinosis can be short - from 5 to 8 days and long - from 28 to 45 days.

• In mild cases, the incubation period is extended to 45 days.
• In severe cases it lasts 7-10 days.
• With a malignant course of the disease, the incubation period is shortened to 1-3 days.

Fever

Fever is a sign of general intoxication. With trichinosis, it can last 1 - 6 weeks. During the acute period, body temperature rises to 40 o and remains at this level for several days. In a chronic course, the body temperature can be subfebrile and persist for months. Fever is manifested by weakness, chills, headaches, and nausea.

• In mild forms of trichinosis, fever may be absent.
• With a moderate illness, body temperature increases within 1 to 4 days.
• In severe forms of the disease, the body increases within 13 to 20 days.

Edema

Swelling of the eyelids, face and conjunctivitis are constant signs of trichinosis. In some cases, patients experience swelling of the arms and lower extremities.

• With mild and moderate severity of trichinosis, puffiness of the face, swelling of the eyelids, brow ridges and conjunctivitis are noted. Edema develops quickly (on the 1st - 5th day of the disease) and lasts for 1 - 2, less often 3 weeks.
• In severe cases of trichinosis, edema develops slowly, reaches a maximum at a later date and lasts a long time. Swelling appears not only on the face, but also on the neck, torso and limbs. In some cases, swelling of the loose tissue of internal organs, membranes and brain parenchyma is noted. Brain damage leads to functional disorders of the central nervous system.

Rice. 5. Swelling with trichinosis: swelling of the eyelids (on the left in the photo), swelling of the conjunctiva (on the right in the photo).

Muscle pain

Muscle pain appears in patients 1 - 3 or more days from the onset and is a constant sign of trichinosis.

• With mild and moderate severity of trichinosis, muscle pain appears 1 - 3 or more days from the onset of the disease. Initially, pains appear in the muscles of the lower extremities, then in the gluteal muscles, muscles of the back and abdomen, arms and neck, tongue and pharynx, eye and occipital muscles.
• In severe trichinosis, muscle pain appears very early, in some patients severe myalgias are recorded with the development of contractures.

Eosinophilia

Eosinophils in the blood with trichinosis increase to 50 - 60%. In some cases, the number of eosinophils can reach 80 - 90%, which is an unfavorable prognostic sign. At the same time, an increased level of leukocytes is noted in the blood - up to 10 - 30 thousand in one microliter.

• With a mild course, eosinophilia reaches a maximum at the 4th week of the disease and is up to 30%.
• With a moderate course, eosinophilia reaches a maximum at the 3rd week of the disease and is up to 60%.
• With a moderate course, eosinophilia reaches a maximum at the 2nd week of the disease and is more than 60%.
• In patients after recovery, eosinophilia in the range of 10-15% persists for up to 3 months or more.

Rice. 6. Eosinophilia is a constant sign of trichinosis. In the photo on the left there is an eosinophil, in the photo on the right there are many eosinophils in the blood.

Allergic dermatitis

With trichinosis, allergic dermatitis often develops. A polymorphic rash of an erythematous-papular character appears on the skin. In extremely severe cases of the disease, a hemorrhagic rash develops.

Rice. 8. Allergic dermatitis due to trichinosis.

Pulmonary syndrome

"Volatile" or eosinophilic infiltrates in trichinosis often accompany eosinophilia of a different nature. With trichinosis of moderate and severe course, this pathology is recorded in 1/3 of patients. The leading role in their appearance is played by the sensitization of the organism, which has developed as a result of helminthic invasion. "Flying" infiltrates are migratory in nature, they are unstable and disappear within 2 to 3 days. The infiltrate is formed as a result of the release of exudate into the alveoli, which contains a large number of eosinophils. Such infiltrates are found by chance during x-ray examination. Symptoms of the disease are scant. Sometimes patients are bothered by a cough with a small amount of sputum. Some patients experience attacks of bronchial asthma and pleurisy. With a very severe course of trichinosis, some patients develop pneumonia with a malignant course.

Rice. 9. The photo shows eosinophilic infiltrates due to helminthic infestation.

Signs and symptoms of trichinosis in heart disease

At high body temperature in patients with trichinosis, symptoms of a violation in the work of the cardiovascular system appear - tachycardia and shortness of breath. On auscultation, a systolic murmur is heard at the apex and deafness of the heart tones is noted.

In severe trichinosis, some patients develop a picture of myocarditis of an allergic nature. Deafness of heart tones, tachycardia, cardiac arrhythmias are the main symptoms of the disease. The ECG shows signs of diffuse changes in the myocardium and coronary disorders. In some cases (more often in elderly patients), circulatory failure develops.

Rice. 10. Inflamed heart muscle is indicated in red.

Signs and symptoms of trichinosis in the gastrointestinal tract

In 25% of cases with trichinosis, abdominal syndrome develops.

• Nausea, vomiting, abdominal pain and loose stools are the main symptoms of damage to the gastrointestinal tract.
• In severe cases of the disease, patients experience nausea and vomiting, and blood and mucus appear in loose stools. Ulcerative-necrotic processes in the mucous membrane of the stomach and intestines, followed by perforation and bleeding, cause the death of the patient.

Neurological symptoms

In some cases, with trichinosis, swelling of the parenchyma and membranes of the brain is observed, which leads to functional disorders of the central nervous system. In the acute period, when the disease is severe, patients experience insomnia and headaches, sometimes hallucinations and depression, and symptoms characteristic of encephalomyetitis and meningoencephalitis appear. In very severe cases, patients experience convulsions, delirium, epileptic seizures and mental disorders.

Rice. 11. Trichinella larvae in muscle tissue under a microscope.

Duration of the disease

The more severe the symptoms of trichinosis, the longer the helminthiasis lasts.

• In the erased form, trichinosis lasts no more than 1 week.
• In mild forms, trichinosis lasts no more than 2 weeks.
• With moderate and severe trichinosis, the acute phase is shortened with hormonal treatment, but recovery occurs only by 4–6 months. Muscle pain can bother the patient for another 1 - 2 months after recovery, eosinophilia within 10 - 15% persists for up to 3 months or more.

Rice. 12. Edema with trichinosis.

Trichinella under a microscope

Complications of trichinosis

• One of the most dangerous complications of trichinosis is allergic myocarditis.
• On the part of the respiratory system, a dangerous complication is asthmatic bronchitis and pneumonia with a malignant course.
• Ulcerative-necrotic processes in the mucous membrane of the stomach and intestines, followed by perforation and bleeding, in some cases cause the death of the patient.
• On the part of the central nervous system, in severe forms of trichinosis, more often in men, epileptiform seizures, severe hysteria, psychosis, paresis and paralysis develop. In some cases, trichinosis is the cause of the development of meningoencephalitis and encephalomyelitis.
• Phlebothrombosis of the lower extremities is a consequence of impaired hemostasis and the blood coagulation system. Thrombosis of cerebral vessels leads to the development of paralysis of the upper and lower extremities.
• A weakened immune system leads to the development of a bacterial infection.

Rice. 13. The photo shows Trichinella in muscle tissue.

Disease prognosis

Uncomplicated trichinosis always ends favorably. The complicated course of the disease ends in death in 5% of cases. In very severe forms of trichinosis, mortality reaches 10 - 30%. The main cause of death in patients is allergic myocarditis and damage to the central nervous system.