Diagnosis and treatment
Most cases of trichinosis, particularly subclinical cases, go undetected. Even extreme infection of 1,000 juveniles or more per gram of body weight may go undetected if the attending physician does not suspect trichinosis. Routine examination rarely detect juveniles in feces, blood, milk, or other secretions. Although muscle biopsy is seldom employed, it remains an accurate diagnostic if trichinosis is suspected. Pressing the tissue between glass plates and examining it under low-power-microscopy is useful, although digestion of the muscle in artificial gastric enzymes for several hours provides a much more reliable diagnostic technique. Xenodiagnosis, feeding suspected biopsies to laboratory rats, may be employed. Several immunodiagnostic techniques have been developed, none of which is 100% effective but which are useful nonetheless.
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No really satisfactory treatment for trichinosis is known. Treatment is basically that of relieving the symptoms by use of analgesics and corticosteroids. Purgs during the initial symptoms may dislodge females that have not yet begun penetrating the intestinal epithelium. thiabendazole has been khown effective in experimental animals, but results in clinical cases have been variable.
Despite and immense amount of research, trichinosis remains an important disease of humans, one that has the potential of striking anyone, anywhere. One hopeful note: for unknown reasons, the incidence of infection has slowly but steadily declined throughout the world.
Epidemiology
The incidence of infection is always higher than suspected because of the vagueness of symptoms, which usually suggests other conditions. trichinosis has a cosmopolitan distribution but is more important as an infection of man in Europe and the United States than it is in the tropics and orient. In China, heman trichinosis have been reported in Tibet, Yunnan, Henan, and the northest part of China.
Most wild and domestic mammals are susceptible to infection. Fatal cases of trichinosis are common among those who eat inadequately cooked or frozen bear, wild pig, cat, dog, or walrus meat. Any wild mammal may be a source of infection. Urban trichinosis is epidemiologically more important to humans because of the close relationship among rats, pigs, and peole. Infected pork is our most common source of infection. Pigs become infected by eating offal or trichinous meat in garbage. It is usually concluded that garbage containing raw pork scraps is the usual source of infection for pigs. The importance of cooking pork thoroughly before it is eaten cannot be overstated. A roast or other piece of solid meat is safe when all traces of pink have disappeard. freezing at -15℃ for 20 days destroys all parasites, at least in the temperate zone strain.
Survivors of trichinosis have varying degree of immunity to further infection.
