Trichinosis

Trichinosis, a parasitic infection, occurs worldwide and affects people of all ages. The parasite, Trichinella spiralis, forms cysts in the flesh of pigs, bears, some marine animals, and certain wild scavengers. In the United States, pigs fed garbage that contains raw meat scraps are the most common trichinosis carriers. Humans typically contract the disease by eating raw or undercooked pork, especially ready-to-eat sausages.

After a person ingests infected meat, the cyst wall surrounding the parasite is broken down in the digestive tract and the larvae penetrate the intestinal walls. Within two days, they mature and mate, and in another week the females begin to discharge larvae. These are carried by the lymph system into the bloodstream, where they are circulated to all parts of the body.

Symptoms vary according to the part of the body harboring the parasites. Early ones usually include abdominal pain, nausea, vomiting, and diarrhea. Fever develops as the larvae spread. Some of the parasites invade skeletal muscles, where they coil up and form cysts that can live for several years. Those that invade other types of muscle do not form cysts; they either reenter the bloodstream or are killed by the body.

Eye muscles are a favored target; in fact, swelling of the eyelid is a common early symptom, followed by eye pain, hemorrhages, light sensitivity, and impaired vision. The tongue is another common site of infection, resulting in swelling and difficulty in swallowing and speaking. Other symptoms include a persistent high fever (102°F, or 39°C), profuse sweating, chills, swollen and painful lymph nodes, rash, coughing, itching, and muscle aches. Depending upon the site, later manifestations of the infection may include inflammation of the heart and lungs, meningitis, seizures, and impaired hearing.

Although death sometimes results, most patients recover in about three months, but some experience fatigue, diarrhea, and muscle pain for months.

Diagnostic Studies and Procedures

Early diagnosis is difficult, because there is no simple test for trichinosis until the larvae invade the muscles. However, an upset stomach, fever, facial swelling, and other symptoms after eating undercooked pork suggest trichinosis. Blood tests showing a rapid rise in eosinophils, a type of white blood cell, is another indicator. About three weeks after infection, antibody tests can confirm the diagnosis; so too can muscle biopsies for the larvae.

Medical Treatments

The trichinosis parasite can be killed by taking mebendazole (Vermox) or thiabendazole (Mintezol) for 5 to 10 days. A corticosteroid, usually prednisone, may be prescribed to control inflammation, especially of the heart, lungs, or brain. Aspirin or ibuprofen will usually alleviate muscle aches; if not, codeine or one of the more potent non-steroidal anti-inflammatory drugs (NSAIDs) such as those that are used to treat arthritis, may be prescribed. NSAIDs, however, can cause further intestinal upset, and thus should not be taken when the person is suffering any gastric symptoms.

Alternative Therapies

No alternative therapies can cure trichinosis, but some can reduce symptoms.

Aromatherapy. To relieve intestinal symptoms, therapists recommend inhaling two drops of geranium or chamomile oil three times a day. Soaking in a hot tub to which you've added a few drops or juniper oil can alleviate muscle aches.

Herbal Medicine. Teas or capsules made of marsh mallow root and meadowsweet are used for gastric symptoms, Ginger tea often eases nausea and vomiting. Applying a poultice of juniper berries that have been simmered in olive oil may relieve muscle pain, as can a poultice made from crushed and boiled uva-ursi leaves.

Hydrotherapy. A whirlpool bath, a hot tub, or hot compresses can ease muscle aches that persist after other symptoms subside. Or try contrast bathing, sitting in a tub of hot water for 10 minutes, then taking a brief cold shower.

Self-Treatment

Bed rest is advised until a fever and other acute symptoms have subsided. Acetaminophen is usually the best choice to lower a fever if there are also intestinal symptoms.

Trichinosis is preventable simply by making sure that all pork, including ready-to-eat sausages, is well-cooked. The parasite also can be killed by freezing the meat at a very low temperature (-10°F, or -23°C) for 7 to 10 days. Even so, its a good idea to cook it until well-done.

Home-raised pigs should not be fed scraps that contain raw meat waste. They should be given commercial feed or root vegetables, as is the custom in France, where trichinosis is rare.

Remember, too. that other meal or foods that come in contact with raw pork can become a source of trichinosis. For example, the disease has been traced to rare hamburger that was ground with the same machine used to make pork sausage. Always thoroughly wash all cutting boards, utensils, and other objects used in the preparation of pork.

Other Causes of Trichinosis Symptoms

The first stage of trichinosis may be mistaken for another type of food poisoning. In the later stages, muscle pain may be wrongly attributed to arthritis and other rheumatic disorders.