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Trichinosis, also called trichinellosis, or trichiniasis, is a parasitic disease caused by eating raw or undercooked pork and wild game infected with the larvae of a species of roundworm Trichinella spiralis, commonly called the trichina worm. The few cases in the United States are mostly the result of eating undercooked game, bear meat, or home reared pigs. It is most common in the developing world and where pigs are commonly fed raw garbage.
The great majority of trichinosis infections have either minor or no symptoms and no complications[1]. Trichinosis initially involves the intestines. Within 1-2 days of contagion, symptoms such as nausea, heartburn, dyspepsia, and diarrhea may appear; the severity of these symptoms depends on the extent of the infection. Later on, as the worms encyst in different parts of the human body, other manifestations of the disease may appear, such as headache, fever, chills, cough, eye swelling, joint pain and muscle pain, petechiae, and itching.
Most symptoms subside within a few years. The most dangerous case is worms entering the central nervous system. They cannot survive there, but they may cause enough damage to produce serious neurological deficits (such as ataxia or respiratory paralysis), and even death.
The worm can infect any species of mammal that consumes its encysted larval stages. When an animal eats meat that contains infective Trichinella cysts, the acid in the stomach dissolves the hard covering of the cyst and releases the worms. The worms pass into the small intestine and, in 1–2 days, become mature. After mating, adult females produce larvae, which break through the intestinal wall and travel through the lymphatic system to the circulatory system to find a suitable cell. Larvae can penetrate any cell, but can only survive in skeletal muscle. Within a muscle cell, the worms curl up and direct the cell functioning much as a virus does. The cell is now called a nurse cell. Soon, a net of blood vessels surround the nurse cell, providing added nutrition for the larva inside.
A blood test or muscle biopsy can identify trichinosis. Stool studies can identify adult worms, with females being about 3 mm long and males about half that size.
Symptoms can be treated with aspirin and corticosteroids. Thiabendazole can kill adult worms in the intestine; however, there is no treatment that kills the larvae.
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