Epidemiology of trichinellosis in Mexico, Central and South America

Trichinella species are widely distributed throughout the world and are found in a large number of carnivorous animals, humans and incidental hosts. The data presented in this review show that Trichinella infection has been reported in both humans and animals in Mexico, Argentina and Chile since the end of the 19th century, and more recently in Bolivia. This parasitic infection is still a public health problem in countries such as Argentina and Chile. Although efforts have focused on the control and prevention of trichinellosis in these countries, there were still human cases and outbreaks of trichinellosis reported. Diagnosis of infection in animals such as pigs still includes, in many endemic areas, the use of trichinoscopy. In Argentina, however, artificial digestion has been recently introduced in slaughterhouses to detect Trichinella infection in pigs. In some endemic areas in Mexico, the use of serological assays for human trichinellosis and pig infections have resulted in improved detection. Most of the outbreaks of human trichinellosis in Mexico, Argentina and Chile have occurred as a result of the consumption of undercooked pork or pork products from animals raised under poor hygienic conditions and which are clandestinely slaughtered. In several studies, rats, dogs and cats have been found to be infected with Trichinella and may be considered a risk for transmission of the infection to pigs or other animals intended for human consumption. Another potential source of transmission of Trichinella to humans is horsemeat; however, information related to horse trichinellosis in Latin-American countries is scarce. In most cases the etiological agent of human trichinellosis in Central and South America has been reported to be Trichinella spiralis; however, only in a few cases has the parasite species been properly identified. Based on the reports available, it is clear that there is a need to carry out better controlled epidemiological studies to determine the true prevalence of the infection in this region of the world. Also, more sensitive methods of diagnosis and improvements in conditions for pig production as well as better sanitary inspection systems, are needed for controlling and preventing transmission of trichinellosis in these countries.     

Experimental trichinellosis in horses: biological and parasitological evaluation

Three groups of three horses each were, respectively, infected with 5000, 20,000 and 50,000 larvae of Trichinella spiralis. The strain used was isolated from a human biopsy during horsemeat-related outbreaks of trichinellosis in France. Transient muscular disorders were only observed in two of the horses infected with 50,000 larvae but none of the horses had fever. A significant increase in blood eosinophils was noticed in 5 horses. Serum LDH, aldolase and CPK peaked at the fifth week post-infection. Specific IgG assayed by indirect immunofluorescence and ELISA, appeared 2-5 weeks post-infection and disappeared between 16 and 40 weeks. The distribution of T. spiralis larvae was maximal in the tongue, masseters and diaphragm, but a large decrease in the number of larvae recovered from the muscles was noticed among the horses slaughtered at the beginning and end of the experiment. In muscular histological sections, larvae were observed in an intramyofibrillar position and were surrounded by a mild to severe inflammatory reaction.     

Epidemiology of trichinellosis in Asia and the Pacific Rim

The epidemiology of trichinellosis, species of Trichinella present and the food and eating habits of people affected in Asia and the Pacific Rim are reviewed with emphasis on Japan, China and Thailand. Trichinella seems to be prevalent throughout this region although outbreaks of trichinellosis have not been reported in some areas. Major outbreaks of the disease have been reported primarily in China and Thailand. This is the result of three factors: (1) China and Thailand are highly endemic areas for this parasite; (2) the two countries are well-organized and there is a public health system that enables precise reporting of disease outbreaks and (3) culinary habits provide many opportunities to eat undercooked meats. Trichinella found in Asia and the Pacific Rim includes both encapsulated species (Trichinella spiralis, Trichinella britovi, Trichinella nativa) and noncapsulated species (Trichinella pseudospiralis, Trichinella papuae). T. britovi, isolated in Japan, is a different genotype from the European strain. Therefore, the Japanese strain of T. britovi is designated Trichinella T9. Human trichinellosis caused by T. pseudospiralis has occurred in New Zealand and Thailand. Tasmania has had animal cases of T. pseudospiralis infection and animals with T. papuae infection have been found in Papua New Guinea. Economic losses due to Trichinella infection are not negligible in China, where there have been more than 500 outbreaks of human trichinellosis, affecting more than 20,000 people and causing more than 200 deaths. In Thailand, over the past 27 years, 120 outbreaks were reported involving nearly 6700 patients and 97 deaths. Japan has had fewer outbreaks and some sporadic cases have been attributed to imported infection.     

New patterns of Trichinella infection

Human and animal trichinellosis should be considered as both an emerging and reemerging disease. The reemergence of the domestic cycle has been due to an increased prevalence of Trichinella spiralis, which has been primarily related to a breakdown of government veterinary services and state farms (e.g., in countries of the former USSR, Bulgaria, Romania), economic problems and war (e.g., in countries of the former Yugoslavia), resulting in a sharp increase in the occurrence of this infection in swine herds in the 1990s, with a prevalence of up to 50% in villages in Byelorussia, Croatia, Latvia, Lithuania, Romania, Russia, Serbia, and the Ukraine, among other countries. The prevalence has also increased following an increase in the number of small farms (Argentina, China, Mexico, etc.) and due to the general belief that trichinellosis was a problem only until the 1960s. The sylvatic cycle has been studied in depth at both the epidemiological and biological level, showing the existence of different etiological agents (Trichinella nativa, Trichinella britovi, Trichinella murrelli, Trichinella nelsoni) in different regions and the existence of "new" transmission patterns. Furthermore, the role of game animals as a source of infection for humans has greatly increased both in developed and developing countries (Bulgaria, Canada, Lithuania, some EU countries, Russia, USA, etc.). The new emerging patterns are related to non-encapsulated species of Trichinella (Trichinella pseudospiralis, Trichinella papuae, Trichinella sp.), infecting a wide spectrum of hosts (humans, mammals including marsupials, birds and crocodiles) and to encapsulated species (T. spiralis, T. britovi, and T. murrelli) infecting herbivores (mainly horses). The existence of non-encapsulated species infecting mammals, birds and crocodiles had probably remained unknown because of the difficulties in detecting larvae in muscle tissues and for the lack of knowledge on the role of birds and crocodiles as a reservoir of Trichinella. On the other hand, it is not known whether horse and crocodile infections existed in the past, and their occurrence has been related to improper human behavior in breeding. The problem of horse-meat trichinellosis is restricted to France and Italy, the only two countries where horse-meat is eaten raw, whereas mutton and beef have been found to be infected with Trichinella sp. only in China.     

Real-time PCR as a surveillance tool for the detection of Trichinella infection in muscle samples from wildlife

Trichinella nematodes are the causative agent of trichinellosis, a meat-borne zoonosis acquired by consuming undercooked, infected meat. Although most human infections are sourced from the domestic environment, the majority of Trichinella parasites circulate in the natural environment in carnivorous and scavenging wildlife. Surveillance using reliable and accurate diagnostic tools to detect Trichinella parasites in wildlife hosts is necessary to evaluate the prevalence and risk of transmission from wildlife to humans. Real-time PCR assays have previously been developed for the detection of European Trichinella species in commercial pork and wild fox muscle samples. We have expanded on the use of real-time PCR in Trichinella detection by developing an improved extraction method and SYBR green assay that detects all known Trichinella species in muscle samples from a greater variety of wildlife. We simulated low-level Trichinella infections in wild pig, fox, saltwater crocodile, wild cat and a native Australian marsupial using Trichinella pseudospiralis or Trichinella papuae ethanol-fixed larvae. Trichinella-specific primers targeted a conserved region of the small subunit of the ribosomal RNA and were tested for specificity against host and other parasite genomic DNAs. The analytical sensitivity of the assay was at least 100 fg using pure genomic T. pseudospiralis DNA serially diluted in water. The diagnostic sensitivity of the assay was evaluated by spiking 10 g of each host muscle with T. pseudospiralis or T. papuae larvae at representative infections of 1.0, 0.5 and 0.1 larvae per gram, and shown to detect larvae at the lowest infection rate. A field sample evaluation on naturally infected muscle samples of wild pigs and Tasmanian devils showed complete agreement with the EU reference artificial digestion method (k-value=1.00). Positive amplification of mouse tissue experimentally infected with T. spiralis indicated the assay could also be used on encapsulated species in situ. This real-time PCR assay offers an alternative highly specific and sensitive diagnostic method for use in Trichinella wildlife surveillance and could be adapted to wildlife hosts of any region.     

The occurrence and ecology of Trichinella in marine mammals

Trichinella in marine mammals has a circumpolar arctic distribution and a narrow range of host species. It is commonly found in polar bears (Ursus maritimus), and increasingly in walruses (Odobenus rosmarus) where it presents a significant zoonotic hazard. This has resulted in the implementation of food safety programs in some arctic communities to test harvested walrus meat for Trichinella larvae prior to consumption. Trichinella has been reported infrequently in bearded seals (Erignathus barbatus) and ringed seals (Phoca hispida), and was once observed in a Beluga whale (Delphinapterus leucas). Cannibalism is probably the most important factor in maintaining a Trichinella cycle in polar bears. Arctic carnivores such as polar bears, arctic foxes (Alopex lagopus) and domestic dogs (Canis familiaris) have a high prevalence of Trichinella infection and the carcasses of at least some of these animals are deposited in the ocean. Scavenging of these carcasses by walruses probably occurs, but may not account for the high prevalence the parasite seen in this host species. Predation, carrion feeding and cannibalism have been documented for walruses and a sylvatic cycle similar to that of bears may exist in walrus populations. Seals and whales are likely infected through infrequent exposure to infected carcasses, either directly by scavenging or indirectly by consuming amphipods or fish that have fed on infected carcasses. The inefficiency of this mechanism may account for the low prevalence of Trichinella in seals and whales. It is known that isolates from marine mammals are cold tolerant, and infectious for man, and have been identified as Trichinella nativa (T2). Molecular and other phylogenetic studies would be useful to facilitate studies on the inter-relationship of Trichinella cycles involving marine and terrestrial mammals in the arctic and subarctic, and in the investigation of human outbreaks of trichinellosis in these areas.     

Epidemiology of Trichinella infection in the horse: the risk from animal product feeding practices

A discovery in 2002 of a Trichinella spiralis-infected horse in Serbia offered an opportunity to conduct needed epidemiological studies on how horses, considered herbivores, acquire a meat-borne parasite. This enigma has persisted since the first human outbreaks from infected horse meat occurred in then 1970s. The trace back of the infected horse to a farm owner was carried out. Interviews and investigations on the farm led to the conclusion that the owner had fed the horse food waste in order to condition the horse prior to sale. Further investigations were then carried out to determine the frequency of such practices among horse owners. Based on interviews of horse producers at local horse markets, it was revealed that the feeding of animal products to horses was a common practice. Further, it was alleged that many horses, particularly those in poor nutritional condition would readily consume meat. A subsequent series of trials involving the experimental feeding of 219 horses demonstrated that 32% would consume meat patties. To confirm that horses would eat infected meat under normal farm conditions, three horses were offered infected ground pork balls containing 1100 larvae. All three became infected, and at necropsy at 32 weeks later, were still positive by indirect IFA testing, but not by ELISA using an excretory-secretory (ES) antigen. This result indicates that further study is needed on the nature of the antigen(s) used for potential serological monitoring and surveillance of horse trichinellosis, especially the importance of antigenic diversity. The experimentally-infected horses also had very low infection levels (larvae per gram of muscle) at 32 weeks of infection, and although the public health consequences are unknown, the question of whether current recommended inspection procedures based on pepsin digestion of selected muscle samples require sufficient quantities of muscle should be addressed. It is concluded that horses are more willing to consume meat than realized and that the intentional feeding of animal products and kitchen waste is a common occurrence among horse owners in Serbia (and elsewhere?). This is a high risk practice which demands closer scrutiny by veterinary and food safety authorities, including the implementation of rules and procedures to ensure that such feeds are rendered safe for horses, as is now required for feeding to swine.     

Trichinellosis: a worldwide zoonosis

Trichinella spp. are some of the most widespread parasites infecting people and other mammals all over the world, regardless of climate. This paper attempts to describe the present status of trichinellosis worldwide and to determine if and why trichinellosis is emerging or re-emerging. The global prevalence of the disease is difficult to evaluate but as many as 11 million people may be infected. More than 10000 cases of human trichinellosis were reported by the International Commission on Trichinellosis from 1995 to June 1997 and about 10000 porcine infections were reported by the Office International des Epizooties in 1998. The disease is particularly worrisome in the Balkans, Russia, the Baltic republics, in some parts of China and Argentina. Horsemeat-related outbreaks have been reported in France and Italy and have involved about 3000 patients in the past 25 years. The emergence of trichinellosis in some countries is explained by a better knowledge of the disease (formerly often misdiagnosed as influenza), modifications of consumer habits, re-forestation in Europe and increase of wild game, importation of meats from countries where trichinellosis is endemic and failure of veterinary control due to human error or to social upheavals. This disease linked to meat-consumption which is theoretically easy to prevent by adequate cooking, freezing and veterinary controls, should deserve the attention of all persons involved in public health and it could be eradicated at least from domestic pigs.     

Evaluation of ELISA and Western Blot Analysis using three antigens to detect anti-Trichinella IgG in horses

We assessed a serological method for detecting Trichinella infection in horses, specifically, an ELISA using three antigens to detect anti-Trichinella IgG (i.e. a synthetic tyvelose glycan-BSA (stg-BSA) antigen, an excretory/secretory (ES) antigen, and a crude worm extract (CWE) antigen). Serum samples were collected from 2502 horses (433 live horses from Romania and 2069 horses slaughtered in Italy and originating from Italy, Poland, Romania, and Serbia). Serum samples were also taken from horses experimentally infected with different doses of T. spiralis and T. murrelli larvae, as controls. The cut-off value of ELISA was determined on serum samples from 330 horses from Trichinella-free regions of Italy, which were also examined by artificial digestion of preferential-muscle samples. In the experimentally infected horses, the stg-BSA and ES antigens were less sensitive than the CWE antigen. Trichinella spiralis showed a higher immunogenicity than T. murrelli, and the IgG immunoresponse was dose-dependent. The kinetics of anti-Trichinella IgG were similar among all experimentally infected horses. No circulating antibodies were detected 4-5 months after experimental infection, although these horses still harbored infective larvae. Depending on the antigen used, for 4-7 of the 330 horses from Trichinella-free areas, the optical density (OD) of the serum sample was higher than the cut-off value, yet these samples were negative when subjected to Western Blot. Similar results were obtained for the 1739 horses slaughtered in Italy (originating from Italy, Poland, Romania, and Serbia) and the 433 live Romanian horses. Of the 4 horses with muscle larvae, only one was positive by ELISA and Western Blot. Because the anti-Trichinella IgG remain circulating for only a short period of time, whereas the larvae remain infective for longer periods, serology cannot be used for either diagnosing Trichinella infection in horses or estimating the prevalence of infection. Artificial digestion of at least 5 g of preferential-muscle tissue continues to be the method of choice at the slaughterhouse for preventing equine-borne trichinellosis in humans.     

Evaluation of a digestion assay and determination of sample size and tissue for the reliable detection of Trichinella larvae in walrus meat.

A digestion assay was validated for the detection of Trichinella larvae in walrus (Odobenus rosmarus) meat, and appropriate samples for testing were determined using tissues from infected walruses harvested for food. Examination of muscles from 3 walruses showed that the tongue consistently contained approximately 2-6 times more larvae than the pectoral and intercostal muscles. Comparison of numbers of larvae in the root, body, and apex of the tongue from 3 walruses failed to identify a predilection site within the tongue, but the apex was considered an optimal tissue because of the high larval density within the tongue and the ease of collection. All 31 spiked samples weighing 50 g each and containing between 0.1 and 0.4 larvae per gram (lpg) were correctly identified as infected, indicating that the sensitivity of this procedure is adequate for diagnostic use. A sample size of 10 g consistently detected larvae in 2 walrus tongues containing > or = 0.3 lpg (n = 40), and until additional data are available, sample sizes from individual walrus tongues should be a minimum of 10 g. This study provides the preliminary data that were used for the development of a food safety analytical protocol for the detection of Trichinella in walrus meat in arctic communities.     

Outbreak of trichinellosis associated with consumption of game meat in West Greenland

The Inuit population of the Arctic has always been at risk of acquiring trichinellosis and severe outbreaks have been recorded in Alaska and Canada. In West Greenland, a number of large outbreaks took place during the 1940s and 1950s; they involved total 420 cases including 37 deaths. Since then only sporadic cases have been reported. Here, we describe an outbreak of infection with Trichinella spp. after consumption of infected meat presumably from walrus or polar bear caught in western Greenland. Six persons who had eaten of the walrus and polar bear meat were two males and four females, age range 6--47 years. Using ELISA and Western blot analysis (Trichinella-specific IgG antibodies against excreted/secreted antigen and synthetic tyvelose antigen, respectively) four of these persons were found to be sero-positive for Trichinella antibodies, with three of these having clinical symptoms compatible with trichinellosis. On re-test, 12--14 months later one of the two sero-negative persons had sero-converted, probably due to a new, unrelated infection. This study demonstrates that acquiring Trichinella from the consumption of marine mammals remains a possibility in Greenland, and that cases may go undetected. Trichinellosis in Greenland can be prevented by the implementation of public health measures.     

Detection and surveillance for animal trichinellosis in GB

The zoonotic disease trichinellosis is considered one of the re-emerging diseases with surveillance and control methods constantly gaining more importance worldwide. Recent change in European Union (EU) legislation introduces Trichinella-free production, and the possibility of risk-based monitoring for Trichinella in pigs. This has increased the role of wildlife surveillance programmes and their impact on protecting human health as well as highlighted the need for harmonised surveillance protocols and test methods for these infections. A modified digest method, based on the EU reference method for Trichinella testing of pig meat, was used to screen foxes present in Great Britain (England, Scotland and Wales) for trichinellosis. The method was validated using batched pools of 10 g foreleg muscle from up to 20 foxes (maximum amount 200 g). The method gave an average trichinae recovery rate of 71% for spiked samples. Assuming this recovery rate applies to all contaminated samples, then the test sensitivity would be 70% for all tissue samples with 0.1 trichinae per 10 g of foreleg muscle, 99.9% for samples with 1 trichinae per 10 g, and 100% for samples with 2 or more trichinae per 10 g. In two separate studies, conducted between 1999 to 2001 (Smith et al., 2003) and 2003 to 2007, over 3500 wild foxes have been screened for Trichinella with negative results. In the second study reported here, foxes were collected from locations throughout Great Britain using a stratified sampling method based on fox population densities. All work was conducted in compliance with appropriate quality assurance systems, latterly under ISO 9001. Results to date indicate the national prevalence of trichinellosis in foxes is <0.001 based on a 10 g individual sample size, an infection level of 1 larva per gram (l pg) and 95% confidence interval. This, together with no reports of trichinellosis in domesticated pigs, suggests that Britain can be considered a region of negligible risk of trichinellosis.     

Clinical features of experimental trichinellosis in the raccoon dog (Nyctereutes procyonoides)

Three groups of six raccoon dogs (Nyctereutes procyonoides) were provided for the experiment: the first group was infected with pig-origin Trichinella spiralis, the second with raccoon dog-origin Trichinella nativa, and the third served as controls. Infection dose for both parasite species was 1000 larvae/kg of body weight, which led to intense final infection. Clinical signs, haematology and serum biochemistry with repeated blood samples were monitored up to 12 weeks post-infection. The most significant findings were a short-term eosinophilia in peripheral blood from the end of the first week post-infection until the end of the third week, loss of weight, and mild anaemia. In the early phase of the infection, the animals had gastrointestinal signs, loss of appetite and diarrhoea. No specific differences in clinical findings could be noticed between the groups infected with T. nativa and T. spiralis. In contrast to the symptoms reported in human outbreaks, fever was not observed in any of the infected animals and serum levels of muscle-specific enzymes did not change. No acute-phase response was observed in the enteral or parental phase of the infection. These findings indicate that because Trichinella spp. are very well adapted to the raccoon dog, it thus, could serve as the most crucial reservoir animal for sylvatic trichinellosis in Finland.     

Differential detection of Trichinella papuae, T. spiralis and T. pseudospiralis by real-time fluorescence resonance energy transfer PCR and melting curve analysis

Trichinellosis caused by nematodes of Trichinella spp. is a zoonotic foodborne disease. Three Trichinella species of the parasite including Trichinella spiralis, Trichinella papuae and Trichinella pseudospiralis, have been etiologic agents of human trichinellosis in Thailand. Definite diagnosis of this helminthiasis is based on a finding of the Trichinella larva (e) in a muscle biopsy. The parasite species or genotype can be determined using molecular methods, e.g., polymerase chain reaction (PCR). This study has utilized real-time fluorescence resonance energy transfer PCR (real-time FRET PCR) and a melting curve analysis for the differential diagnosis of trichinellosis. Three common Trichinella species in Thailand were studied using one set of primers and fluorophore-labeled hybridization probes specific for the small subunit of the mitochondrial ribosomal RNA gene. Using fewer than 35 cycles as the cut-off for positivity and using different melting temperatures (T(m)), this assay detected T. spiralis, T. papuae and T. pseudospiralis in muscle tissue and found the mean T(m) ± SD values to be 51.79 ± 0.06, 66.09 ± 0.46 and 51.46 ± 0.09, respectively. The analytical sensitivity of the technique enabled the detection of a single Trichinella larva of each species, and the detection limit for the target DNA sequence was 16 copies of positive control plasmid. A test of the technique's analytical specificity showed no fluorescence signal for a panel of 19 non-Trichinella parasites or for human and mouse genomic DNA. Due to the sensitivity and specificity of the detection of these Trichinella species, as well as the fast and high-throughput nature of these tools, this method has application potential in differentiating non-encapsulated larvae of T. papuae from T. spiralis and T. pseudospiralis in tissues of infected humans and animals.     

The epidemiology of animal trichinellosis in China

The epidemiology of animal trichinellosis in China based mainly upon original Chinese literature published between 1937 and 2004 is reviewed. The seroprevalence of Trichinella infection in herbivores was 0.7% (2/300) in cattle and 0.8% (4/500) in sheep. The prevalence of trichinellosis in naturally infected cattle was 1.2% (2/163). Trichinella larvae were detected in 1.4% (3/215) of sheep and in 2.1% (1/47) of beef cattle sold at markets. Canine trichinellosis was recorded in 13 Provinces, Autonomous Regions or Municipalities (P/A/M) and the average prevalence of the infection in dogs slaughtered in abattoirs was 16.2% (5654/34,983) ranging from 1.2% to 44.8%, with the highest prevalence located in northeast China. The prevalence in dog meat sold at markets was 3.5% (988/27,898) in 5 P/A. Feline Trichinella infection was reported in 10 P/A/M. The prevalence of Trichinella infection in rats varied from 1.1% (51/459) to 15.1% (50/332). Trichinella larvae were detected in 1.5% (9/587) of house rats (Rattus norvegicus) as well as in 0.8% (3/369) of wild rats (Apodemus chevrieri), and the infection was recorded also in other wildlife (foxes, bears, wild boar, weasels, raccoon dogs, muntjak and bamboo rats). Trichinella larvae were detected in 2.6% (4/156) of weasels (Mustela sibirica), 1.5% (2/135) of shrews (Tupaia belangeri) and 7.7% (1/13) of moles (Parascapter leucurus). All Trichinella isolates from domestic pigs were identified as T. spiralis. Some Trichinella isolates from dogs in north-eastern China were identified as T. nativa, which has muscle larvae that are highly resistant to freezing. Twenty-seven outbreaks of human trichinellosis associated with mutton, dog and game meat occurred in China between 1964 and 2004, but the quarantine of Trichinella larvae in such meat is not mandatory in China at present.     

Trichinellosis in Argentina: an historical review

In Argentina, Trichinella infection in pigs is endemic. The first report of human trichinellosis in Argentina was from 1898 in Buenos Aires. The number of human cases increased from 908, between 1971 and 1981, to 6,919, between 1990 and 2002. In pigs slaughtered in official establishments, the prevalence of Trichinella infection was 0.46% in 1914 and 0.01--0.03% during the period 1990--2004. T. spiralis is typically found in the domestic cycle that includes pigs, humans and rodents. Trichinella spp. from a sylvatic cycle has also caused human outbreaks resulting from the consumption of meat from puma, armadillo and wild boar. European migration to Argentina (principally Spanish and Italian) during the first years of the 20th century brought the tradition of preparing and eating raw sausages. This increased the risk of human exposure to Trichinella. Detection in pigs was initially made at slaughter by compression of muscle tissue (trichinoscopy) and continued this way until 1996, when artificial digestion was adopted for use in preventing human trichinellosis in Argentina. The following report synopsizes the evolution of trichinellosis in Argentina over the past century.     

The need for implementation of International Commission on Trichinellosis recommendations, quality assurance standards, and proficiency sample programs in meat inspection for trichinellosis in Serbia

Implementation of methods to control inspection for Trichinella in meat recommended by International Commission on Trichinellosis (ICT), particularly the introduction of the quality assurance standards and proficiency panels for certified analysts is extremely important in Serbia and other countries where Trichinellosis is endemic. In spite of existing regulations, including the inspection of 0.5 g samples of diaphragm by the compression method or by artificial digestion of 1g samples, in Serbia 280 people were diagnosed with clinical trichinellosis after consumption of inspected meat during the period 2001--2002. These outbreaks, which occurred in the municipalities of Kumane, Surcin and Bogatic, were a consequence of inadequate application of inspection methods and insufficient education of some veterinary inspectors. The problem of inadequate veterinary inspection in Serbia can be overcome by strict application of the ICT recommendations for the control of Trichinella with specific emphasis on implementing the quality assurance system (QAS) and proficiency sampling (PS/--PP/panel).     

Control of trichinellosis by inspection and farm management practices

The prevention of human trichinellosis by proper meat inspection is a classic example of successful veterinary public health measures. The microscopic methods which have been used for more than a century to test pigs for trichinae were intended to prevent human disease. However, the value of these relatively insensitive direct detection methods, including trichinoscopy and pooled sample digestion, was debated as soon as more sensitive indirect (serological) methods became available. Two issues related to testing were discussed. First, should public health authorities endeavour to prevent all infections of humans rather than simply prevent the occurrence of disease, and second, would epidemiological surveillance and monitoring of the pig population on farms not provide a better control system to prevent human infection. This latter issue is of particular importance for those countries in the world where human trichinellosis acquired from farmed animals is absent and examination of pigs at the abattoir only results in negative findings. In countries where domestic pig infections are virtually non-existent, monitoring of Trichinella infection in wildlife could also contribute to understanding the infection pressure from nature to livestock. Trichinella-free pig farming is a feasible option for controlling this zoonosis, even in endemic areas. This approach provides an opportunity to combine good veterinary practice, in order to prevent animal diseases, with the prevention of Trichinella infection. All animals with access to the environment, or animals which are fed with potentially Trichinella-infected feed (swill, carcasses) will always constitute a public health threat, and must be inspected individually at slaughter (swine, horses, wild boars). Finally, it is important to recognize that trichinellosis is a world-wide problem that needs continuous public health attention. If no control system exists, for whatever reason, the public should be educated not to consume improperly cooked meat.     

Historical perspectives and current global challenges of Trichinella and trichinellosis

Trichinella spiralis and related species of Trichinella have had a long history of causing human disease, and as a foodborne pathogen have had a major impact on international commerce of pork and other meat animal species which are known to transmit the parasite. Our knowledge of Trichinella has increased substantially over the past few years particularly in the areas of phylogeny, host diversity, epidemiology and control. In this paper, we provide a brief overview of our understanding of Trichinella from its discovery to present time. Past and current challenges of the control of Trichinella and trichinellosis are summarized. As editors of this special issue of Veterinary Parasitology, we introduce a series of invited review articles prepared by experts from around the world, summarizing recent knowledge in Trichinella and trichinellosis.     

A tongue biopsy technique for the detection of trichinosis in swine

A tongue biopsy technique developed for the detection of Trichinella spiralis infection in swine involves taking a deep core biopsy of the tongue musculature, and examination of the sample by digestion. Using this procedure, 31 of 52 (60%) swine from an Indiana herd were found to be infected with T. spiralis. The average biopsy weighed 0.42 g, and the intensity of infection averaged 180 larvae per gram (range 2-1157). The biopsy was quick and easy to perform and the tongues healed well following the procedure. This technique may have applicability for Trichinella detection in epidemiological, control and research studies on swine and other animals.