Reports of Trichinella in Europe climb again after record high in 2018

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The notification rate of Trichinella in Europe almost doubled in 2019 compared to 2018, according to recently released data.

In 2019, 12 countries reported 141 cases of trichinellosis, of which 96 were confirmed. Bulgaria with 55 confirmed cases, Italy with 10 and Spain with 40 but only 12 confirmed cases accounted for most of them. Romania has recorded 21 cases but only six have been confirmed.

Trichinellosis, or trichinosis, is a disease transmitted by eating raw or undercooked pork contaminated with the Trichinella parasite. It may take up to eight weeks for symptoms to appear.

The highest reporting rate was among men aged 25 to 44. Higher rates in males than females were observed in five of six age groups. Bulgaria was the only country to report cases among 0-4 year olds, both men, according to data released by the European Center for Disease Prevention and Control (ECDC).

In 2018, only 66 infections were reported, including 45 from Bulgaria. This is the lowest rate since surveillance began at EU level in 2007. The number of confirmed cases in 2019 was still below the five-year average in the European region.

The number of cases usually peaks between January and February. This recurring spike may reflect the consumption of various pork products during the Christmas holiday period and the wild boar hunting season, the ECDC said. In 2019, a peak in December was due to a foodborne outbreak in Italy caused by Trichinella britovi.

Five households registered
Bulgaria reported two outbreaks of trichinellosis to the European Food Safety Authority (EFSA), while Croatia, Italy and Romania each had one.

The two food-borne outbreaks in Bulgaria were caused by an unspecified species of Trichinella and involved 27 people, including one person who had to be hospitalized.

Trichinella spiralis has been implicated in the two outbreaks reported by Croatia and Romania which involved three and five cases, respectively, all of which required hospitalization. The outbreaks in Bulgaria, Croatia and Romania were associated with meat and pork products, especially wild boar.

The outbreak reported by Italy was caused by Trichinella britovi and three out of nine people were hospitalized; wild boar meat products were the vehicle involved.

Bulgaria, Croatia, France, Poland, Romania and Spain have reported positive infections in domestic pigs not reared in controlled housing conditions. EU regulations require testing for Trichinella on all slaughtered pigs, wild boars, horses and other farmed or wild animals that may be infested with Trichinella from sites not officially recognized as having controlled housing conditions. Animals slaughtered for domestic consumption are not included in this law and national rules differ.

There is a relationship between lack of awareness and low incomes of consumers living in rural areas, insufficient local veterinary meat inspection services and the occurrence of Trichinella in domestic animals in EU countries and outside the EU, the ECDC said.

Consumption of undercooked meat from pigs reared in uncontrolled housing conditions or from hunted wild boars was the highest risk of contracting trichinellosis in Europe.

About the symptoms
The first symptoms of infection in humans are nausea, diarrhea, vomiting, fatigue, fever, and abdominal discomfort. Headache, fever, chills, cough, swelling of the face and eyes, joint and muscle pain, itchy skin, diarrhea or constipation may follow.

Abdominal symptoms can occur one to two days after infection. Other symptoms usually begin two to eight weeks after eating contaminated meat. Freezing, curing or salting, drying, smoking or microwaving meat may not kill infectious worms.

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