Trichinosis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Trichinosis, also called trichinellosis, or trichiniasis, is a parasitic disease caused by eating raw or undercooked pork and wild game products 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 or home reared pigs. It is most common in the developing world and where pigs are commonly fed raw garbage.

Epidemiology and demographics

Trichinosis was known as early as 1835 to have been caused by a parasite, but the mechanism of infection was unclear at the time. It was not until a decade later that American scientist Joseph Leidy pinpointed undercooked meat as the primary vector for the parasite, and not until two decades afterwards that this hypothesis was fully accepted by the scientific community [2].

Infection was once very common, but is now quite rare in the developed world. From 1991 to 1996, an annual average of 12 cases per year were reported in the United States. The number of cases has decreased because of legislation prohibiting the feeding of raw meat garbage to hogs, increased commercial and home freezing of pork, and the public awareness of the danger of eating raw or undercooked pork products. Today, one of the primary causes of trichinosis in America is the consumption of raw or undercooked wild game meats.

In the developing world, most infections are associated with undercooked pork. For example, in Thailand, between 200 and 600 cases are reported annually around the Thai New Year. In parts of Eastern Europe, the WHO reports that some swine herds have trichinosis infection rates above 50%, and there are correspondingly large numbers of human infections [3].

It has been suggested that trichinosis may be one of several factors that led to religious prohibitions in Islam, Judaism, etc. against eating pork products, such as in the kashrut and dhabiĥa halal dietary laws. The medieval Jewish philosopher Maimonides advocated such a theory in his Guide for the Perplexed.

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