Trichinosis - general information about the disease, ways of infection, symptoms, diagnosis and treatment features

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Trichinosis is an acute parasitic disease, which most often occurs in especially severe forms. As a rule, almost all patients lose their ability to work, some neglected forms often lead to death. Trichinosis is diagnosed in almost all climatic zones. In the risk group are all those who live near forests or often eat meat of wild animals. Larvae of Trichinella, they are depicted in the photo, they inhabit transversely striated musculature, individuals that can reproduce are in the intestine, where they actively reproduce, producing larvae. The larvae of Trichinella are very active, they easily perforate the walls of the intestine, thus fall into the bloodstream, and then migrate throughout the body. In order to understand how dangerous trichinosis can be in children and adults, and how treatment should take place, what patients look like, it is necessary to collect as much information about these parasites as possible.

Overview of Trichinosis

What is Trichinella? This is a species of parasites belonging to the class of roundworms. Helminth in sexually mature age is small, the female reaches only 3-3.5 mm in length, and males are even smaller( 1.5-1.6 mm).How they look, can be seen in the photo. Trichinella is a typical biogelmint, its life cycle completely passes in the animal or human body. This means that any mammal can become an intermediate and final link in the chain of development of infestations.

Both males and females participate in the fertilization process, after such an act the males of spiral trichinella die, the females also live another two months. During this time, they produce up to two thousand viable larvae. After two months, the females also die. And larvae of spiral trichinella literally affect the walls of the large intestine, easily penetrate into the lymphatic system and along with the blood flow begin to migrate throughout the body, settling only in certain organs. Unlike other biogelminthes, Trichinella spiral and pseudospiralis settle only on the muscles of certain groups. They affect the diaphragm, intercostal muscles, chewing ligaments, deltoid and calf muscles. In the treatment of children and adult patients, this must be taken into account.

The migration process takes several weeks( up to 6).In the process of migration, most of the larvae of Trichinella spirals die, but those larvae that remain are twisted into a spiral and clogged into a special capsule. This can be seen in the photo. That is why in the names of some species of parasites there is the word "spiral".In this state they are able to live for decades. At the same time the worm continues to feed at the expense of its owner. If a large number of larvae accumulate inside the host organism( human or animal)( up to fifteen thousand pounds per kilogram of muscle tissue), trichinosis develops, a dangerous disease that can lead to death.

Why is trichinosis so dangerous?

When a large number of worms accumulate in the host organism( human or animal), their vital activity results in the accumulation of a huge amount of toxins capable of slowly poisoning a person or an animal. The immune system for such stress always reacts differently. Often against the background of intoxication, both children and adults develop an allergy. Its rapid current can lead to death. In addition, Trichinella have a mechanical effect on the muscles, causing them after infection, individual organs begin to work poorly. That is why any treatment ends with active physiotherapy. In order for the life cycle of one generation of Trichinella to be completed, the owner must change.

Under what conditions can the life cycle be interrupted? Two conditions are needed to interrupt the life cycle:

1. The final host must die, the cadaveric material can not supply the larvae with all the necessary nutrients, so they die.
2. The death of adults and larvae can occur under the influence of very high temperatures( up to +80 degrees Celsius), or low temperatures( down to -40, -50 degrees).From all this it follows that neither the smoking of meat, nor its drying, salting, can not be protected from invasion.

Features of the clinical picture of trichinosis

As mentioned above, certain conditions are necessary for the development of invasion, the consequences of which are visible in the photo. While there are few larvae in the host's body, the disease flows asymptomatically, it does not manifest itself in any way, so a person does not know about the risks. The pathological process is able to develop sharply, then the disease trichinosis goes in three stages:

• The first stage is enzymatic-toxic.
• The second stage is allergic.
• The third stage is immunopathological.

The first stage - enzyme-toxic - the initial stage of trichinosis. Worms only penetrate into the intestinal mucosa, larvae mature to a mature image, adult individuals actively parasitize, purify their vital functions, contribute to the development of the inflammatory process, the focus of which is in the lumen of the hollow organ.

The second stage - allergic - is characterized by the appearance of the first characteristic symptoms. About them we'll talk a little lower, but for the time being we will describe in detail what happens inside the body during the next stage of the disease trichinosis. After the first week of infection, adults begin to multiply actively, the larvae migrate throughout the body and settle in the musculature, which is actively fueled by the blood flow. This process lasts several weeks, its presence may indicate a high level of antibodies, which is revealed when analyzing the blood of an infected person or animal. The appearance of antibodies in the blood provokes a response - the emergence of a violent allergy. It is exacerbated if a person often takes alcohol.

Allergy can manifest in different ways, maybe as it is seen in the photo, much depends on the strength of the host's immunity, the number of helminths within it, on the degree of adaptation of trichinella within the host. The more parasites, the more pronounced allergic reactions, the weaker becomes immunity.

The third stage - immunopathological - the disease develops immediately after intensive infection. It is characterized by dangerous manifestations, such as inflammation of the walls of blood vessels. This phenomenon has a dangerous for human life complication - the formation of nodular infiltrates. When they appear in the brain, on the heart muscle, in the liver, a person dies. Trichinosis in the third stage in a child and in an adult can provoke the appearance of focal pneumonia, meningoencephalitis, allergic myocardium. When such diseases are combined with each other, the chances of surviving and recovering are reduced to zero.

Acute trichinosis at the end of the fifth sixth week leads to the appearance of dystrophic manifestations, the restoration of the host organism after such changes is extremely slow. Even if the disease can be defeated after taking a full course of treatment, a person can return to normal life only a year after intensive rehabilitation and compliance with a certain diet. In some cases, the return of working capacity becomes impossible, so it is often asked about the appointment of a disability. That is why the described species of helminths is so dangerous. To maintain health, it is important to know how the infection occurs, what the first symptoms may indicate the development of trichinosis. That is why it is necessary to dwell on the disclosure of data in more detail.

Trichinosis infections

Trichinella are biogelminthes, they parasitize in the muscle fibers of mammals. To date, more than 100 species of animals are known - potential sources of danger of trichinosis development. To identify the sources of infection, specialists identify three foci of infestation:

1. Natural.
2. Synanthropic.
3. Mixed.

In natural sources, helminth circulation occurs between wild animals of different species. The vectors of invasion are boars, bears, roe deer and moose. Trichinella can affect almost all mammal species that live in forests, including rodents, as well as marine animals( seals and whales).Invasions are transmitted by alimentary route, when eating carrion or predation. The source of infection with human trichinosis is the eating of poorly cooked meat, obtained on hunting or fishing. The causative agent is the larva of roundworms, it is the larvae that are the main cause of the development of a dangerous disease.

A synanthropic source of infection involves the circulation of helminths between domestic animals( pigs, cats, dogs, domestic rodents - rats and mice).A person is very susceptible to this parasite, it is enough to eat only fifteen grams of the infected product so that the Trichinella will permanently settle inside the body. Trichinosis is a group disease. Invasion occurs in everyone who sat at a table and ate an infected product( wild boar or domestic piglet).The incubation period is 10-25 days. The risk of infection increases many times, if the food is not enough cooked or roasted product. Larvae of Trichinella( pathogens) die only at a temperature of +80 degrees Celsius. Knowing how to cook meat properly can help avoid infection.

Synanthropic foci are formed as a result of improper household management. If pets move freely along the forest belt, or wander around the yard, if there is free access to cattle for dogs and cats, as well as for rodents, the risk of spreading trichinosis increases at times. Such negligent attitude is the main cause of danger for a person.

Rodents, which in summer spend in the woods, and in winter return to the home, become sources for the formation of a mixed( natural-synanthropic) foci of infestation. Free grazing of domestic animals, as well as feeding them with waste that remains after the carcasses of wild animals - is another possible source of infection with trichinosis. Of course, such information is not a reason to completely abandon the use of suspicious products. If you take certain security measures, you can easily protect yourself and all members of your family. An important preventive measure is checking the products for trichinosis. Let's talk about where it can be conducted, how to check the meat of a wild boar, bear or homemade pork for a parasite at home. So, considering the fact that one kilogram of meat can contain up to two hundred larvae of Trichinella( potential causative agents of parasitic lesion), it becomes clear why it is so important to analyze the meat and identify the facts of its infection, and also to know the length of the durationincubation period. At home, an ordinary person does research and can not test meat for trichinosis. And all because the appearance, color and smell of the infected product is not much different from healthy. It is possible to detect the presence of a parasite only under a microscope, so it is necessary to perform a study only in the laboratory. Meat, past a similar express test, is branded, and then put on the market.

In order to avoid infection, each private trader has the opportunity to test the meat of a wild boar or domestic pig in a veterinary laboratory located in the territory of any market or in a sanitary and epidemiological station. For the described study, one piece is not enough, it is better to bring a whole carcass, because for sampling, meat is taken from different sites. Typically, the study passes the muscles located under the ribs, chewing muscle ligament, the language of the pet. If at least one larva of Trichinella is found during the analysis, the carcass of the animal is discarded.

But even after a laboratory check, the risk of contracting trichinosis is preserved. Therefore, doctors strongly recommend that you give up meat that has been subjected to short heat treatment. With extreme caution, one should eat the meat of wild animals extracted from hunting in endemic areas. It is dangerous to eat jerky, steaks with blood, sausages cooked at home, ham, dishes made with minced meat. When the first symptoms of infection appear, each person should immediately begin treatment. It is important to remember that trichinosis is not transmitted from person to person.

How is trichinosis manifested?

The manifestation of symptoms of trichinosis in adults and children largely depends on the number of larvae( here they are in the photo), trapped inside the host's body, and on the organs in which they settled after migration( in the lungs, heart, liver or kidneys).It is necessary to understand that the manifestation of symptoms of trichinosis in humans is not associated with the parasites themselves, but with how the organism( or rather, immunity) reacts to their presence.

The first signs of trichinosis appear already in the first week of infection. So, as adults and larvae literally gnaw into the intestinal wall, they easily damage the mucous layer. As a result, inflammation occurs, so a sick child and an adult can complain about the following symptoms:

1. Alternating diarrhea and constipation.
2. Rumbling and gurgling in the abdomen.
3. Constant causeless nausea.
4. Loss of appetite.
5. Blunt pain in the peritoneum.

Migration of trichinella in the human body begins only in the second week after infection, the larvae penetrate into the muscles, into the striated musculature. And even in the eyeball. Here's how it looks in the photo. In this case, sexually mature specimens in the intestine begin to inject toxins into the blood. They form the symptoms of general intoxication of the body and allergies. What can sick children and adults complain about?

1. On muscular pain. Larvae that settle in muscle fibers, bore them, damage the integrity of the ligaments. First, the calves on the legs and shins begin to hurt, then the pain starts to rise upwards, to the knees, hips, to the stomach and to the shoulders. To the sick person it seems, that elbows hurt, actually there unpleasant sensations only irradiate.
2. To fever. The rise in temperature to 38, to 40 degrees in combination with muscle pain is the main sign of the presence of the described parasite. A similar manifestation is a response to general intoxication. The temperature can last for a day, two, a week, two - all depends on the severity of the course of the invasion.
3. On a severe headache, tormenting constantly. It also indicates the effects of toxins that form during the life of trichinella. Toxins act on the human brain, it reacts with the manifestation of painful sensations.
4. To change the psychological state. Disorders in the work of the nervous system - a symptom of poisoning of nerve cells. The patient can complain about the lack of sleep, the emergence of depressive states for no apparent reason.
5. On allergic rashes. A rash throughout the body is a sure sign of the presence of helminths in the body. If it is accompanied by a dry paroxysmal cough, which ends with the release of viscous sputum, it is worth immediately contacting a doctor. The origin of the cough is easy to explain. Trichinella injects a special protein into the blood of an infected person, it comes into conflict with antibodies. As a result, the edema of bronchial mucosa is formed, it is accompanied by the release of not very much sputum.
6. On the violation of swallowing. This symptom appears when the larvae seed the muscles responsible for fixing the tongue.

Chronic trichinosis

These symptoms are typical of the acute phase of trichinosis. Chronic forms of invasion have more vivid signs, for example, periorbital edema. It occurs in humans when the migration of larvae leads to insemination of the oculomotor muscles. This phenomenon leads to inflammation of all tissues around the eyeball. Interstitial fluid begins to accumulate in them, and therefore a strong swelling appears. Look at the photo, here's how it might look.

The edema captures the upper eyelid, the lower eyelid, and the space near the bridge of the nose. Such a symptom leads to soreness, it is born with every movement of the eyeball. When trichinella larvae damage the eye vessels, small hemorrhages develop. Trichinosis provokes abundant lacrimation and itching. Constant combing leads to the development of conjunctivitis. Periorbital edema, conjunctivitis, and also puffiness of the face are the true signs of trichinosis. If you find one or more of the above symptoms, it's a reason to suspect a dangerous invasion and seek help from specialists. The following diagnostic tests can confirm the diagnosis.

Diagnosis of trichinosis

How to identify an invasion? Diagnosis of trichinosis is a complex study that involves several stages. At the very first, experts carefully collect an epidemiological anamnesis. As a rule, trichinosis has symptoms, the totality of which is of diagnostic importance. If the patient has swelling of the eyes, conjunctivitis, gastrointestinal disorders, if he has muscle pains, eye pains, skin rashes, if such a clinical picture unfolds against a background of fever, there are all the prerequisites to suspect a diagnosis of "trichinosis."The following diagnostic tests and laboratory tests help determine and confirm it:

• A general blood test is the most effective study.
• Serological diagnosis.
• Intravenous allergic test.
• Muscle biopsy.
• Animal meat research.

If suspected of trichinosis, the patient will be asked to do a general analysis in the laboratory - a study that can give a detailed answer and identify common suspicions. Blood - litmus paper, according to the reactions taking place in it, you can understand what pathology develops inside the body. How does the invasion manifest itself? In the blood there are white blood cells - white corpuscles, presented in different varieties. One of them is eosinophils. They take an active part in the formation and the course of allergic reactions. Considering the fact that the acute phase of trichinosis is accompanied by bright allergic reactions, a large number of eosinophils are present in the blood in the presence of invasion. General analysis - the simplest study conducted in the laboratory, it is the best way to detect the causative agent. In trichinosis, there are general changes in the blood:

• First, the inflammation of the intestinal mucosa, which always accompanies any invasion, contributes to an increase in the number of white blood cells, and this diagnostic study should necessarily show this.
• Secondly, at peak times of invasion, the number of eosinophils is 80% of all leukocytes.

General analysis in the laboratory helps to diagnose trichinosis or to suspect it at the earliest stages of the invasion. Elevated rates persist for two months after the patient fully recovered.

Serological diagnosis is a special study that allows studying the patient's immune response to the presence of certain antibodies. It also helps to detect antibodies that are always actively produced in the body of an infected person at a time when helminths are being introduced into it. To diagnose trichinellosis, antibodies isolated from Trichinella larvae are used. Serological diagnosis involves several types of procedures:

1. A reaction that helps determine the associated complement( RSK).The essence of this method is that with trichinellosis, antibodies appear in the blood. They are able to bind to the antigen and draw to itself a complement molecule, a link that actively participates in all reactions associated with the protective functions of the organism itself. In the presence of parasites, the DSC gives a positive reaction.
2. Reaction to detect indirect hemagglutination( RNHA).This diagnostic study is based on the ability of erythrocytes to weld together, provided that there is an antibody and antigen on their surface.
3. Immunosorbent assay( ELISA).Antibodies and antigens are labeled with a special label. Special enzymes act as it. The label allows you to trigger reactions during which it is able to indicate the presence of Igg - the main immunoglobulin, an increase in which indicates the presence of trichinosis. Such a diagnostic examination is considered mandatory in case of suspicion of the described invasion.
4. Immunofluorescence reaction( RIF).It shows how the antibody reacts to the presence of the antigen. The presence of a glow gives a positive result.
5. Reaction arising from the labeling of an antibody enzyme( REMA).This is another label produced with a special enzyme. It allows you to determine and evaluate the result of the research.

Allergic test is another analysis, the next diagnostic study, which is necessarily prescribed for suspected trichinosis. With the help of injection, a special solution is introduced into the skin under the skin, which contains antigens. If the body contains larvae of the parasite, the skin on the spot of the allergic test will turn red, and then a small blister will form. Such a method helps to identify the described disease at an earlier time( already in the second week of infection).A positive test for trichinosis will be detected in the patient within ten years from the moment of recovery. That is why with repeated infection, preference is given to comprehensive diagnosis - a full study of trichinosis.

If the symptoms of invasion are present, and the diagnostic tests listed above do not give a positive result, the physician has the right to conduct a muscle biopsy - a complex analysis. To do this, using a needle, a small piece of muscle fiber is taken, then it is studied under a microscope under laboratory conditions. Multiple magnification makes it possible to clearly see the presence of larvae.

As a rule, it is possible to confirm the diagnosis by studying the meat of an animal that was eaten before a person fell ill. Specialists, using a microscope, are able to see capsules of larvae.

Features of treatment of trichinosis

When the diagnosis of "trichinosis" is confirmed, treatment of the invasion takes place exclusively in a stationary setting. And all because a similar parasitic disease in a person is capable of rapidly progressing. During epidermal outbreaks, even with an early appeal to specialists, thirty percent of the infected die. That is why self-medication of trichinosis with folk remedies is undesirable. Some folk remedies can be used for patients with mild helminthiasis, but only as an integrated therapy, of which prevention is part.

There is a well-developed treatment regimen, it involves taking certain medications. Their appointment is made taking into account the severity of trichinosis. At the first, easy stage, anti-inflammatory non-steroid medication is effective. The necessary preventive measures are also in place to prevent the deterioration of the patient's condition.

For the treatment of moderate disease in humans, drugs are used, which contain one active substance - mebendazole. He literally deprives the helminths of vital energy, violating the assimilation of glucose. Parasites die from metabolic disorders. Tablets are taken three times a day for ten days. Dosage verifies the attending physician.

There are several medications for medicinal treatment, in which there is mebendazole, each has its own contraindications. For example, Albendazole can not be administered to pregnant women and patients with eye retina diseases. Vermox is actively used in the treatment of trichinosis in children. The effectiveness of the application is 90%.Antiparasitic drug of a new generation - Tiabendazole can boast the same efficacy and minimal amount of side effects. This is why it is often used as a prophylaxis for infestation.

The death of trichinella in children and in adults can give rise to dangerous responses that can lead to a significant deterioration in health. Therefore, along with non-steroid drugs during treatment, anti-inflammatory Brufen and Voltaren are used. They help to cope with the consequences that were born of allergic reactions.

If trichinosis in an adult is accompanied by high fever, antipyretic drugs are added to the treatment process. Aspirin or acetylsalicylic acid is prescribed if the body temperature rises above 38 degrees. During the course of severe stages of trichinosis, hormonal drugs can be prescribed, those that are able to depress the immune system and suppress allergic reactions. You can apply them strictly after the appointment of a doctor. You can not use them during the prevention of trichinosis.

When the worms settle in the muscles, their defeat occurs. The sick person temporarily loses mobility, therefore during treatment and after it the special leaving is necessary for him. Drug therapy helps to significantly alleviate the condition, but after recovery the patient will have to undergo a long rehabilitation course consisting of several courses of massage and physiotherapy. Only with them will it be possible to restore muscle mobility.

As already mentioned above, trichinosis is dangerous because after it all kinds of complications are possible. That is why treatment with folk remedies is unacceptable. Knowing how to properly treat it, it is not difficult to try to minimize risks. But with aggressive invasion, anything can happen. One patient may need drugs that improve blood circulation in blood vessels. Others are medicines that can protect liver or brain cells from toxins. Is trichinosis in children cured? Successfully! Today, effective therapy has been developed, which successfully helps to cope even with severe, malignant infestation.

Prevention is part of the treatment for trichinosis

Given the fact that trichinosis is easier to prevent than treat, it is important to prevent disease. An important component of preventive therapy is observance of the epizootological principle. It is designed to prevent the introduction of invasions on the home farmstead from natural foci( forests and marine reservoirs).The one who often goes on a hunt should not bring carcasses of uneaten animals and birds, carcasses of wild animals. You can not feed raw meat to domestic dogs and cats.

If the cattle died from trichinosis in the house, carcasses must be treated before burial. The burial itself should be carried out at a depth of more than one meter. To treat infected cattle does not make sense.

Another important point in the prevention of trichinosis is to ensure the correct maintenance of pigs. Their free grazing is unacceptable. Each pet should be in the stall. Twice a year with the assistance of veterinary services it is necessary to produce trichinelloscopy. If it gives a positive result, the meat is sent for technical disposal. To consume contaminated meat in food is by no means possible. Many people think that heat treatment will help kill the larvae of dangerous worms, but no one knows at what temperature trichinosis dies. Kill the larva is capable only of high temperature( more than +80 Celsius).No frying, no prolonged quenching such conditions can not provide. Therefore, there is no contaminated meat. For the same reason, you can not eat salted lard, jerky foods, stroganina, home-made sausages. Heavy forms of invasion are treated extremely difficult, only prevention helps prevent the development of the most dangerous scenarios.

Prevention of trichinosis - is part of effective treatment, it is carried out at different levels. Buying all meat products in stores or markets, you can be sure that all of them are checked for the presence of larvae of the described parasite. It is important to remember that most often the infection occurs when buying meat from the owners of a private farmstead. Not all farmers check the meat of slaughtered cattle for trichinosis, and hunters do not rush to make an examination of the meat extracted in the forest, not everyone knows at what temperature trichinella dies. Therefore, each of us must understand this and make personal prophylaxis, using only the products examined for food.

Knowing what trichinosis is, how to treat it, how you can destroy the pathogen, what kind of prevention you need to use, you can try to prevent the development of infestation.