Human Outbreak of Trichinellosis Caused by Trichinella papuae Nematodes, Central Kampong Thom Province, Cambodia.

Yannick Caron,Sang Houn Prum,Virak Khieu,Hélène Yera,Sun Bun Hong Lim,Sarin Chan,Michel Pluot,Mala Sim,Ly Sovann,Mary Nheb,Yi Sengdoeurn,Isabelle Vallée,Sotharith Bory

doi:10.3201/eid2608.191497

Abstract

In September 2017, a severe trichinellosis outbreak occurred in Cambodia after persons consumed raw wild pig meat; 33 persons were infected and 8 died. We collected and analyzed the medical records for 25 patients. Clinical signs and symptoms included myalgia, facial or peripheral edema, asthenia, and fever. We observed increased levels of creatine phosphokinase and aspartate aminotransferase, as well as eosinophilia. Histopathologic examination of muscle biopsy specimens showed nonencapsulated Trichinella larvae. A Trichinella excretory/secretory antigen ELISA identified Trichinella IgM and IgG. Biopsy samples were digested and larvae were isolated and counted. PCR for the 5S rDNA intergenic spacer region and a multiplex PCR, followed by sequencing identified the parasite as Trichinella papuae. This species was identified in Papua New Guinea during 1999 and in several outbreaks in humans in Thailand. Thus, we identified T. papuae nematodes in humans in Cambodia.

Highlights

In September 2017, a severe trichinellosis outbreak occurred in Cambodia after persons consumed raw wild pig meat; 33 persons were infected and 8 died
We report an outbreak of T. papuae nematode infection in Cambodia and provide epidemiologic, molecular, laboratory, and clinical data
T. papuae nematodes might have been the causative species in these infections because it is often found in reptile meat

Summary

Introduction

In September 2017, a severe trichinellosis outbreak occurred in Cambodia after persons consumed raw wild pig meat; 33 persons were infected and 8 died. Numerous animals species (≈100), including humans, can be infected and the most common source of human trichinellosis is meat from pig or wild pig (Sus scrofa) [2]. This zoonotic disease is a public health hazard and represents an economic problem in porcine animal production and food safety. Humans acquired the parasite by the consumption of raw meat from domestic animals, wild pigs, saltwater crocodiles, and turtles [17] This species was identified in Thailand in humans during outbreaks in 2006 [14] and 2007 [13] and in a patient returning from Malaysia in 2011 [18]. The objective of this study was to report and describe a documented human outbreak of trichinellosis caused by T. papuae nematodes in Cambodia

Objectives

Methods

Results

Conclusion