Trichinella Spp Research Articles

Detection of Trichinella murrelli in coyotes (Canis latrans) from Oklahoma and North Texas

We determined the prevalence and mean intensity of Trichinella sp. infection in coyotes from six counties in Oklahoma and one in northern Texas. Tongues from 77 coyotes were examined using histology and artificial tissue digestion. Histological examination showed a prevalence of 3.9% (3 of 77) whereas the prevalence was 6.5% (5 of 77) based on artificial digestion of 5.0g of muscle from coyote tongues. One sample was positive for Trichinella sp. on histology but negative by artificial digestion. Combining data from both diagnostic techniques showed that six of 77 (7.8%) coyotes were infected with Trichinella spp. The mean intensity of Trichinella sp. larvae ranged from 0.2 to 66.2 with an average of 16.0 larvae per gram (LPG) of tongue. Genotyping results demonstrated that the coyotes were infected with Trichinella murrelli. This is the first report of T. murrelli infection in coyotes in Oklahoma. T. murrelli had previously been isolated from coyotes in Texas.

PREVALENCE OF ANTIBODY TO TOXOPLASMA GONDII AND TRICHINELLA SPP. IN FERAL PIGS (SUS SCROFA) OF EASTERN NORTH CAROLINA

Feral pigs (Sus scrofa) survive in many climates, reproduce year-round, and are dietary generalists. In the United States, the size and range of the feral pig population has expanded, resulting in greater interaction with humans and domestic swine and increased potential for disease transmission. We conducted a serosurvey in feral pigs from eastern North Carolina to determine exposure to the zoonotic parasites, Toxoplasma gondii and Trichinella spp. Between September 2007 and March 2009, blood serum was collected from 83 feral pigs harvested at Howell Woods Environmental Learning Center, Four Oaks, North Carolina, USA. We used a modified agglutination test to test for T. gondii antibodies and an enzyme-linked immunosorbent assay to test for Trichinella spp. antibodies. The prevalences of antibodies to T. gondii and Trichinella spp. were 27.7% and 13.3%, respectively and 4% (n=3) had antibodies to both agents. We detected an increased risk of T. gondii antibodies with age, whereas the risk of exposure to T. gondii across years and between sexes was similar. In eastern North Carolina, feral pigs have been exposed to T. gondii and Trichinella spp. and may pose a health risk to domestic swine and humans.

Molecular cloning and characterization of transgelin-like proteins mainly transcribed in newborn larvae of Trichinella spp.

A cDNA library was constructed from Trichinella pseudospiralis muscle larvae. One cDNA clone, designated Tp4, contained a cDNA transcript of 783bp in length, with a single open reading frame that encoded 153 amino acids (16,793Da as the estimated molecular mass). The predicted amino acid sequence of Tp4 showed that the clone had a calponin homology domain and was approximately 50% identical to the transgelin-like proteins (calponin-family members) present in Bombyx mori or Tribolium castaneum. A homologue of the Tp4 clone was also present in cDNA from Trichinella spiralis, and this clone was designated Ts4. A comparison of the amino acid sequence of the transgelin-like proteins from T. spiralis (Ts4 protein) with the Tp4 protein indicated that the two proteins are very similar (about 94% homology). Real time quantitative polymerase chain reaction results showed that the transcription level of the Tp4 and Ts4 genes was highest in newborn larvae. On Western blot, the recombinant Tp4 and Ts4 proteins migrated at 20kDa when reacted to an antibody against the recombinant Tp4 and Ts4 proteins, respectively. An antibody against the recombinant Tp4 and Ts4 proteins strongly stained two bands migrating at approximately 9 and 8kDa in the crude extracts from adult worms and newborn larvae, but only weakly stained proteins in muscle larvae. However, an immunocytochemical study showed that the Tp4 protein was present within the muscle of the muscle larvae of T. pseudospiralis. The antibody level against the recombinant Tp4 antigens in infected mice began to increase from 8 days post-infection, was highest in 13 days post-infection, and then slowly decreased.

A Study to Demonstrate Freedom fromTrichinellaspp. in Domestic Pigs in Switzerland

Trichinellosis is a food-borne zoonotic disease caused by the nematode Trichinella spp. Many omnivorous and carnivorous animal species can act as host for this parasite, including domestic pigs. To protect public health, it should be ensured that pork should not contain infective Trichinella larvae. Surveillance for Trichinella spp. can be done using direct (larval detection) and indirect (antibody detection) diagnostic techniques. The aim of this study was to demonstrate the absence of infection in Swiss domestic pigs. An ELISA was used as the initial screening test, and sera reacting in ELISA were further investigated using both a Western blot for serology and an artificial digestion test with 20 g of diaphragm tissue for larval detection. A total of 7412 adult pigs, 9973 finishing pigs and 2779 free-ranging pigs were tested. Samples from 17 (0.23%) adult pigs, 16 (0.16%) finishing pigs and nine (0.32%) free-ranging pigs were ELISA-positive, but all of these sera were subsequently negative by Western blot and by the artificial digestion method. Based on these findings, an absence of Trichinella infections in adult pigs (target prevalence 0.04%) and finishing pigs (target prevalence 0.03%) can be concluded. The results also demonstrated that the prevalence of Trichinella infections does not exceed 0.11% in free-ranging pigs, the group with the highest risk of exposure.

Sylvatic Trichinella spp. Infection in Finland

Although human infections caused by Trichinella sp. have not been reported in Finland for several decades and Trichinella sp. infection in pork has become virtually extinct in the last decade, sylvatic Trichinella spp. infection is still highly prevalent in Finland. Muscle digestion of 2,483 carnivorous wild animals from 9 host species during 1999-2005 showed 617 positive animals (24.8%). Molecular identification from 328 larval isolates revealed 4 different endemic Trichinella species, i.e., T. nativa, T. spiralis, T. britovi, and T. pseudospiralis. Seven percent of the infected animals carried mixed infections. Trichinella nativa was the most common species (74%), but T. spiralis was identified in 12%, T. britovi in 6%, and T. pseudospiralis in 1% of the animals. Host species showed different sample prevalence and Trichinella species distribution. Geographical distribution also varied, with the southern part of the country having significantly higher percentages than the northern part. Infection density was dependent on both the infecting Trichinella species and the host species. Trichinella spiralis was discovered in areas with no known domestic infection cases, indicating that it can also occur in the sylvatic cycle. Raccoon dogs and red foxes are the most important reservoir animals for T. spiralis , as well as for the sylvatic Trichinella species in Finland.

Vorkommen von Trichinella spp. beim Wildschwein in der Schweiz

Trichinellosis is a worldwide occurring zoonosis caused by the intracellular nematode Trichinella spp. One of the main infection sources in Europe is raw or undercooked meat from wild boar. Trichinella britovi is prevalent in wild carnivores in Switzerland, thus a possible inclusion of wild boar in this wildlife cycle cannot be excluded. In order to assess the prevalence of Trichinella infection in wild boar, we tested 1,458 animals with both parasitological and serological methods. In none of the animals Trichinella-larvae could be recovered by the artificial digestion method (prevalence of larvae: 0 %; 95 % CI 0.0 - 0.3). Antibodies in meat juice were detected in 57 animals using a standardized E/S-Ag-ELISA. However, in the confirmatory westernblot, only 3 animals remained seropositive (seroprevalence: 0.2 %; 95 % CI 0.07 %-0.60 %). The occurrence of wild boar positive for anti-Trichinella-antibodies indicates that meat inspection for Trichinella-larvae in this species is important to prevent human infections.

Evaluation of a New Commercial Enzyme-Linked Immunosorbent Assay for the Detection of Porcine Antibodies against Trichinella Spp.

Trichinellosis is a zoonotic disease that is caused by the nematode Trichinella spp. Both European Union regulations and guidelines from the World Organization for Animal Health foresee the possibility of conducting serological surveillance for Trichinella spp. A newly developed commercial enzyme-linked immunosorbent assay (ELISA) was evaluated against 2 existing diagnostic techniques: an in-house ELISA and an in-house Western blot. A total of 875 Trichinella larva-negative samples of pigs and 93 Trichinella larva-positive samples of both naturally and experimentally infected pigs were included in the study. Bayesian modeling techniques were used to correct for the absence of a perfect reference test. The sensitivity and specificity of the commercial ELISA was 97.1-97.8% and 99.5-99.8%, respectively. Sensitivity analysis demonstrated high stability in the models. In a serological surveillance system, ELISA-positive samples should be tested by a confirmatory test. The Western blot is a suitable test for this purpose. With the use of the results of the models, the sensitivity and specificity of a test protocol in both ELISA and Western blot were 95.9% and 99.9%, respectively. The high sensitivity and specificity were achieved with a lower limit of detection than that of the routine artificial digestion test, suggesting that serological surveillance is a valuable alternative in surveillance for Trichinella spp. in pig production.

Validation of a Western Blot for the detection of anti-Trichinella spp. antibodies in domestic pigs

Trichinellosis is a zoonotic disease in humans caused by Trichinella spp. According to international regulations and guidelines, serological surveillance can be used to demonstrate the absence of Trichinella spp. in a defined domestic pig population. Most enzyme-linked immunosorbent assay (ELISA) tests presently available do not yield 100% specificity, and therefore, a complementary test is needed to confirm the diagnosis of any initial ELISA seropositivity. The goal of the present study was to evaluate the sensitivity and specificity of a Western Blot assay based on somatic Trichinella spiralis muscle stage (L1) antigen using Bayesian modeling techniques. A total of 295 meat juice and serum samples from pigs negative for Trichinella larvae by artificial digestion, including 74 potentially cross-reactive sera of pigs with other nematode infections, and 93 meat juice samples from pigs infected with Trichinella larvae were included in the study. The diagnostic sensitivity and specificity of the Western Blot were ranged from 95.8% to 96.0% and from 99.5% to 99.6%, respectively. A sensitivity analysis showed that the model outcomes were hardly influenced by changes in the prior distributions, providing a high confidence in the outcomes of the models. This validation study demonstrated that the Western Blot is a suitable method to confirm samples that reacted positively in an initial ELISA.

Functional genes and proteins of Trichinella spp.

Research of Trichinella proteins has been conducted with emphasis on excretory-secretory (E-S) products of muscle larvae because of two reasons. The first is that it has prominent and narrow specific antigenicity, and the second is that it may play some role in nurse cell formation after being secreted into host muscle cells. Proteomic analysis of E-S proteins was further advanced by the aid of new analytical methods such as gene cloning, matrix-assisted laser desorption-ionization time-of-flight mass spectrometry, and expressed sequence tags database analysis. As the research progressed, the interest of researchers moved to identification of function of E-S products, which has shed further light on the intriguing relationships between parasites and hosts. Major constituents of the E-S products include 43-, 53-, and 45-kDa glycoprotein derived from the stichosome. Many proteins were discovered in E-S products after the 43-, 53-, and 45-kDa proteins although the relationships among them remain unclear. Some of the new proteins were partially defined in terms of their function including nuclear antigens, MyoD-like protein, TsJ5 protein, etc. There are better-characterized proteins based on the gene molecular method, which allow easier identification of the function of proteins of interest. Such examples were demonstrated by proteinases, proteinase inhibitors, heat shock proteins, glycosidases, etc.

Trichinella spp. infection in horses of Romania: Serological and parasitological survey

Herbivorous animals are usually, by virtue of their diet, outside the major transmission cycles of Trichinella spp. However, since 1975, the year of the first report of human trichinellosis caused by the consumption of infected horse meat, the domestic horse has appeared as a novel vector of Trichinella spp. infection to humans, with 15 outbreaks documented in France and Italy. Romania, one of the main countries exporting horses into the European Union (EU), experienced a dramatic increase of Trichinella spp. infection in both domestic pigs and humans in the 1990s. Some Trichinella spiralis-infected horses were exported to the EU during this period. The aim of this study was to evaluate the prevalence of Trichinella spp. infections in horses from Romania using both direct and indirect tests. Of 3000 serum samples tested in 2001, none were positive by ELISA using three different Trichinella antigens (crude; excretory/secretory, ES; stg-BSA antigens). Of 2992 serum samples tested in 2002, 17 (0.56%) showed optical density values higher than the cut-off in an ELISA using ES antigens and one was confirmed by western blot (WB). Four of the 17 ELISA positive horses, including the horse with a confirmed serology by WB, were subjected for intensive meat examination at slaughter, but no Trichinella spp. larvae were detected. Further, no Trichinella spp. larvae were detected by trichinelloscopy and artificial digestion of 25,838 horses slaughtered in Alexandria and Timisoara between 2001 and 2004. The false positive results obtained by serology confirm the previous work on the unreliability of serology for detection of Trichinella spp. infection in horses. Furthermore, the lack of detection of Trichinella spp. infected horses by artificial digestion, suggests a very low prevalence of infection in horses in Romania.

TRICHINELLA MURRELLI IN SCAVENGING MAMMALS FROM SOUTH-CENTRAL WISCONSIN, USA

Tissues and serum from 59 raccoons (Procyon lotor), 42 coyotes (Canis latrans), and seven Striped Skunks (Mephitis mephitis) collected in Dane and Iowa Counties, Wisconsin, USA, between October 2005 and March 2006 were microscopically and serologically examined for the presence of Trichinella spp. Encapsulated larvae were found on compression slides prepared from tongue tissues from a few animals. Complete tissue digestion of tongues revealed that 19% of the raccoons, 26% of the coyotes, and none of the seven skunks tested were infected with Trichinella spp. Cats were subsequently experimentally infected by feeding them the raccoon tissues containing muscle larvae, and muscle larvae isolated from the collected tongues were experimentally transmitted to mice. Multiplex polymerase chain reaction analysis of the isolated muscle larvae demonstrated two distinct bands migrating at 127 base pairs (bp) and 316 bp in all samples, which together are diagnostic for Trichinella murrelli; the isolates were assigned Istituto Superiore di Sanita (ISS) codes ISS1656 through ISS1667, and ISS1708 through ISS1710 by the International Trichinella Reference Centre. These findings extend the geographic range of T. murrelli into Wisconsin, USA.

Trichinella zimbabwensis in wild reptiles of Zimbabwe and Mozambique and farmed reptiles of Ethiopia

In 1995, a new species of Trichinella ( Trichinella zimbabwensis) was discovered in farmed Nile crocodiles ( Crocodylus niloticus) in Zimbabwe, where the mode of transmission was the consumption of the meat of slaughtered crocodiles, used as feed. To determine whether T. zimbabwensis affects poikilotherm vertebrates in the wild, monitor lizards ( Varanus niloticus) and Nile crocodiles were collected in Zimbabwe and Mozambique. In 5 (17.6%) of the 28 monitor lizards from Zimbabwe, T. zimbabwensis larvae were identified. For the wild Nile crocodiles from Mozambique, species-level identification was not possible, yet immunohistochemical analysis revealed that 8 (20%) of the 40 animals harboured non-encapsulated Trichinella sp. larvae, which probably belonged to T. zimbabwensis. This is the first report of T. zimbabwensis in wild reptiles, and the findings are consistent with reports that vertebrates with scavenger and cannibalistic behaviour are the most important hosts of Trichinella spp. The wide distribution of monitor lizards and crocodiles in Africa and the development of national crocodile breeding programs in many African countries should be taken into consideration when evaluating the risk of transmission of this parasite to mammals, including humans.

Triquinosis: aspectos epidemiológicos, clínicos y de laboratorio. Estudio retrospectivo a 10 años (1994-2003)

Trichinellosis is a parasitic zoonosis caused by ingestion of infected meat containing cysts of Trichinella spp. To analyze the epidemiological, clinical and laboratory findings of trichinellosis patients in our center and compare the results with those from published series. To analyze the relationship between the clinical symptoms and laboratory findings. The clinical records of 127 patients were retrospectively analyzed. Epidemiological: 61% were male and mean age was 32 years; 95% were associated with other cases. The food implicated was always pork. Clinical: 45% presented gastrointestinal symptoms and 98% systemic symptoms. Three patients required intensive care unit hospitalization and one died. In 53%, treatment consisted of associated antiparasitic and anti-inflammatory drugs. Laboratory: 59% presented leukocytosis and 72% absolute eosinophilia. Creatine phosphokinase was elevated in 62%, lactic dehydrogenase in 56% and glutamic-oxaloacetic transaminase (GOT) in 30%. Among 52 patients, 65% had positive serology; trichinoscopy of food samples was positive in three outbreaks. The population studied had a mean of 5 signs and/or symptoms. The patient group with more than 5 signs and/or symptoms presented higher white blood cell counts and GOT levels (p < 0.05) Our results were comparable to those of other series; however, there was a low rate of complications. An association was found between a larger number of signs and symptoms and higher leukocyte counts and GOT levels. The relevance of these findings should be assessed in future studies. There is no agreement as to the best therapeutic option, a fact reflected in the various treatment modalities seen in our study.

Expressed sequence tags from life cycle stages of Trichinella spiralis: Application to biology and parasite control

While the approach taken to date to study Trichinella spp., involves mainly characterization of individual genes of interest, we initiated a genomics approach as an antecedent to more complete genome sequencing. Our approach involves use of expressed sequence tags (ESTs) obtained from three life cycle stages of Trichinella spiralis; adult worms (AD), mature muscle larvae (ML) and immature L1 larvae (immL1, also known as newborn larvae) ( Mitreva et al., 2004a) to improve the technical capacity for research on Trichinella spp. and to generate information that will aid prospective development of relevant hypotheses. In this review, we will summarize findings of our EST analysis and discuss how they relate to topics mentioned above. The foundation laid by this data will also contribute toward development of a more substantial genomic database and technical capacity to dissect molecular interactions between vertebrate hosts and Trichinella spp.

Trichinellosis outbreaks in Spain (1990-2001)

Trichinellosis is a helminth infection having a wide geographical distribution. It is acquired by ingestion of raw or undercooked meat infected with Trichinella spp. The present work reviews the human trichinellosis outbreaks recorded in Spain during 1990-2001, taking into account both the geographical distribution and source of the infection. The parasite was isolated from suspected meats with the digestion technique. Molecular characterization of Trichinella isolates was done by random amplified polymorphic DNA (RAPD) analysis and Western-blot with US5 and US9 monoclonal antibodies. Anti-Trichinella antibodies in the patients' sera were investigated by indirect immunofluorescence (IIF). A total of 49 trichinellosis outbreaks were detected in Spain during 1990-2001, 75.5% produced by ingestion of infected wild boar, 14.3% by infected domestic pig and 10.2% by an unknown source. Of the 49 outbreaks, 21 were followed up in our laboratory. We were able to perform molecular identification of the Trichinella species involved in 13 outbreaks, with 61.5% produced by T. britovi and 38.5% by T. spiralis. Serological diagnosis of the trichinellosis patients by IIF allowed confirmation of helminth infection. With the use of molecular markers, T. spiralis and T. britovi were identified as the causative organisms in trichinellosis outbreaks detected in Spain during 1990-2001. These results reveal the importance of T. britovi in Spanish public health.

Helminth fauna of the racoon dog (Nyctereutes procyonoides Gray, 1834) in Belorussian Polesie.

The racoon dog is a canid species that has been introduced into Belarus and is now widespread throughout nearly the whole territory of this country. Acclimatization of this animal began in the 1930s. To date, racoon dogs have accumulated many helminths from the Belorussian aboriginal animals. This report is the result of the helmintological examination of 78 carcasses and 179 stools of racoon dogs, carried out in natural and transformed ecosystems of Belorussian Polesie (southern part of Belarus, Brest, Gomel regions) between 1981 and 1999. The animals were killed by hunters. The stools were gathered by us on drainage channel banks. The total rate of infection of racoon dogs by helminths was 83.3% (assessed by helmintological dissection, organ compression). These animals are hosts to 25 species of helminths (Table 1). Alaria alata, Isthmiophora melis, Toxocara canis and Uncinaria stenocephala were the most frequently detected parasites. The prevalence of these helminths in the intestine of racoon dogs was 47.4%, 24.4%, 20.5% and 52.6, respectively. The eggs and larvae of helminths were found in 93.1% of racoon dog faecal samples. The most frequently registered were larvae of Strongylata spp (45.8%) and eggs of A. alata (50.8%), Taenia spp (24.6%), Toxocara spp (23.5%) and U. stenocephala (21.8%). All helminth species (except Strongyloides erschovi) are important for medical and veterinary sciences. These species of helminth are known as parasites of humans (all trematode species, Ancylostoma caninum, Dipylidium caninum, Eucoleus aerophilus, Mesocestoides lineatus, Spirometra erinacei, Taenia crassiceps, T. hydatigena, Toxascaris leonina, Toxocara canis, Trichinella spp, Trichuris vulpis, Uncinaria stenocephala), cats and dogs (all helminth species) and pigs (all trematode species except Pseudamphistomum truncatum, D. caninum as a casual parasite, S. erinacei, Taenia hydatigena, Trichinella spp). Parasitol Res (2002) 88: 944–945 DOI 10.1007/s00436-001-0582-3

Associations between Trichinella species and host species in Finland.

Examination of 627 wild animals--raccoon dogs (Nyctereutes procyonoides), red foxes (Vulpes vulpes), European lynxes (Lynx lynx), brown bears (Ursus arctos), wolves (Canis lupus), and badgers (Meles meles)--revealed Trichinella spp. The prevalence varied according to geographical region of Finland (north; southwest, SW; and southeast, SE) and was the highest among lynxes (70%, SW). The risk of trichinellosis was higher in the SE (odds ratio, OR, 19.4) and SW regions (OR 14.3), as compared with the northern region (OR 1), with no difference between the former 2 regions. Foxes (OR 2.1) and lynxes (OR 1.9) had a higher risk than raccoon dogs (OR 1) of being infected. The distribution of different Trichinella species was evaluated in 87 wild and domestic mammals by multiplex polymerase chain reaction. Trichinella spiralis was detected more often in domestic and synanthropic animals than in sylvatic hosts. Trichinella nativa was detected only in wildlife. Trichinella pseudospiralis was found both in sylvatic and synanthropic hosts. Trichinella britovi was detected only in mixed infections with other Trichinella species. The raccoon dog was the sole host for all 4 Trichinella species and also carried the most intense infections.

Cloning and characterization of Rab and Ran/TC4 cDNA clones in Trichinella spp.

The cloning and characterization of seven Rab and three Ran/TC4 partial cDNA sequences in both cystic (Trichinella spiralis and T. britovi) and noncystic species (T. pseudospiralis) are reported. These molecules were cloned by rapid amplification of cDNA ends via polymerase chain reaction (RACE-PCR), using cDNA from the aforementioned Trichinella spp. coupled to the AP1 adaptor. As primers, AP1 and 5B (derived from the WDTAGQE sequence of region 2 specific for Rab and Ran proteins) sequences were included in the PCR. The cloned cDNAs were sequenced and characterized by both Southern-blot and Northern-blot analysis. Trichinella spp. Rab- and Ran-like molecules showed divergences in both the nucleotide and the deduced amino acid sequences as compared with the corresponding homologues previously described in other organisms. In addition, differences were observed among the Trichinella species, mainly between the cystic and the noncystic species, in both DNA restriction-enzyme polymorphism and expression of the six GTPases isolated.

Trichinosis.

Trichinosis is a worldwide zoonotic disease closely related to cultural and dietary habits caused by a nematode Trichinella spp. Human infection is acquired through ingestion of undercooked meat containing infective encysted larvae. There are two cycles of transmission, one domestic and the other wild. A complete life cycle develops in a single host harboring adult worms in the small intestine, from which newborn larvae migrate and finally encyst in striated muscle. Traumatic and immunological alterations are responsible for the main clinical features, including diarrhea, febrile syndrome, myalgias, oculopalpebral signs and eosinophilia. Cardiovascular, lung and CNS involvement characterize severe trichinosis. CNS inflammatory infiltration and damage may result from larval migration and vascular obstruction, or from the effect of toxic parasite antigens, or eosinophil infiltration. Humoral and cellular immune host response are relevant both to protect against re-infection and for immunodiagnosis. DNA probes and PCR technology may help to identify Trichinella spp. Muscle biopsy may disclose T spiralis larvae coiled within a muscle fibre host nurse cell surrounded by a capsule. Inflammatory infiltration includes monocytes, plasma cells, eosinophils and T lymphocytes mainly of the suppressor/cytotoxic phenotype. Histological appearance and histochemical profile of the host nurse cell differ from that of striated muscle fibre and are partly indicative of regeneration. Our own histological and histochemical findings in experimental studies of infected mouse muscle support the concept that changes induced by the larva encysting within a single host skeletal muscle fibre which becomes a nurse cell are unique of Trichinella infection. Interestingly, no dystrophin could be detected within the host nurse cell-capsule interface. It has been advanced that larva-induced host muscle fibre changes may be regulated at muscle gene transcription level whilst host regulatory pathways governed by cell cycle phase may also contribute to larval development.

Clinical aspects of infection with Trichinella spp.

Isolated cases and outbreaks of infection with Trichinella spp. occur frequently throughout the world, sometimes resulting in fatalities. The clinical presentations of signs and symptoms are remarkably constant for most of the species of Trichinella, but in infections with Trichinella nativa and Trichinella britovi, classical symptoms of trichinellosis may be absent. It is important to be able to correlate the clinical presentation of trichinellosis with the life cycle of these helminths in order to make an accurate diagnosis. Knowledge of the epidemiology of the disease enables the physician to identify other potential cases, since most epidemics can be traced back to a common source of raw or undercooked meat. A comprehensive summary relating the most important clinical variables is presented graphically for easy reference to the text. Symptoms and signs are considered in relation to severity of infection. Laboratory findings and diagnostic techniques, including new modalities (e.g., DNA and antigen detection), are discussed. A discussion of treatment and preventive measures concludes our review.