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''Trichinella spiralis'' is a viviparous
nematode The nematodes ( or grc-gre, Νηματώδη; la, Nematoda) or roundworms constitute the phylum Nematoda (also called Nemathelminthes), with plant- parasitic nematodes also known as eelworms. They are a diverse animal phylum inhabiting a bro ...
parasite Parasitism is a close relationship between species, where one organism, the parasite, lives on or inside another organism, the host, causing it some harm, and is adapted structurally to this way of life. The entomologist E. O. Wilson h ...
, occurring in rodents, pigs, bears, hyenas and humans, and is responsible for the disease trichinosis. It is sometimes referred to as the "pork worm" due to it being typically encountered in undercooked pork products. It should not be confused with the distantly related pork tapeworm.


Description

''Trichinella'' species, the smallest nematode parasite of humans, has an unusual lifecycle, and are one of the most widespread and clinically important parasites in the world. The small adult worms mature in the
small intestine The small intestine or small bowel is an organ (anatomy), organ in the human gastrointestinal tract, gastrointestinal tract where most of the #Absorption, absorption of nutrients from food takes place. It lies between the stomach and large intes ...
of a definitive host, such as a pig. Each adult female produces batches of live
larva A larva (; plural larvae ) is a distinct juvenile form many animals undergo before metamorphosis into adults. Animals with indirect development such as insects, amphibians, or cnidarians typically have a larval phase of their life cycle. ...
e, which bore through the intestinal wall, enters the blood (to feed on it) and
lymphatic system The lymphatic system, or lymphoid system, is an organ system in vertebrates that is part of the immune system, and complementary to the circulatory system. It consists of a large network of lymphatic vessels, lymph nodes, lymphatic or lymphoid ...
, and are carried to striated muscle. Once in the muscle, they encyst, or become enclosed in a capsule. Humans can become infected by eating infected pork, horsemeat, or wild carnivores such as fox, cat, hyena or bear.


Morphology

Males of ''T. spiralis'' measure between 1.4 and 1.6 mm long, and are more flat anteriorly than posteriorly. The anus can be found in the terminal end, and they have a large copulatory pseudobursa on each side. The females of ''T. spiralis'' are about twice the size of the males, and have an anus found terminally. The vulva is located near the esophagus. The single uterus of the female is filled with developing eggs in the posterior portion, while the anterior portion contains the fully developed juveniles.


Lifecycle

''Trichinella spiralis'' can live the majority of its adult life in the intestines of humans. To begin its lifecycle, ''T. spiralis'' adults invade the intestinal wall of a pig, and produce larvae that invade the pig's muscles. The larval forms are encapsulated as a small cystic structure within a muscle cell of the infected host. When another animal (perhaps a human) eats the infected meat, the larvae are released from the nurse cells in the meat (due to stomach pH), and migrate to the intestine, where they burrow into the intestinal mucosa, mature, and reproduce. Juveniles within nurse cells have an anaerobic or facultative anaerobic metabolism, but when they become activated, they adopt the aerobic metabolism characteristics of the adult. Female ''Trichinella'' worms live for about six weeks, and in that time can produce up to 1,500 larvae; when a spent female dies, she passes out of the host. The larvae gain access to the circulation and migrate around the body of the host, in search of a muscle cell in which to encyst. The migration and encystment of larvae can cause fever and pain, brought on by the host inflammatory response. In some cases, accidental migration to specific organ tissues can cause
myocarditis Myocarditis, also known as inflammatory cardiomyopathy, is an acquired cardiomyopathy due to inflammation of the heart muscle. Symptoms can include shortness of breath, chest pain, decreased ability to exercise, and an irregular heartbeat. Th ...
and
encephalitis Encephalitis is inflammation of the brain. The severity can be variable with symptoms including reduction or alteration in consciousness, headache, fever, confusion, a stiff neck, and vomiting. Complications may include seizures, hallucinations ...
that can result in death.


Nurse cell formation

This nematode is a multicellular parasite that lives within a single muscle cell, which it extensively modifies according to its own requirements. Nurse cell formation in skeletal muscle tissue is mediated by the hypoxic environment surrounding the new vessel formation. The hypoxic environment stimulates muscle cells in the surrounding tissue to upregulate and secrete angiogenic
cytokines Cytokines are a broad and loose category of small proteins (~5–25 kDa) important in cell signaling. Cytokines are peptides and cannot cross the lipid bilayer of cells to enter the cytoplasm. Cytokines have been shown to be involved in autocrin ...
, such as vascular endothelial growth factor (VEGF). This allows the migrating ''T. spiralis'' larva to enter the myocyte and induce the transformation into the nurse cell. VEGF expression is detected surrounding the nurse cell immediately after nurse cell formation, and the continued secretion of VEGF can maintain the constant state of hypoxia.


Symptoms

The first symptoms may appear between 12 hours and two days after ingestion of infected meat. The migration of adult worms in the intestinal
epithelium Epithelium or epithelial tissue is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. It is a thin, continuous, protective layer of compactly packed cells with a little intercellul ...
can cause traumatic damage to the host tissue, and the waste products they excrete can provoke an immunological reaction. The resulting inflammation can cause symptoms such as nausea, vomiting, sweating, and diarrhea. Five to seven days after the appearance of these symptoms, facial
edema Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels tight, the area ma ...
and fever may occur. Ten days following ingestion, intense muscular pain, difficulty breathing, weakening of pulse and blood pressure, heart damage, and various nervous disorders may occur, eventually leading to death due to heart failure, respiratory complications, or kidney malfunction, all due to larval migration. In pigs, infection is usually subclinical, but large worm burdens can be fatal in some cases.


Diagnosis and treatment

Muscle biopsy may be used for trichinosis detection. Several immunodiagnostic tests are also available. Typically, patients are treated with either mebendazole or albendazole, but efficacy of such products is uncertain. Symptoms can be relieved by use of analgesics and corticosteroids. In pigs,
ELISA The enzyme-linked immunosorbent assay (ELISA) (, ) is a commonly used analytical biochemistry assay, first described by Eva Engvall and Peter Perlmann in 1971. The assay uses a solid-phase type of enzyme immunoassay (EIA) to detect the presen ...
testing is possible as a method of diagnosis. Anthelmintics can treat and prevent ''Trichinella'' infections.


Prevention and control

Trichinosis (trichinellosis) is a disease caused by tissue-dwelling roundworms of the species ''Trichinella spiralis''. In the United States, the national trichinellosis surveillance system has documented a steady decline in the reported incidence of this disease. During 1947 to 1951, a median of 393 human cases was reported annually, including 57 trichinellosis-related deaths. During 1997–2001, the incidence in the US decreased to a median of 12 cases annually, with no reported deaths. The decrease was largely due to improved compliance with standards and regulations by commercial pork producers. In the United States, Congress passed the Federal Swine Health Protection Act, restricting the use of uncooked garbage as feed stock for pigs, and creating a voluntary Trichinae Herd Certification Program. The Trichinae Herd Certification Program is a voluntary pre-slaughter pork safety program that provides documentation of swine management practices to minimize ''Trichinella'' exposure. The goal of the program is to establish a system under which pork production facilities that follow good production practices might be certified as Trichinella-safe.National Pork Board. Trichinae Herd Certification. Des Moines, Iowa: National Pork Producers Council, 2000. Available at http://www.aphis.usda.gov/vs/trichinella/. In addition to the reduction in ''Trichinella'' prevalence in commercial pork, processing methods also have contributed to the dramatic decline in human trichinellosis associated with pork products. Through the U.S. Code of Federal Regulations, the USDA has created guidelines for specific cooking temperatures and times, freezing temperatures and times, and curing methods for processed pork products to reduce the risk of human infection from ''Trichinella'' contaminated meat. Pork products meeting these guidelines are designated certified pork. It was reported in 2005 that the prevalence of human infections from ''Trichinella spiralis'' was low in the United States, despite nonexistent meat inspection with respect to trichinella. This was due to strict enforcement of the regulations applying to large meat production facilities: most cases have been from raw or undercooked meat from game animals. Also reported in 2005, the rate of infection from ''Trichinella spiralis'' was significantly higher in people living in parts of Europe, Asia, and Southeast Asia than in the United States. However, EU nations employ several strategies for detecting meat infected with ''Trichinella spiralis''. If tests are consistently negative, then a trichinella-free designation is applied to a given meat supply. Rare outbreaks still occur despite this rigorous system: France, Italy, and Poland have reported outbreaks due to eating raw horsemeat. At that time, the parasite was considered endemic in Japan and China, while Korea had recently reported its first human cases of trichinosis. In most abattoirs, the diaphragms of pigs are routinely sampled to detect ''Trichinella'' infections. Post-slaughter human exposure is also preventable by educating consumers on simple steps that can be taken to kill any larvae that can potentially be in meat bought at the local supermarket. Freezing meat in an average household freezer for 20 days before consumption will kill some species of ''Trichinella''. Cooking pork products to a minimum internal temperature of 160 °F (72 °C) will kill most species, and is the best way to ensure the meat is safe to eat.


Economic impact

It was reported in 2009 that political and economic changes had caused an increase in the prevalence and incidence rates of this parasite in many former eastern European countries due to weakened veterinary control on susceptible animals. This complicated the meat trade industry within European Union countries, and exportation of pork outside the EU. As a result, the European Union and some associated countries implemented a Trichinella monitoring program for pigs, horses, wild boar, and other wildlife species; while the European Commission implemented a new regulation to control Trichinella in meat in order to improve food safety for European consumers Illegal pork importation from places with low safety standards allows the spread of the parasite from endemic to nonendemic countries. Illegal importation and new food practices and dishes including raw meat have resulted in human trichinosis outbreaks in many European countries, including Denmark, Germany, Italy, Spain, and the United Kingdom. The economic cost of detecting trichinosis can be another cost burden. In 1998, a rough global cost estimate was $3.00 per pig to detect the parasite. At the same time, in the 15 countries comprising the European Union in 1998, about 190 million pigs were killed in slaughterhouses annually, leading to an estimated economic impact of testing of about $570 million per year. However, depending on the size of the specific slaughterhouse, the actual costs could be more than an order of magnitude smaller (i.e. less than $0.30 per pig).


Genome

The ''Trichinella spiralis'' draft
genome In the fields of molecular biology and genetics, a genome is all the genetic information of an organism. It consists of nucleotide sequences of DNA (or RNA in RNA viruses). The nuclear genome includes protein-coding genes and non-coding ...
became available in March, 2011. The genome size was 58.55 Mbp with an estimated 16,549 genes. The ''T. spiralis'' genome is the only known
nematode The nematodes ( or grc-gre, Νηματώδη; la, Nematoda) or roundworms constitute the phylum Nematoda (also called Nemathelminthes), with plant- parasitic nematodes also known as eelworms. They are a diverse animal phylum inhabiting a bro ...
genome to be subject to
DNA methylation DNA methylation is a biological process by which methyl groups are added to the DNA molecule. Methylation can change the activity of a DNA segment without changing the sequence. When located in a gene promoter, DNA methylation typically acts ...
, an epigenetic mechanism that was not previously thought to exist in nematodes.


See also

* List of parasites (human)


References

* 14 "Microbiology: An Introduction 9/e" (2006)


Further reading

*
Dickson Despommier Dickson D. Despommier (June 5, 1940) is an emeritus professor of microbiology and Public Health at Columbia University. From 1971 to 2009, he conducted research on intracellular parasitism and taught courses on parasitic diseases, medical eco ...
, ''People, Parasites, and Plowshares: Learning from Our Body's Most Terrifying Invaders'',
Columbia University Press Columbia University Press is a university press based in New York City, and affiliated with Columbia University. It is currently directed by Jennifer Crewe (2014–present) and publishes titles in the humanities and sciences, including the fie ...
, 2016 (first edition in 2013), . Chapter 1 on ''Trichinella spiralis''.


External links

* * *
Fluorescence image of Trichina
{{Taxonbar, from=Q730937 Parasitic nematodes of humans Parasitic nematodes of mammals Parasites of rodents Animal diseases Trichocephalida Veterinary helminthology Nematodes described in 1835