Trichinellosis is one of the most widespread human parasitoses, with approximately 11 million people at risk of acquiring it worldwide.[8]Dupouy-Camet J. Trichinellosis: a worldwide zoonosis. Vet Parasitol. 2000;93:191-200.
http://www.ncbi.nlm.nih.gov/pubmed/11099837?tool=bestpractice.com
Throughout the world, the occurrence of trichinellosis is closely related to the dietary habits of affected humans. In countries with strict meat regulations and mandatory reporting of cases, the disease has become rare.[9]Centers for Disease Control and Prevention. Trichinellosis (trichinosis). Sep 2024 [internet publication].
https://www.cdc.gov/trichinellosis/about/index.html
In the US, an outbreak of trichinellosis was seen in 2022 following consumption of frozen meat of a black bear harvested in Canada.[10]Centers for Disease Control and Prevention. Morbidity and mortality weekly report (MMWR): outbreak of human trichinellosis - Arizona, Minnesota, and South Dakota, 2022. May 2024 [internet publication].
https://www.cdc.gov/mmwr/volumes/73/wr/mm7320a2.htm
Six cases were identified, of which two only consumed vegetables that were grilled with the meat.[10]Centers for Disease Control and Prevention. Morbidity and mortality weekly report (MMWR): outbreak of human trichinellosis - Arizona, Minnesota, and South Dakota, 2022. May 2024 [internet publication].
https://www.cdc.gov/mmwr/volumes/73/wr/mm7320a2.htm
Another outbreak was reported in North Carolina in 2023, wherein undercooked bear meat led to 10 cases of trichinellosis.[11]Centers for Disease Control and Prevention. Morbidity and mortality weekly report (MMWR): notes from the field: suspected outbreak of trichinellosis associated with undercooked bear meat - North Carolina, November 2023. Oct 2024 [internet publication].
https://www.cdc.gov/mmwr/volumes/73/wr/mm7340a4.htm?s_cid=mm7340a4_w
Trichinellosis is relatively rare in Europe. In 2019, 12 western European countries (European Union/European Economic Area member states) reported 96 confirmed cases of trichinellosis, the majority of which were reported in Italy, Spain, and Bulgaria.[12]European Centre for Disease Prevention and Control. Trichinellosis - annual epidemiological report for 2019. Nov 2021 [internet publication].
https://www.ecdc.europa.eu/en/publications-data/trichinellosis-annual-epidemiological-report-2019
The overall EU/EEA notification rate was 0.02 cases per 100,000 population in 2019.[12]European Centre for Disease Prevention and Control. Trichinellosis - annual epidemiological report for 2019. Nov 2021 [internet publication].
https://www.ecdc.europa.eu/en/publications-data/trichinellosis-annual-epidemiological-report-2019
Trichinellosis has, however, re-emerged in eastern Europe, presumably as a consequence of the political and economic disruption of the 1990s.[13]Blaga R, Durand N, Antoniu S, et al. A dramatic increase in the incidence of human trichinellosis in Romania over the past 25 years: impact of political changes and regional food habits. Am J Trop Med Hyg. 2007;76:983-986.
http://www.ajtmh.org/cgi/content/full/76/5/983
http://www.ncbi.nlm.nih.gov/pubmed/17488927?tool=bestpractice.com
[14]Hotez PJ, Gurwith M. Europe's neglected infections of poverty. Int J Infect Dis. 2011 Sep;15(9):e611-9.
https://www.doi.org/10.1016/j.ijid.2011.05.006
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[15]Vutova K, Velev V, Chipeva R, et al. Clinical and epidemiological descriptions from trichinellosis outbreaks in Bulgaria. Exp Parasitol. 2020 May;212:107874.
http://www.ncbi.nlm.nih.gov/pubmed/32179068?tool=bestpractice.com
[16]Dubinský P, Antolová D, Reiterová K. Human Trichinella infection outbreaks in Slovakia, 1980-2008. Acta Parasitol. 2016 Mar;61(2):205-11.
http://www.ncbi.nlm.nih.gov/pubmed/27078642?tool=bestpractice.com
Trichinellosis is common in many Asian and South American countries, including Argentina, Chile, Mexico, Thailand, Indonesia, Laos, Malaysia, and Myanmar.[2]Gottstein B, Pozio E, Nockler K. Epidemiology, diagnosis, treatment, and control of trichinellosis. Clin Microbiol Rev. 2009;22:127-45.
http://cmr.asm.org/cgi/content/full/22/1/127?view=long&pmid=19136437
http://www.ncbi.nlm.nih.gov/pubmed/19136437?tool=bestpractice.com
Epidemiologic data from China indicate that, during 2009-2020, human trichinellosis was principally localized in southwestern areas.[17]Zhang XZ, Wang ZQ, Cui J. Epidemiology of trichinellosis in the People's Republic of China during 2009-2020. Acta Trop. 2022 May;229:106388.
http://www.ncbi.nlm.nih.gov/pubmed/35231417?tool=bestpractice.com
Eight outbreaks were reported, seven of which were caused by ingesting raw or semi-cooked pork. Two deaths were reported among 479 cases.[17]Zhang XZ, Wang ZQ, Cui J. Epidemiology of trichinellosis in the People's Republic of China during 2009-2020. Acta Trop. 2022 May;229:106388.
http://www.ncbi.nlm.nih.gov/pubmed/35231417?tool=bestpractice.com
Human seroprevalence of swine anti-Trichinella IgG varied from 0% to 42% by province.[17]Zhang XZ, Wang ZQ, Cui J. Epidemiology of trichinellosis in the People's Republic of China during 2009-2020. Acta Trop. 2022 May;229:106388.
http://www.ncbi.nlm.nih.gov/pubmed/35231417?tool=bestpractice.com
Poor pig rearing practices and consumption of improperly cooked or raw pig meat have been implicated.[17]Zhang XZ, Wang ZQ, Cui J. Epidemiology of trichinellosis in the People's Republic of China during 2009-2020. Acta Trop. 2022 May;229:106388.
http://www.ncbi.nlm.nih.gov/pubmed/35231417?tool=bestpractice.com
[18]Cui J, Wang ZQ, Xu BL. The epidemiology of human trichinellosis in China during 2004-2009. Acta Trop. 2011;118:1-5.
http://www.ncbi.nlm.nih.gov/pubmed/21324302?tool=bestpractice.com
The prevalence of trichinellosis increases with advancing age, although there are no reported differences in the prevalence of the disease between men and women.[19]Zimmermann WJ, Steele JH, Kagan IG. Trichiniasis in the U.S. population, 1966-70. Prevalence and epidemiologic factors. Health Serv Rep. 1973;88:606-623.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1617023/pdf/healthservrep00033-0032.pdf
http://www.ncbi.nlm.nih.gov/pubmed/4795729?tool=bestpractice.com
Certain religious groups (Muslims, Jews, Seventh Day Adventists, and Rastafarians) are at lower risk of developing trichinellosis as their religions forbid the consumption of pork.[20]Akkoc N, Kuruuzum Z, Akar S, et al. Trichinellosis Outbreak Study Group. A large-scale outbreak of trichinellosis caused by Trichinella britovi in Turkey. Zoonoses Public Health. 2009;56:65-70.
http://www.ncbi.nlm.nih.gov/pubmed/18705658?tool=bestpractice.com
Certain religious rites may increase the risk of acquiring trichinellosis, such as the Romanian thanksgiving custom of “pig’s alms” (consumption of different pork products, including raw meat).[21]Neghina R. Trichinellosis, a Romanian never-ending story: an overview of traditions, culinary customs, and public health conditions. Foodborne Pathog Dis. 2010;7:999-1003.
http://www.ncbi.nlm.nih.gov/pubmed/20491611?tool=bestpractice.com