The Trichinella notification rate in Europe almost doubled in 2019 compared to 2018, according to recently published data.

In 2019, 12 countries reported 141 cases of trichinellosis of which 96 were confirmed. Bulgaria with 55 confirmed cases, Italy with 10 and Spain with 40 but only 12 confirmed accounted for most of these. Romania recorded 21 cases but only six were confirmed.

Trichinellosis, or trichinosis, is a disease transmitted by eating raw or undercooked pork contaminated with the parasite Trichinella. It can take up to eight weeks for symptoms to develop.

The highest reporting rate was in males aged 25 to 44 years old. Higher rates in males than females were observed in five out of six age groups. Bulgaria was the only country to report cases in 0 to 4 years old with both being males, according to data published by the European Centre for Disease Prevention and Control (ECDC).

In 2018, only 66 infections were reported with 45 of these coming from Bulgaria. This was the lowest rate since the start of EU-level surveillance in 2007. The number of confirmed cases in 2019 was still lower than the five-year average in the European region.

Case numbers typically peak between January and February. This recurring peak may reflect the consumption of various pork products during the Christmas holiday period and the wild boar hunting season, said ECDC. In 2019, a peak in December was because of a foodborne outbreak in Italy caused by Trichinella britovi.

Five outbreaks recorded
Bulgaria reported two trichinellosis outbreaks to the European Food Safety Authority (EFSA) while Croatia, Italy and Romania all had one each.

The two foodborne outbreaks in Bulgaria were caused by unspecified Trichinella species and involved 27 people, including one person who required hospitalization.

Trichinella spiralis was implicated in the two outbreaks reported by Croatia and Romania that involved three and five cases, respectively, all of which needed hospitalization. The outbreaks in Bulgaria, Croatia and Romania were associated with pig meat and products including wild boar.

The outbreak reported by Italy was caused by Trichinella britovi and three out of nine people were hospitalized; wild boar meat products were the implicated vehicle.

Bulgaria, Croatia, France, Poland, Romania and Spain reported positive infections in domestic pigs not raised under controlled housing conditions. EU regulation requires tests for Trichinella in all slaughtered pigs, wild boars, horses and other farmed or wild animals susceptible to Trichinella infestation from sites not officially recognized as applying controlled housing conditions. Animals slaughtered for home consumption are not included in this law and national rules differ.

There is a relationship between the lack of awareness and low-income of consumers living in rural areas, an inadequacy of local veterinary meat inspection services, and the occurrence of Trichinella in domestic animals in EU and non-EU countries, said ECDC.

Consumption of undercooked meat from pigs raised under non-controlled housing conditions or hunted wild boar was the highest risk for acquiring trichinellosis in Europe.

About symptoms
Initial symptoms of infection in people are nausea, diarrhea, vomiting, fatigue, fever, and abdominal discomfort. Headaches, fevers, chills, cough, swelling of the face and eyes, aching joints and muscle pains, itchy skin, diarrhea or constipation may follow.

Abdominal symptoms can occur one to two days after infection. Further symptoms usually start two to eight weeks after eating contaminated meat. Freezing, curing or salting, drying, smoking, or microwaving meat may not kill infective worms.

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