Diaz James H, Warren Rebecca J, Oster Marissa J
Program in Environmental and Occupational Health Sciences, School of Public Health, Louisiana State University Health Sciences Center (LSUHSC), New Orleans, LA.
Program in Environmental and Occupational Health Sciences, School of Public Health, Louisiana State University Health Sciences Center (LSUHSC), New Orleans, LA.
Wilderness Environ Med. 2020 Jun;31(2):235-244. doi: 10.1016/j.wem.2019.12.003. Epub 2020 Mar 10.
Historically, human trichinellosis was caused by Trichinella spiralis and transmitted to humans by consumption of undercooked domestic pork. Today, most cases of trichinellosis are caused by other Trichinella species and transmitted by consumption of raw or undercooked wild game meats. Given the increasing global prevalence of wild animal meat-linked trichinellosis, the objectives of this review are: 1) to describe the life cycle and global distribution of Trichinella worms; 2) to describe the changing epidemiology of trichinellosis; 3) to describe the clinical phases of trichinellosis; 4) to recommend the latest diagnostic tests; and 5) to recommend treatment and prevention strategies. Internet search engines were queried with keywords as subject headings to meet the objectives of this review. Although trichinellosis surveillance systems and laws regulating commercial pork production have limited T spiralis-caused trichinellosis in Europe and the United States, trichinellosis due to consumption of raw and undercooked wild boar and feral hog meat continues to occur throughout Southeast Asia. Trichinellosis due to consumption of raw or undercooked meats of other infected game, such as bear, deer, moose, and walrus, continues to occur worldwide. Only adherence to hygienic practices when preparing wild game meats and cooking wild game meats to recommended internal temperatures can prevent transmission of trichinellosis to humans. Wilderness medicine clinicians should be prepared to advise hunters and the public on the risks of game meat-linked trichinellosis and on how to diagnose and treat trichinellosis to prevent fatal complications.
从历史上看，人类旋毛虫病是由旋毛形线虫引起的，通过食用未煮熟的家猪肉传播给人类。如今，大多数旋毛虫病病例是由其他旋毛虫物种引起的，通过食用生的或未煮熟的野生动物肉传播。鉴于与野生动物肉相关的旋毛虫病在全球的患病率不断上升，本综述的目的如下：1）描述旋毛虫的生命周期和全球分布；2）描述旋毛虫病不断变化的流行病学；3）描述旋毛虫病的临床阶段；4）推荐最新的诊断测试；5）推荐治疗和预防策略。使用关键词作为主题词查询互联网搜索引擎以实现本综述的目的。尽管旋毛虫病监测系统以及规范商业猪肉生产的法律在欧洲和美国已经限制了由旋毛形线虫引起的旋毛虫病，但在整个东南亚，因食用生的和未煮熟的野猪和野猪猪肉而导致的旋毛虫病仍在继续发生。因食用其他受感染野味（如熊、鹿、驼鹿和海象）的生肉或未煮熟的肉而导致的旋毛虫病在全球范围内仍在继续发生。只有在准备野生动物肉时坚持卫生做法，并将野生动物肉煮至推荐的内部温度，才能防止旋毛虫病传播给人类。野外医学临床医生应准备好就与野味肉相关的旋毛虫病风险以及如何诊断和治疗旋毛虫病以预防致命并发症向猎人及公众提供建议。
