Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University - Sofia, Specialized Hospital of Infectious and Parasitic Diseases "Prof. I. Kirov", 1606, Acad. I. Geshov Blvd 17, Sofia, Bulgaria.
Department of Infectious Diseases, Parasitology and Tropical Medicine, Medical University - Sofia, Specialized Hospital of Infectious and Parasitic Diseases "Prof. I. Kirov", 1606, Acad. I. Geshov Blvd 17, Sofia, Bulgaria.
Exp Parasitol. 2020 May;212:107874. doi: 10.1016/j.exppara.2020.107874. Epub 2020 Mar 13.
Bulgaria is one of European countries where trichinellosis continues to be regularly diagnosed and registered. The clinical and epidemiological features of 72 cases of trichinellosis associated with five outbreaks caused by Trichinella spiralis and Trichinella britovi between 2009 and 2011, are described. At hospital admission, patients were often initially treated with antibiotics, without any improvement. A range of signs and symptoms were recorded, including: myalgia, elevated temperature, arthralgia, difficulty with movement, facial oedema, conjunctival hyperaemia, ocular haemorrhages, diarrhoea, skin rash, headache, and fatigue. Due to the variable clinical course of the disease, the diagnostic process for trichinellosis is often complex and difficult. This means the diagnosis may be established late for an appropriate treatment, potentially leading to a severe course of the disease with complications. Laboratory abnormalities were expressed by marked eosinophilia (97.2%), leucocytosis (70.8%), elevated serum creatine phosphokinase levels (82%), and antibody-positive results by ELISA and indirect hemagglutination. Patients were treated with albendazole (Zentel) 10 mg/kg for 7-10 days. In two outbreaks, the aetiological agent was T. spiralis, in one outbreak T. britovi, and an unknown Trichinella species in the fourth outbreak. The sources of infection were domestic pigs, probably fed with scraps and offal of wild game. In one outbreak, T. spiralis was also detected in brown rats trapped close to where the pig had been raised in the backyard. These epidemiological factors are relevant in considering implementation of targeted control programmes.
保加利亚是一个在欧洲，旋毛虫病继续定期诊断和注册的国家。描述了 2009 年至 2011 年期间由旋毛虫和布氏旋毛虫引起的五起旋毛虫病相关的 72 例病例的临床和流行病学特征。在住院时，患者通常首先接受抗生素治疗，但没有任何改善。记录了一系列症状和体征，包括肌痛、发热、关节炎、运动困难、面部水肿、结膜充血、眼部出血、腹泻、皮疹、头痛和疲劳。由于该病的临床病程多变，旋毛虫病的诊断过程往往复杂且困难。这意味着可能会延迟适当的治疗，导致疾病严重并出现并发症。实验室异常表现为明显的嗜酸性粒细胞增多症（97.2%）、白细胞增多症（70.8%）、血清肌酸磷酸激酶水平升高（82%），以及 ELISA 和间接血凝试验的抗体阳性结果。患者用阿苯达唑（丙硫咪唑）10mg/kg 治疗 7-10 天。在两次暴发中，病原体是旋毛虫，一次暴发是布氏旋毛虫，第四次暴发是未知的旋毛虫。感染源是家猪，可能食用了来自野生猎物的残余物和内脏。在一次暴发中，后院饲养猪的地方附近捕获的褐鼠中也检测到了旋毛虫。这些流行病学因素与考虑实施有针对性的控制计划有关。
