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TRICHINOSIS

DESCRIPTION

Trichinosis is an infection caused by larvae of parasites that live in the intestines of pigs and bears. Body parts involved include the gastrointestinal tract (where larvae enter), the lymphatic system and bloodstream (through which they are transported), and the large muscles of the body, especially the diaphragm large muscle used in breathing that separates the chest from the abdomen, arms, and legs (in which larvae become embedded).
Appropriate health care includes:
  • Self-care after diagnosis.
  • Physician's monitoring of general condition and medications.
  • Hospitalization (worst cases).

    SIGNS & SYMPTOMS
    Early stages (usually begin in 7 to 10 days):

  • Loss of appetite, nausea, vomiting, diarrhea, and abdominal cramps. Later stages:
  • Puffy eyelids and face.
  • Muscle pain.
  • Itching, burning skin.
  • Sweating.
  • High fever (102F to 104F or 38.9C to 40C). Late stages:
  • Symptoms subside, but some muscle tissues remain permanently infected with microscopic cysts. In rare cases these may cause your child heart and central nervous system disorders.

    CAUSES
    Infection with a parasite, trichina spiralis, which is transmitted to children when they eat infected animals. Thorough cooking kills the parasite and makes infected meat safe to eat. The parasites pass from animal to animal in contaminated food -- usually raw garbage.

    RISK FACTORS

  • Eating improperly cooked or raw pork or bear meat.
  • Use of immunosuppressive drugs.

    PREVENTING COMPLICATIONS OR RECURRENCE

    Your child should not eat raw or undercooked pork (including sausage) or bear meat.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory blood studies.
  • Muscle biopsy.

    POSSIBLE COMPLICATIONS

    Overwhelming infection, which can lead to:
  • Congestive heart failure.
  • Respiratory failure.
  • Permanent damage to the child's central nervous system.

    PROBABLE OUTCOME
    Usually curable in most children with anti-parasite drugs and, in severe cases, expert supportive care. Some deaths have been reported. Allow up to 6 months for your child's recovery.

    TREATMENT

    HOME CARE

    Reduce the child's fever if it goes over 103F (39.4C). See Appendix 17, How to Reduce Your Child's Fever.

    MEDICATION

  • Your doctor may prescribe anti-helminthic drugs (usually thiabendazole) to kill the parasites.
  • You may give the child non-prescription drugs, such as acetaminophen, to reduce fever and discomfort.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    Your child should rest in bed until the symptoms subside. While the child is confined to bed, moving the legs frequently reduces the likelihood of deep-vein blood clots. Normal activities may be resumed gradually.

    DIET & FLUIDS
    Your child should eat a special high-protein diet to help rebuild damaged muscle tissue. The diet will be prescribed by your doctor and explained by a dietitian. Usually the child can progress to an unrestricted, well-balanced diet within 6 months.

    OK TO GO TO SCHOOL?

    When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

  • Your child has symptoms of trichinosis.
  • The following occurs during treatment: -- Fever spikes (rises suddenly) to over 104F (40C). -- Irregular heartbeat. -- Shortness of breath. -- Puffy ankles. -- Clumsy finger or thumb movement.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects, especially nausea, vomiting, skin rash, or fever. ‡
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