[Trichinellosis in Poland in 2010].Przegl Epidemiol 2012; 66(2):307-10PE
Trichinellosis is still an epidemiological problem in Poland as well as in other countries in the European Union (EU). Across the EU, reporting cases oftrichinellosis is mandatory. In Poland, tirchinellosis is an endemic disease, occurring mainly in territories where it is customary to eat raw meat products prepared from pigs and wild boars.
The aim of this work is to evaluate the epidemiological situation of trichinellosis in Poland in the year 2010 in comparison to previous years.
MATERIAL AND METHODS
Cases of trichinellosis infections were classified according to criteria contained in the definition approved by the European Committee on 28th April 2008 amending the decision 2002/253/EC, and was introduced in Poland in 2009. Case definitions used in are available at http://www.pzh. gov.pl/oldpage/epimeld/inne/Def_PL2_Rob1 h.pdf. An infection was classified and reported as Trichinella spp. if the genus of Trichinella that caused the infection was not specified using molecular examination.
In 2010 the number of registered human trichinellosis cases was similar to the average number of cases from the last several years, and it did not exceed 55 (the exceptions were in 2004 and 2007, when larger outbreaks occurred). In 2010, 51 Trichinella infections were registered, yielding an infection rate of 0.13 per 100 000 inhabitants. The infections occurred in 5 voivodeships (table 1). Using the criteria from the definitions, 41 cases were classified as probable and 10 were confirmed cases. Trichinella infections diagnoses were based on the presence of clinical symptoms and an epidemiological link. Serological diagnostic tests confirming the presence of Trichinella antibodies was performed in approximately 20% of the cases. Four individual cases were reported, along with 4 outbreaks in which a total of 47 people were infected? The infections were generally mild. Twenty-two infected persons were hospitalised (43%). Just like in previous years, no trichinellosis-related deaths were reported. The outbreaks of trichinellosis in 2010 occurred in voivodships where they are reported almost every year. Groups of 10 people and above were affected, consisting of family and friends. The incidence rate in three outbreaks ranged from 24% to 37%. In the Pomorskie voivodship this number was much higher--above 82%. This could mean that the infected products contained a large number of Trichinella larvae or that not all of the infected people were reached by the sanitary services. Small children are very rarely infected. In 2010 in the Wielkopolskie voivodeship, two such cases were reported in children who were 4 and 6 years old. Epidemiological investigation revealed that in the reported outbreaks the infections were most likely caused by the consumption of wild boar meat products, especially raw sausages. This finding was confirmed by analysing meat samples using the artificial digestion method. The particular genus of Trichinella was not specified in any of the cases and therefore they were classified as caused by Trichinella spp. The reason why infected wild boar meat was permitted to be consumed in two of the outbreaks was due to faulty carcass examination results. These examinations were conducted using the trichinoscopy method, which is still allowed in Poland despite being less sensitive than the artificial digestion method. In the Podlaskie voivodship outbreak the carcasses were not examined, and in the Pomorskie voivodship outbreak it could not be determined whether any examinations had been conducted. CONCLUSIONS. The annual occurrence of trichinellosis outbreaks and infections points to insufficient control of consumable meat products and lack of public awareness about the dangers of consuming raw/rare wild boar meat and pork that has not undergone prior veterinary inspection.