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Trichinella Nativa Outbreak With Rare Thrombotic Complications Associated With Meat From a Black Bear Hunted in Northern Ontario.
Clin Infect Dis 2017; 64(10):1367-1373CI

Abstract

Background

Although trichinellosis is known to cause thrombotic disease, serious thrombotic events are rare and have not been previously associated with Trichinella nativa infection.

Methods

Patient interviews and medical chart reviews were conducted on 10 men who became ill following consumption of a common source of black bear meat. Trichinella serology on patient sera as well as polymerase chain reaction (PCR) and larval identification of the meat samples was conducted.

Results

All 10 exposed individuals developed an acute illness clinically compatible with trichinellosis, characterized by fever, abdominal pain, and diarrhea, along with eosinophilia ranging from 0.9 × 109/L to 6.1 × 109/L. Within 2 weeks of the diarrheal illness, systemic symptoms developed in all exposed individuals characterized by fever, myalgia, periorbital edema, and fatigue. ST-elevation myocardial infarction and sinus venous tract thrombosis occurred as a complication of trichinellosis in 2 patients. Acute serology was nonreactive in all patients, though convalescent serology was reactive in 6 of 8 (75%) patients for whom sera was available. Multiplex PCR identified T. nativa from the bear meat, and was corroborated by microscopic larval identification.

Conclusions

We report a 100% attack rate of T. nativa from bear meat among those who were exposed, and demonstrate that this species can cause serious thrombotic complications of trichinellosis in humans. Education of hunters and the public regarding the importance of proper preparation of wild game prior to ingestion is warranted.

Authors+Show Affiliations

Northern Ontario School of Medicine, Thunder Bay, Canada.US Department of Agriculture, Animal Parasitic Diseases Laboratory, Beltsville, Maryland.Government of Northwest Territories, Department of Environment and Natural Resources, Fort Simpson, and.US Department of Agriculture, Animal Parasitic Diseases Laboratory, Beltsville, Maryland.Northern Ontario School of Medicine, Thunder Bay, Canada.Northern Ontario School of Medicine, Thunder Bay, Canada.Public Health Ontario, Toronto.Public Health Ontario, Toronto.Public Health Ontario, Toronto.Public Health Ontario, Toronto. St Joseph's Health Sciences Centre, Toronto.Public Health Ontario, Toronto. Tropical Disease Unit, Toronto General Hospital, and. Department of Medicine, University of Toronto, Ontario, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28329274

Citation

Dalcin, Daniel, et al. "Trichinella Nativa Outbreak With Rare Thrombotic Complications Associated With Meat From a Black Bear Hunted in Northern Ontario." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 64, no. 10, 2017, pp. 1367-1373.
Dalcin D, Zarlenga DS, Larter NC, et al. Trichinella Nativa Outbreak With Rare Thrombotic Complications Associated With Meat From a Black Bear Hunted in Northern Ontario. Clin Infect Dis. 2017;64(10):1367-1373.
Dalcin, D., Zarlenga, D. S., Larter, N. C., Hoberg, E., Boucher, D. A., Merrifield, S., ... Boggild, A. K. (2017). Trichinella Nativa Outbreak With Rare Thrombotic Complications Associated With Meat From a Black Bear Hunted in Northern Ontario. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 64(10), pp. 1367-1373. doi:10.1093/cid/cix165.
Dalcin D, et al. Trichinella Nativa Outbreak With Rare Thrombotic Complications Associated With Meat From a Black Bear Hunted in Northern Ontario. Clin Infect Dis. 2017 May 15;64(10):1367-1373. PubMed PMID: 28329274.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trichinella Nativa Outbreak With Rare Thrombotic Complications Associated With Meat From a Black Bear Hunted in Northern Ontario. AU - Dalcin,Daniel, AU - Zarlenga,Dante S, AU - Larter,Nicholas C, AU - Hoberg,Eric, AU - Boucher,Daniel A, AU - Merrifield,Samuel, AU - Lau,Rachel, AU - Ralevski,Filip, AU - Cheema,Karamjit, AU - Schwartz,Kevin L, AU - Boggild,Andrea K, PY - 2016/11/25/received PY - 2017/02/15/accepted PY - 2017/3/23/pubmed PY - 2018/1/24/medline PY - 2017/3/23/entrez KW - Trichinella nativa KW - black bear KW - eosinophilia KW - thrombotic sequelae. KW - trichinellosis SP - 1367 EP - 1373 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin. Infect. Dis. VL - 64 IS - 10 N2 - Background: Although trichinellosis is known to cause thrombotic disease, serious thrombotic events are rare and have not been previously associated with Trichinella nativa infection. Methods: Patient interviews and medical chart reviews were conducted on 10 men who became ill following consumption of a common source of black bear meat. Trichinella serology on patient sera as well as polymerase chain reaction (PCR) and larval identification of the meat samples was conducted. Results: All 10 exposed individuals developed an acute illness clinically compatible with trichinellosis, characterized by fever, abdominal pain, and diarrhea, along with eosinophilia ranging from 0.9 × 109/L to 6.1 × 109/L. Within 2 weeks of the diarrheal illness, systemic symptoms developed in all exposed individuals characterized by fever, myalgia, periorbital edema, and fatigue. ST-elevation myocardial infarction and sinus venous tract thrombosis occurred as a complication of trichinellosis in 2 patients. Acute serology was nonreactive in all patients, though convalescent serology was reactive in 6 of 8 (75%) patients for whom sera was available. Multiplex PCR identified T. nativa from the bear meat, and was corroborated by microscopic larval identification. Conclusions: We report a 100% attack rate of T. nativa from bear meat among those who were exposed, and demonstrate that this species can cause serious thrombotic complications of trichinellosis in humans. Education of hunters and the public regarding the importance of proper preparation of wild game prior to ingestion is warranted. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/28329274/Trichinella_Nativa_Outbreak_With_Rare_Thrombotic_Complications_Associated_With_Meat_From_a_Black_Bear_Hunted_in_Northern_Ontario_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cix165 DB - PRIME DP - Unbound Medicine ER -