5-50
Clinical Disease in Animals: Fluid-filled vesicle in the skeletal and cardiac musculature
Probable Mode of Transmission: Ingestion of undercooked pork containing Cysticercus cellulosae
Known Distribution: Worldwide where swine are raised; rare in USA, Canada, UK, Scandinavia
Echinococcosis (Cystic hydrated disease)
Agent: Echinococcus granulosus
Principal Animal Hosts: Dogs, cattle, sheep, swine, rodents, deer
Clinical Disease in Animals: Typically asymptomatic
Probable Mode of Transmission: Ingestion of tapeworm eggs
Known Distribution: worldwide
Dipylidiasis (Dog tapeworm)
Agent: Dipylidium caninum
Principal Animal Hosts: Dogs, cats, fleas
Clinical Disease in Animals: Asymptomatic, flea infestation
Probable Mode of Transmission: Ingestion of fleas
Known Distribution: Worldwide
ID: Trichinellosis (Trichinosis)
LTC Glenn Wortmann, MC, USAIntroduction: Trichinosis develops when undercooked meat contaminated with Trichinella spiralis is ingested.
Most infections result from eating undercooked pork, although bear or walrus meat can transmit the infection.
Symptoms appear from a few to 15 days after ingestion.
Subjective: Symptoms
Most infections are asymptomatic. For heavier exposures, diarrhea, fever, periorbital edema, photophobia
and muscle pain occurs.
Focused History: Have you eaten undercooked pork in the last few weeks? (Symptoms peak 2-3 weeks after
ingestion) Are your muscles sore and weak? (myalgias and weakness are common) How long have you been
having symptoms? (Trichinosis is usually a self-limited infection, lasting for a few weeks).
Objective: Signs
Using Basic Tools: Fever, splinter hemorrhages under the nails and conjunctivae, upper eyelid edema,
muscle tenderness
Using Advanced Tools: Lab: Review of peripheral blood smears will show an increased number of
eosinophils.
Assessment: Fever and myalgias after recent ingestion of pork is very suggestive of trichinosis
Differential Diagnosis: Fever and muscle tenderness - myositis, tetanus and schistosomiasis (Katayama
fever)
Plan:
Treatment: Supportive therapy with bed rest and pain medication. In the rare event that a patient is known
to have eaten infected meat within a week, mebendazole 200-400 mg po tid x 3 days, then 400-500 mg po tid
x 10 days can be given. Mebendazole is only effective against intestinal worms. It does not kill muscle larvae,
so it has no effect on established infections.
Patient Education
General: Avoid improperly prepared foods
Activity: As tolerated
Diet: As tolerated
Medications: Occasional gastrointestinal side effects