Trichinosis Food Poisoning

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KEY POINTS

• Trichinosis is an infection caused by a parasite that usually enters the body through food.
• Dehydration caused by diarrhea and vomiting can be very dangerous.
• You need to drink enough liquid to replace the fluids and minerals lost.
• Treatment may include medicine or IV fluids until your symptoms get better.

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What is trichinosis?

Trichinosis is an infection caused by a parasite called Trichinella. Because the parasite usually enters the body through food, it is also called food poisoning.

Trichinosis is rare in the US, but it is a common infection worldwide.

What is the cause?

The parasite can live in the animal or human intestine. You may get infected if:

• You eat raw or undercooked pork or pork products.
• You eat undercooked wild game.

What are the symptoms?

The time between when you eat food containing the parasite and when you first start having symptoms of the disease is generally 7 to 14 days. However, it’s possible to start having symptoms as soon as a day after you eat contaminated food. It’s also possible not to have any symptoms. The symptoms may last just a few days or they may last longer, changing over time.

Symptoms during the first week may include:

• Cramps or tenderness in your belly
• Generally not feeling well
• Nausea, vomiting, or diarrhea

Symptoms during the first month after infection may include:

• Muscle pain and tenderness
• Headache
• High fever that may reach 104°F (40°C) and sweating
• Redness of your eyes or swelling around your eyes
• Severe weakness
• Feeling out of breath or coughing
• Rash

Symptoms by the second month may include muscle pain, weakness, and a general feeling of poor health. These symptoms may last for several months.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• Muscle biopsy, which is the removal of a small sample of muscle tissue for testing

How is it treated?

Most people who have a mild infection get better without treatment.

For more severe illness, your healthcare provider may prescribe medicine to kill the parasite. Your provider may also recommend medicine to treat pain and fever.

If you have a severe infection, you may need to stay at the hospital. Your healthcare provider may prescribe high doses of steroid medicine to help control the symptoms. After 24 to 48 hours of high doses, you may then need lower doses for several days or weeks at home. Using a steroid for a long time can have serious side effects. Take the steroid medicine exactly as your healthcare provider prescribes. Don’t take more or less of it than prescribed by your provider and don’t take it longer than prescribed. Don’t stop taking a steroid without your provider's approval. You may have to lower your dosage slowly before stopping it.

How can I take care of myself?

Follow your healthcare provider’s instructions. Take your medicine exactly as it is prescribed. If you quit taking your medicine too soon, the infection may come back. If you have side effects from your medicine, talk to your provider.

Here are some things you can do to feel better:

• Rest your stomach and bowel but make sure that you keep getting fluids. You can do this by not eating anything and by drinking clear liquids only. Clear liquids include water, weak tea, fruit juice mixed half and half with water, Jell-O, or clear soft drinks without caffeine (like lemon-lime soda). Stir soda until the bubbles are gone (the bubbles can make vomiting worse).
• If you have been vomiting a lot, it’s best to have just small, frequent sips. Drinking too much at once may cause more vomiting. Avoid liquids that are acidic, like orange juice, or caffeinated, like coffee. If you have diarrhea, don’t drink milk.
• It may be easier to keep down liquids that are cold. Suck on ice chips or Popsicles if you feel too sick to sip fluids. Build up to drinking larger amounts of clear fluids. If you vomit, wait an hour and then start over with small sips.
• If you have severe vomiting or diarrhea, your body can lose too much fluid and you can get dehydrated. Dehydration can be very dangerous, especially for children and older adults. You may also be losing minerals that your body needs to keep working normally. Your healthcare provider may recommend an oral rehydration solution, which is a drink that replaces fluids and minerals.
• You may start eating soft, plain foods when you have not vomited for several hours and are able to drink clear liquids without further upset. Good choices are soda crackers, toast, plain noodles, or rice, cooked cereal, applesauce, and bananas. Eat slowly and avoid foods that are hard to digest or may irritate your stomach, such as foods with acid (like tomatoes or oranges), spicy or fatty food, meats, and raw vegetables. You may be able to go back to your normal diet in a few days.
• Rest as much as possible. Sit or lie down with your head propped up. Don’t lie flat for at least 2 hours after eating.
• Don’t take aspirin, ibuprofen, or other nonsteroidal anti-inflammatory drugs (NSAIDS) without checking first with your healthcare provider. NSAIDs, such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take this medicine for more than 10 days.

Ask your healthcare provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent trichinosis?

These steps can help prevent food poisoning:

• Wash your hands and clean any dishes or utensils before you prepare, cook, or serve food. Keep kitchen counters and other food preparation surfaces clean. Replace used dishcloths and kitchen towels with clean ones often.
• Cook food thoroughly, especially pork and wild game meats. Pork should be heated to an internal temperature of at least 160°F (71°C). Freezing meats, even for long periods of time, may not kill all parasites unless an extremely cold temperature is used, such as minus 14°F (minus 26°C) or lower.
• Thaw frozen meats in the refrigerator or a microwave. Do not let meat stand at room temperature.
• Refrigerate any food you will not be eating right away.
• Wash your hands before preparing food, after you go to the bathroom, and after touching animals.
• When you travel to places where contamination is more likely, eat only hot, freshly cooked food.
• If you take care of young children, wash your hands often and dispose of diapers carefully so that bacteria can't spread to other surfaces or people.