International Commission on Trichinellosis: Recommendations on post-harvest control of Trichinella in food animals.

Domestic and wild animals which consume meat are at risk of becoming infected with Trichinella and therefore may pose a public health risk. Among domestic livestock, pigs are most commonly associated with Trichinella infection, but human outbreaks have also resulted from consumption of horsemeat, wild boar, bear, walrus and other wild animals. For animals that are not produced under controlled management conditions and for wild animals, specific steps should be taken to prevent human exposure to Trichinella. These steps include appropriate testing of individual carcasses to identify those that pose a public health risk, post-slaughter processing to inactivate Trichinella in meat that might be infected, and education of consumers regarding the need for proper preparation methods for meat that might contain Trichinella larvae. The International Commission on Trichinellosis recognizes three (3) acceptable means of treatment to render potentially Trichinella-infected meats safe for consumption: 1) cooking, 2) freezing (for meat from domestic pigs), and 3) irradiation. Proper use of these methods is described here, along with specific cautions on use of other methods, including curing and heating with microwaves.

International Commission on Trichinellosis: Recommendations for quality assurance in digestion testing programs for Trichinella.

Effective performance of digestion testing methods for Trichinella, and their use for the detection of infected animals and the prevention of human trichinellosis require system-wide incorporation of appropriate quality assurance (QA) practices. The recommendations of the International Commission on Trichinellosis (ICT) aim to facilitate reliable test results when laboratories operate within a quality management system (QMS) which includes: 1) a quality manual (or similar documentation of the QMS); 2) a validated test method with identified critical control points; 3) a training program; 4) procedures utilizing proficiency testing and other methods to confirm technical capability of analysts; 5) equipment calibration and maintenance; 6) standard operating procedures, related documentation and reporting; 7) procedures to enable continuous monitoring and improvements; and 8) regular internal and third party audits. The quality manual or similar documentation describes the QMS within a testing laboratory, and lists the QA policies and good laboratory practices. Quality assurance goals contained in such documentation are the foundation of an effective QA program and must be explicit, measurable, and expressed in terms of performance criteria for the test method based on purpose for testing. The digestion method is capable of consistently detecting Trichinella larvae in meat at a level of sensitivity that is recognized to be effective for use in controlling animal infection and preventing human disease. However, consistent performance of the assay is assured only when parameters of the test method have been defined, scientifically validated as fit for purpose, and used within an effective QMS. The essential components of a digestion assay, specifically the critical control points and minimum standards for test performance are described. Reliable proficiency samples and their appropriate use in a quality system are key factors for certifying and maintaining an effective testing laboratory, including qualifying, re-qualifying and disqualifying of analysts as appropriate. Thus recommendations are included for the preparation and use of proficiency samples in a Trichinella digestion testing laboratory. The minimum training requirements for analysts performing a quality assured digestion assay, as well as suggested requirements for the content of a training manual, are also outlined. Finally, these ICT recommendations include essential components and minimum standards for maintaining and achieving certification and maintenance of a laboratory performing digestion testing for Trichinella. The certification program for the laboratory, including qualifying analysts, may be administered by a National Reference Laboratory or an authorized third party certifying body, under the auspices of the appropriate competent authority.

Association of angiopoietin-2 and dimethylarginines with complicated course in patients with leptospirosis.

Leptospirosis is one of the most relevant zoonosis worldwide and a potentially life-threatening infectious disease. While it is frequent in tropic regions, it is uncommon in European industrialized countries. Angiopoietin-2 (Angpt-2) and asymmetric and symmetric dimethylarginine (ADMA and SDMA) are markers of endothelial activation and systemic inflammation. These parameters have been studied recently in the context of sepsis and MODS showing potential to determine disease severity and outcome specific parameters like acute kidney injury (AKI) and survival. These biomarkers were measured in 13 patients with leptospirosis. High levels of Angpt-2 were statistically significant associated with a complicated clinical course with occurrence of AKI, Sepsis and intensive care unit treatment. ADMA was significantly associated with occurrence of AKI and ICU treatment whereas SDMA was associated with AKI. Therefore these endothelial markers may serve as additional tools for risk stratification in these patients.

Trichinella spp. infection in horses of Romania: serological and parasitological survey.

Herbivorous animals are usually, by virtue of their diet, outside the major transmission cycles of Trichinella spp. However, since 1975, the year of the first report of human trichinellosis caused by the consumption of infected horse meat, the domestic horse has appeared as a novel vector of Trichinella spp. infection to humans, with 15 outbreaks documented in France and Italy. Romania, one of the main countries exporting horses into the European Union (EU), experienced a dramatic increase of Trichinella spp. infection in both domestic pigs and humans in the 1990s. Some Trichinella spiralis-infected horses were exported to the EU during this period. The aim of this study was to evaluate the prevalence of Trichinella spp. infections in horses from Romania using both direct and indirect tests. Of 3000 serum samples tested in 2001, none were positive by ELISA using three different Trichinella antigens (crude; excretory/secretory, ES; stg-BSA antigens). Of 2992 serum samples tested in 2002, 17 (0.56%) showed optical density values higher than the cut-off in an ELISA using ES antigens and one was confirmed by western blot (WB). Four of the 17 ELISA positive horses, including the horse with a confirmed serology by WB, were subjected for intensive meat examination at slaughter, but no Trichinella spp. larvae were detected. Further, no Trichinella spp. larvae were detected by trichinelloscopy and artificial digestion of 25,838 horses slaughtered in Alexandria and Timisoara between 2001 and 2004. The false positive results obtained by serology confirm the previous work on the unreliability of serology for detection of Trichinella spp. infection in horses. Furthermore, the lack of detection of Trichinella spp. infected horses by artificial digestion, suggests a very low prevalence of infection in horses in Romania.

Swine infection with Trichinella spiralis: Comparative analysis of the mucosal intestinal and systemic immune responses.

The immune protective response developed by swine against Trichinella spiralis is not yet fully understood, particularly at the mucosal level. This study aimed to characterise intestinal immunity to T. spiralis by comparison with the systemic response in specifically pathogen-free pigs. For this purpose, the kinetics of cytokine and antibody production were assessed in the intestinal mucosa and serum of swine infected with T. spiralis for up to 60 days post-infection (dpi). An ex vivo model of jejunum mucosa culture was used to collect the supernatant as a source of antibodies (Abs). Mucosal antibodies were observed by Western blot from 15 dpi, while serum antibodies were expressed from 20 dpi. Both sources of antibodies initially recognized a 110 kDa protein, followed by the identification of 35, 43/46 and 55/59 kDa proteins. IgG1 and IgA antibodies were strongly expressed within the mucosa. The expression levels of Type 1 (IFN-gamma, IL-12), Type 2 (IL-4, IL-6), pro-inflammatory (TNF-alpha) and regulatory (IL-10, TGF-beta) cytokines were assessed by RT-PCR in the intestinal mucosa and spleen. Both IL-10 and IFN-gamma mRNA levels were increased in mucosa, whereas IL-6 and IL-12 mRNA were expressed in spleen. Taken together, these results demonstrated a mixed Type 1/Type 2 profile, the Type 2 profile being dominant in the mucosa.

A field study to estimate the prevalence of Trypanosoma equiperdum in Mongolian horses.

From May to July 2000, a cross-sectional study was conducted to estimate the prevalence of Trypanosoma equiperdum in the horse population of the central province (Tuv aimag) of Mongolia. On average, four herds were selected from each of the 29 aimag subdivisions (119 herds). From each herd, 10 horses were sampled in proportion to sex and age categories in the respective herds (1190 horses). Sera from 1122 horses were analysed for T. equiperdum antibodies using two serological assays, the complement fixation test (CFT) and the enzyme-linked immunosorbent assay (ELISA). The crude estimate of the CFT and the ELISA seroprevalence was 7.6 and 6.7%, respectively. Concordance between the CFT and ELISA results was high (96%). The highest number of CFT positive animals was detected in one herd in Möngönmorit (6/10), followed by herds in Bayandelger (5/10) and in Bayantsagaan (5/10). Poor body condition was significantly correlated with positive serological status in both CFT and ELISA. A history of abortion appeared to be a risk factor for both CFT and ELISA seropositivity. Blood samples of all horses belonging to herds with at least three (3/10) seropositive animals (CFT and/or ELISA) were analysed by light microscopy and by PCR using a Trypanosoma (Trypanozoon) brucei specific primer pair. No trypanosomes or any other haemoparasites could be detected in Giemsa stained thin blood smears. Eight out of the 130 samples (6.2%) analysed by PCR gave positive signals. Seven out of the eight PCR positive horses were also serologically positive. One PCR (and ELISA) positive stallion from Möngönmorit showed emaciation, scrotal and preputial oedema and an oedematous skin plaque. From the serological and DNA-based results it is concluded, that trypanosome infections occur in horses in the Tuv aimag of Mongolia. Since at present neither serological nor DNA-based tests allow a subspecies specific identification within the subgenus Trypanozoon, no definitive diagnosis can be given for T. equiperdum. Whether the examined herds are infected with T. equiperdum or with T. evansi, the causative agent of surra, remains an open question. However, based on the clinical findings, the negative parasitological results and the concentration of conspicuous seroprevalences in single herds, circumstantial evidence supports the existence of infections with the causative agent of dourine.