Trichinella britovi outbreak in Piedmont, North-West Italy, 2019–2020: Clinical and epidemiological insights in the one health perspective. Issue 47 (May 2022)

• Record Type: Journal Article
• Authors: Stroffolini, Giacomo; Rossi, Luca; Lupia, Tommaso; Faraoni, Silvia; Paltrinieri, Giovanna; Lipani, Filippo; Calcagno, Andrea; Bonora, Stefano; Di Perri, Giovanni; Calleri, Guido
• Is Part Of: Travel medicine and infectious disease. Issue 47(2022)
• Publication Date: 2022-05
• Subjects: Trichinellosis -- Surveillance -- Epidemic -- Wild boar; Travel -- Health aspects -- Periodicals; Communicable diseases -- Periodicals; Tropical medicine -- Periodicals; 610.5
• DOI: 10.1016/j.tmaid.2022.102308
• Languages: English
• ISSNs: 1477-8939

Abstract

Abstract: Background: Trichinellosis, a foodborne zoonosis due to nematodes of the genus Trichinella, occurs in the form of outbreaks following meat consumption. North Italy has been rarely involved. We report here the most significant wildlife derived trichinellosis outbreak ever registered in the Piedmont region. Method: We retrospectively included 96 outpatients referred to our institution (December 20th, 2019–January 15th, 2020) 2020 after consuming raw sausages prepared from a single wild boar hunted in the Susa Valley, 59 km away from Torino, in November 2019. Results: We confirmed 35 cases and found additional 10 probable/suspected cases. Our cohort found that 47% of patients were symptomatic, with a median time from symptoms to presentation at clinic and serology testing of 14 days. Peripheral blood eosinophilia >500/μl and CK alterations were common. Further qualitative and quantitative analysis at the International Trichinella Reference Center c/o ISS, Rome identified T. britovi as the causative agent. Conclusions: No autochthonous human case has ever been detected in Torino province, and a single wild boar has tested positive for Trichinella since active surveillance was implemented in 2013. This outbreak should raise attention on the preventive role of veterinary surveillance and the need to optimize sampling procedures and targeted health education. Highlights: Trichinellosis, a foodborne zoonosis due to nematodes of the genus Trichinella, occurs in the form of outbreaks. North Italy has been rarely involved. We report the most significant wildlife-derived outbreak in Piedmont region. This report proves that zoonotic foodborne transmission of Trichinella is not an extinguished problem. Possible explanations for the mild clinical picture are the involved species and the low quantity of larvae in the meat. In view of the evolving global picture of climate change, we must continue raising attention about this parasite.