Trichiniasis is a name given to a disease produced by the embryos of
the trichina spiralis. In the adult condition the trichina spiralis
lives in the small intestines. The embryos migrate into the muscles
where they finally become encapsulated. Man is infected by eating
insufficiently cooked pork containing the encapsulated worm, which
is set free during the digestive process. About the third day they
attain their full growth and become sexually mature. Each one
discharges large numbers of embryos. As soon as born the young brood
is carried away from the bowel and invade the muscles through various
channels—principally by means of the blood stream and along the
connective tissue routes. The female trichina may bring forth several
broods of embryos in succession. In nine or ten days after infection
the first brood reaches its destination. They attain to maturity in
about two weeks after entering the muscular tissue. In this process an
interstitial myositis is excited and a fibrous capsule is formed in
four to six weeks. The capsule gradually becomes thicker and finally
calcareous infiltration may take place.
Thorough cooking destroys the parasite. The disease is most frequent
among the Germans who eat raw ham and sausages.
=Symptoms.=—These are sometimes absent, especially when only a few are
eaten. If large numbers have been ingested, gastro-intestinal symptoms
develop in the course of a few days. Vomiting, diarrhea, and pain in
the abdomen may be present.
In from one to two weeks muscular symptoms develop. There is fever,
muscular pain, especially during motion, and the muscles are stiff,
tense and sometimes swollen. When the respiratory muscles are involved
dyspnea is produced, which may prove fatal. Eosinophilia is a helpful
diagnostic point. Edema, especially of the face, is an important
symptom. Profuse sweats, itching and tingling of the skin have been
observed.
=Diagnosis.=—Epidemics of this disease are more easily diagnosed than
an isolated case. Among the Germans, if cases of apparent typhoid
fever occur after a picnic or other feasting occasion, where raw ham
or sausages have been indulged in, this disease should be suspected.
Examination of the stools and of the muscles will be of aid. The worms
may be discovered in the pork, a portion of which has been eaten by the
patient.
=Prognosis.=—This depends upon the number of worms ingested. The
prognosis should always be guarded. Early, marked diarrhea is favorable.
=Treatment.=—Prophylactic treatment is of great importance in
trichiniasis. Inspection of the meat supply, is doing much to prevent
trichiniasis; although the most practical way to prevent the disease is
to thoroughly cook all pork and sausages. The central portions of the
meat should be well cooked.
In the feeding of hogs care should be taken that they do not receive
any offal, but only milk, grain, vegetables, etc.
When a person is infected with trichiniasis, thorough and prompt
evacuation of the bowels should be performed at once, so that the
embryos will not have time to pass into the muscles, but will be
ejected from the body. This should be followed by a thorough and
persistent treatment for several days of the liver and intestines;
treat both the liver and intestines directly and through the spine.
The object of this treatment is to render all the digestive juices
active, so that they may dislodge the animal parasite, and to prevent
their passing into the muscles. Also keep the bowels active for several
days.
When the larval parasites have entered the muscles, a treatment cannot
be applied to affect them directly, but the health of the body should
be maintained if possible, and the severer symptoms, as the muscular
pains, weakness and insomnia combated. Thorough manipulation, massage
and hot baths will be of special aid in relieving the stiffness and
weakness of the muscles.