Brotes epidémicos de triquinosis ocurridos en Aragón durante el periodo 1998-2017

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Abstract

RESUMEN Fundamentos: En Aragón, los controles oficiales veterinarios para detectar la presencia de triquina en productos cárnicos, han permitido que la triquinosis sea una enfermedad de baja incidencia, que se presenta en forma de brotes, asociados al consumo familiar de productos cárnicos no controlados sanitariamente. El objetivo del trabajo fue describir las características epidemiológicas de los brotes de triquinosis ocurridos en Aragón durante el periodo de estudio y las medidas de actuación llevadas a cabo, lo que sirvió de base para rediseñar y fortalecer las medidas de prevención y control. Métodos: Estudio descriptivo de las características tiempo, lugar, persona, alimentos implicados, agente etiológico y medidas de control implementadas en los brotes identificados por la Red de Vigilancia Epidemiológica de Aragón desde el 01/01/1998 al 31/12/2017. Para el análisis descriptivo se calcularon la media con su desviación estándar y las proporciones. Resultados: Durante el periodo de estudio (desde el 01/01/1998 hasta el 31/12/2017) se declararon 7 brotes familiares con 294 expuestos, 103 casos (Tasa de Ataque 35%), de los que 29 fueron hospitalizados (28,1%). La tasa de letalidad fue del 1%. La media de edad de los casos fue de 43,3 años (desviación típica 15,9). El 70,8% de los casos fueron varones. Los brotes se concentraron entre diciembre y mayo. Cinco brotes se originaron tras el consumo de jabalí. El agente etiológico aislado en muestras cárnicas y/o muestras biológicas procedentes de los casos, fue Trichinella spiralis en cuatro brotes y Trichinella britovi en otros dos brotes. En todos los brotes las actuaciones se realizaron conforme a las recomendaciones establecidas por la Red Nacional de Vigilancia Epidemiológica (RENAVE). Conclusiones: La triquinosis en Aragón se presenta en forma de brotes familiares esporádicos coincidentes con la época de caza de jabalí y matanza domiciliaria del cerdo y se asocia al consumo de productos cárnicos no controlados sanitariamente, por lo que es necesario reforzar la educación para la salud y la colaboración intersectorial en la elaboración e implantación de estrategias de prevención y control.

Translated abstract

ABSTRACT Background: In Aragon, official veterinary controls to detect the presence of Trichinella in meat products have allowed trichinosis to be a low-incidence disease in the form of outbreaks associated with family consumption of meat products that are not sanitarily controlled. The aim of the work was to describe the epidemiological characteristics of the trichinosis outbreaks that occurred in Aragon during the study period and the action measures carried out, which served as a basis for redesigning and strengthening prevention and control measures Methods: Descriptive study of the characteristics of time, place, person, food implicated, etiological agent and control measures implemented in the outbreaks identified by the Epidemiological Surveillance Network of Aragón from 01/01/1998 to 31/12/2017. For the descriptive analysis, the mean with its standard deviation and proportions were calculated. Results: During the study period (from 01/01/1998 until 31/12/2017) there were 7 family outbreaks with 294 exposed, 103 cases (Attack Rate 35%), of which 29 were hospitalized (28.1%). The case fatality rate was 1%. The average age of the cases was 43.3 years (standard deviation 15.9). 70.8% of the cases were male. Outbreaks were concentrated between December and May. Five outbreaks originated after consumption of wild boar. The etiological agent identified in meat and/or biological samples from the cases was Trichinella spiralis in four outbreaks and Trichinella britovi in two other outbreaks, while the agent could not be identified in one outbreak. In all outbreaks, actions were carried out in accordance with the recommendations established by the National Epidemiological Surveillance Network (RENAVE). Conclusions: Trichinosis in Aragon takes the form of sporadic family outbreaks coinciding with the time of wild boar hunting and home slaughtering of pigs and is associated with the consumption of meat products not controlled sanitarily, so it is necessary to strengthen health education and intersectoral collaboration in the development and implementation of prevention and control strategies.

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Meat sources of infection for outbreaks of human trichinellosis.

Ali Rostami, H Gamble, Jean Dupouy-Camet … (2017)

Trichinellosis is one of the most important foodborne zoonotic diseases, with worldwide distribution. While human risk for trichinellosis has historically been linked to pork, modern pork production systems and slaughter inspection programs have reduced or eliminated pork as a source for trichinellosis in many countries. While pork may no longer pose a significant risk for trichinellosis, many other animal species may be hosts for Trichinella species nematodes and when human consume meat from these animal species, there may be risk for acquiring trichinellosis. This review article describes the various non-pork meat sources of human trichinellosis outbreaks, where these outbreaks have occurred and some of the factors that contribute to human risk. The literature reviewed here provides evidence of the persistence of Trichinella as a human health risk for people who eat meat from feral and wild carnivores and scavengers, as well as some herbivores that have been shown to harbor Trichinella larvae. It points to the importance of education of hunters and consumers of these meats and meat products.

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Systematic Assessment of the Climate Sensitivity of Important Human and Domestic Animals Pathogens in Europe

K. McIntyre, Christian Setzkorn, Philip Hepworth … (2017)

Climate change is expected to threaten human health and well-being via its effects on climate-sensitive infectious diseases, potentially changing their spatial distributions, affecting annual/seasonal cycles, or altering disease incidence and severity. Climate sensitivity of pathogens is a key indicator that diseases might respond to climate change, but the proportion of pathogens that is climate-sensitive, and their characteristics, are not known. The climate sensitivity of European human and domestic animal infectious pathogens, and the characteristics associated with sensitivity, were assessed systematically in terms of selection of pathogens and choice of literature reviewed. Sixty-three percent (N = 157) of pathogens were climate sensitive; 82% to primary drivers such as rainfall and temperature. Protozoa and helminths, vector-borne, foodborne, soilborne and waterborne transmission routes were associated with larger numbers of climate drivers. Zoonotic pathogens were more climate sensitive than human- or animal-only pathogens. Thirty-seven percent of disability-adjusted-life-years arise from human infectious diseases that are sensitive to primary climate drivers. These results help prioritize surveillance for pathogens that may respond to climate change. Although this study identifies a high degree of climate sensitivity among important pathogens, their response to climate change will be dependent on the nature of their association with climate drivers and impacts of other drivers.