Trichinellosis and poverty in a Romanian industrial area: an epidemiological study and brief review of literature

Trichinellosis is a foodborne parasitic disease that is acquired by humans through ingestion of raw or inadequately cooked meat containing larvae of different Trichinella species. During a high endemic year, Hunedoara County, part of Transylvania region, was the second most affected Romanian county, with an incidence of 84.8 cases per 100,000 inhabitants. The objective of this study was to bring new epidemiological and clinical data on human trichinellosis from an endemic former industrial area characterized by high rates of poverty and unemployment. Data have been collected from the medical charts of 492 patients (mean age, 27.6 years) found to have trichinellosis and admitted between 1996 and 2005 in two infectious disease hospitals. A brief review of relevant epidemiological and epizoological information regarding the evolution of the infection in this region was also considered. Women (55.1%, n = 271), townsfolk (77.0%, n = 379), and unemployed (40.1%, n = 126) were the most affected categories. The clinical symptoms included myalgia (64.6%, n = 118), edema (45.3%, n = 223), and headache (38.6%, n = 190). Eosinophilia ranged between 10% and 19.99% in 28.0% (n = 138) of the cases. For 47.8% (n = 235) of the patients, the hospitalization period ranged from 1 to 7 days. Thiabendazole was administered in 72.0% (n = 329) of the cases. For a long period of time, trichinellosis represented a serious public health and ecological concern because of the favorable social, economic, cultural, and geographic conditions of this territory. Despite rich history, an overall decrease in the number of human trichinellosis cases over the 10-year study period was revealed and the decline might have been favored by the following positive aspects: improvement of sanitary conditions, implementation of a more reliable collaboration between veterinarians and pig breeders/consumers, education of the population, and a more careful supervision of the public health services.