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ARS Home » Northeast Area » Beltsville, Maryland (BARC) » Beltsville Agricultural Research Center » Animal Parasitic Diseases Laboratory » Research » Publications at this Location » Publication #337068
Title: Trichinella nativa outbreak with rare thrombotic complications associated with meat from a black bear hunted in Northern Ontario

Author
item DALCIN, DANIEL - Northern Ontario School Of Medicine
item Zarlenga, Dante
item LARTER, NICHOLAS - Government Of The Northwest Territories
item BOUCHER, DANIEL - Northern Ontario School Of Medicine
item MERRIFIELD, SAMUEL - Northern Ontario School Of Medicine
item LAU, RACHEL - Public Health Ontario
item RALEVSKI, FILIP - Public Health Ontario
item CHEEMA, KARAMJIT - Public Health Ontario
item SCHWARTZ, KEVIN - St Joseph'S Health Center
item Hoberg, Eric
item BOGGILD, ANDREA - University Of Toronto

Submitted to: Clinical Infectious Diseases
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/10/2017
Publication Date: 2/22/2017
Citation: Dalcin, D., Zarlenga, D.S., Larter, N.C., Boucher, D.A., Merrifield, S., Lau, R., Ralevski, F., Cheema, K., Schwartz, K.L., Hoberg, E.P., Boggild, A.L. 2017. Trichinella nativa outbreak with rare thrombotic complications associated with meat from a black bear hunted in Northern Ontario. Clinical Infectious Diseases. 64:1367-1373. doi: 10.1093/cid/cix165.

Interpretive Summary: Trichinellosis is a helminthic disease that causes significant morbidity and mortality worldwide. Of the nine species and three undefined genotypes of Trichinella, Trichinella nativa and the Trichinella T6 genotype are freeze-resistant and the most prevalent in sylvatic hosts endemic above the -6oC isotherm. In Ontario, Canada, trichinellosis is rare with only five reported cases between 2004 and 2015. This work describes the clinical and epidemiological features of an outbreak of human trichinellosis caused by T. nativa involving 10 adult men (25-50 years old). The infection resulted from the ingestion of dried meat (jerky) from a black bear hunted in Northern Ontario; the meat had been frozen for 7 months prior to processing and consumption. This outbreak was accompanied by rare, life-threatening complications in two of the 10 patients. This information is important because it clearly demonstrates that Trichinella, though substantially eliminated from the domestic food supplies in North America, remains a public health risk from sylvatic sources and that freezing meat in more artic regions of North America is not a viable means to render the pathogen non-infectious. This information is important not only to the medical community and to clinicians, but also to consumers who routinely hunt and ingest meat from wild animals.

Technical Abstract: Although trichinellosis is known to cause thrombotic disease, serious thrombotic events are rare and have previously not been shown to be associated with Trichinella nativa. Patient interviews and medical chart reviews were conducted on ten men who became ill following consumption of a common source of black bear meat. Trichinella serology on patient sera as well as PCR and larval identification of the meat samples was conducted. ST-elevated myocardial infarction and sinus venous tract thrombosis occurred as a complication of trichinellosis. Multiplex PCR identified T. nativa from the bear meat and was corroborated by microscopic larval identification. This report demonstrates that T. nativa can cause serious thrombotic disease in humans. Education of hunters and the public regarding the importance of properly cooking wild game is warranted.