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Home Eurosurveillance Weekly Release  2007: Volume 12/ Issue 11 Article 1
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Eurosurveillance, Volume 12, Issue 11, 15 March 2007
Articles

Citation style for this article: Gallardo MT, Mateos L, Artieda J, Wesslen L, Ruiz C, García MA, Galmés-Truyols A, Martín A, Hernández Pezzi G, Andersson Y, Gárate T, Christensson D. Outbreak of trichinellosis in Spain and Sweden due to consumption of wild boar meat contaminated with Trichinella britovi. Euro Surveill. 2007;12(11):pii=3154. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3154

Outbreak of trichinellosis in Spain and Sweden due to consumption of wild boar meat contaminated with Trichinella britovi

MT Gallardo1, L Mateos1, J Artieda2, L Wesslen3, C Ruiz4, MA García5, A Galmés-Truyols6, A Martín7, G Hernández-Pezzi (ghpezzi@isciii.es)7, Y Andersson8, T Gárate9, D Christensson10

1Delegación de Sanidad y Bienestar Social de Castilla y León, Palencia, Spain*
2Delegación de Sanidad del País Vasco, Guipúzcoa, Spain*
3Department of Infectious Diseases, Gävle Hospital, Sweden
4Consejería de Sanidad y Bienestar Social de Castilla y León, Valladolid, Spain*
5Consejería de Sanidad del País Vasco, Vitoria, Spain*
6Consejería de Sanidad y Consumo de Islas Baleares, Palma de Mallorca, Spain*
7Centro Nacional de Epidemiología (National Centre of Epidemiology), Madrid, Spain
8Smittskyddsinstitutet (Swedish Institute for Infectious Disease Control), Stockholm, Sweden
9Centro Nacional de Microbiologia (Spanish National Centre of Microbiology), Madrid, Spain
10Statens Veterinärmedicinska Anstalt (Swedish National Veterinary Institute), Uppsala, Sweden
*Spanish National Epidemiological Surveillance Network

Early this year, 21 people became ill with trichinellosis in both Spain and Sweden. This was traced to consumption of home-made wild boar sausage from an original source in Spain.

An outbreak of trichinellosis was detected on 24 January 2007, when four cases resident in Castile and León, Spain were notified to the provincial and regional authorities. During the course of the investigation, it was found that a further three people had been exposed in the Basque Country and the Balearic Islands and one person that subsequently travelled to Sweden. This was reported to Spain's National Centre for Epidemiology in Madrid. This information was also sent to the regional Spanish and the Swedish health authorities (30 and 31 January respectively) once information needed to locate the affected persons had been obtained.

The suspected food was Spanish sausage (chorizo), made from the meat of two wild boars (jabalí) which came from a private hunt held in Castile and León. Meat from the wild boars was analysed by trichinoscopy by the local veterinarian and tested negative for Trichinella. Home-made sausage was then prepared by a relative and distributed within one family circle.

Most of the exposed subjects participated in a family meal held on 31 December 2006 in Spain. One of the family was a student temporarily residing in Sweden, who took some of the sausages with him when he returned to Sweden, where they were consumed by a further seven Spanish companions. The Basque Country health authorities recommended that the student and his companions visit the Swedish health services and provide them with leftover samples of the sausage for further investigation.

To date (15 March) there have been 21 cases with trichinellosis symptoms, one of them requiring hospitalisation, and two suspected cases, with a total of 62 people exposed. Most of the symptoms presented by the patients were of myalgia, cephalalgia, asthenia and fever. The results of serological testing are still awaited.

The case distribution was as follows: 16 cases in Castile and León, with 51 persons exposed; one case in the Basque Country, with two persons exposed; one case of one exposed in the Balearic Islands; and eight exposed people in Sweden, where one case has been confirmed and a further two cases are awaiting confirmation.

Immediately following the detection of the outbreak, remaining meat and sausages were found and retained. The various pieces of meat and sausage were studied, and the molecular techniques used both in Sweden and in Spain identified Trichinella britovi. The results of the artificial digestion method were: 1.4 larvae/g of Trichinella in Sweden; 12 larvae/g at the Spanish National Centre of Microbiology; and 18 larvae/g at a Madrid University's Parasitology Laboratory. Analysis of pieces of the frozen meat proved negative at all laboratories.
An outstanding feature of this outbreak was the degree of cross-level (local to international) collaboration mobilised in the two countries, both in the health care and laboratory and in the epidemiology and public health fields. A total of nine outbreaks attributable to consumption of wild boar meat (all non-commercially marketed) have been reported in Spain in the last five years (according to data from the Spanish National Epidemiological Surveillance Network). Of these, four outbreaks were due to T. britovi.

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