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Home Eurosurveillance Weekly Release  2007: Volume 12/ Issue 29 Article 2
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Eurosurveillance, Volume 12, Issue 29, 19 July 2007
Articles

Citation style for this article: Golab E, Szulc M, Wnukowska N, Rozej W, Fell G, Sadkowska-Todys M. Outbreak of trichinellosis in north-western Poland – Update and exported cases, June-July 2007. Euro Surveill. 2007;12(29):pii=3238. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=3238

Outbreak of trichinellosis in north-western Poland – Update and exported cases, June-July 2007

E Golab1, M Szulc2, N Wnukowska1, W Rozej1, G Fell3, M Sadkowska-Todys (mtodys@pzh.gov.pl)4

1. Department of Medical Parasitology, National Institute of Hygiene, Warsaw, Poland
2. Voivodeship Sanitary-Epidemiological Station, Szczecin, Poland
3. Institut fuer Hygiene und Umwelt (Institute for Hygiene and the Environment), Hamburg, Germany
4. Department of Epidemiology, National Institute of Hygiene, Warsaw, Poland

Cases in Poland
Last week, we reported an outbreak of trichinellosis in West-Pomerania, Poland, that had involved 198 cases (excluding exported cases) as of 2 July [1].
From 2 to 17 July, 16 additional cases of trichinellosis were registered in Poland, bringing the total number of people infected in this outbreak in Poland to 214, as of 18 July. Due to serious clinical symptoms, 81 patients were hospitalised.

Serological examinations on 119 of the Polish patients were performed in the National Institute of Hygiene (NIH) in Warsaw, using an in-house ELISA test with excretory-secretory Trichinella antigen. The results for 73 samples were positive, and seven samples gave equivocal results. In one case Trichinella larvae were found in a muscle tissue sample.
Molecular examinations were performed to determine the species of Trichinella. The result of these examinations indicated Trichinella spiralis as the cause of the outbreak.

Exported cases
Several other cases linked to this outbreak of trichinellosis have occurred in other European countries.
Two cases were reported in Ireland in a couple that had visited their relatives in West-Pomerania in May. More information can be found in the accompanying article 'Importation of Polish trichinellosis cases to Ireland, June 2007' in this issue of Eurosurveillance [2].
Three further linked cases were found in a family in Germany who had travelled to Poland at the end of May, and are described in the accompanying article ’Cluster of trichinellosis cases in Germany, imported from Poland, June 2007’ [3].

In addition to this family cluster, a fourth German case has been reported to the Public Health authorities in Hamburg, Germany. The patient had visited relatives in West-Pomerania for a week in mid May together with her family. During her stay, she consumed raw pork sausage bought in a local butchery, whereas her family members did not. From the end of May, she started to develop symptoms of fever, myalgia and periorbital oedema. About one month later, trichinellosis was diagnosed by proof of elevated antibody titres against Trichinella spp.

A fifth suspected case occurred in North Rhine-Westphalia, Germany. A man who had visited relatives in West-Pomerania for three days in mid May developed symptoms of trichinellosis 19 days after his return to Germany, such as facial and periorbital oedema, myalgia and conjunctivitis. He was admitted to hospital on 10 June. During his stay in Poland he had consumed raw pork sausage.

References:
  1. Golab E, Szulc M, Sadkowska-Todys M. Outbreak of trichinellosis in north-western Poland, June 2007. Euro Surveill 2007;12(7):E070712.1. Available from: http://www.eurosurveillance.org/ew/2007/070712.asp#1
  2. McHugh G, Kiely D, Low J, Healy ML, Hayes C, Clarke S. Importation of Polish trichinellosis cases to Ireland, June 2007. Euro Surveill 2007;12(7):E070719.3. Available from: http://www.eurosurveillance.org/ew/2007/070719.asp#3
  3. Schmiedel S, Kramme S. Cluster of trichinellosis cases in Germany, imported from Poland, June 2007. Euro Surveill 2007;12(7):E070719.4. Available from: http://www.eurosurveillance.org/ew/2007/070719.asp#4

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