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Update Trichinosis by J. C. Leighty" One might summarize this paper by stating that The problem may have a number of possible Trichinella s-pirulis is alive and well and living in causes. Pork may be added to ground beef deliber- domestic swine. ately or through use of common processing equip- ment. Mixtures of meat from the species is some- Thc latest Annual Summary from the Ccwter Tor tw70 times prepared for use in the home in mcat loavcs Disease Control indicates that 284 cases \\7ere re- ported in 1975, with one death.' In 1947 when the dis- or meat balls, and may be inadvertently mislabeled. ease first became reportable 451 cases occurred. 5', mcc At any rate, these incidents and the studies that that time the incidence has gradually declined to ,in followed clearly point to a mechanism for infection annual mean of 133 cases for the years 1965 through of which we should all be aware. 1974. In 1947 fourteen deaths oculurred. The total num- The sudden surge in reported cases from 141 in ber of deaths from 1965 through 1974 was 16. 1974 to 284 in 1973 raises questions about the status It is of interest that 69% of the cases reported for of swine as an infection source. A high percentage of pork is commercially processed in a manner that de- 1975 were detected by careful epidemiological in- stroys trichina. A large volume of uncured pork is vestigations, iricluding serological techniques, of 20 sqarate common source incidents that involved 2 or frozen either for commercial distribution or for stor- age in the home. hIost states actively prevent the more cases each. Five of these accounted for 148, feeding of raw garbage to swine. For many years the 52%, of the total number. public has been advised, through media such as home The source of infection, where identified, was pork economics classes, cookbooks and newspaper food from domestic swine in 186 cases (73%).Sausage ac- sections, to cook pork to temperatures adequate to counted for 149 (92.6%) of the 161 cases in which the destroy T. spiralis. Why is it then that infected prod- pork product was identified. Meat from wild animals uct seem5 to be waiting for the unwary? Why is it was implicated in 33 cases. And, 34 cases involved that an incidence of infection rather comparable to ground beef which was apparently adulterated with those of 30 years ago can occur with a much different pork since natural infection with T. spiralis is un- incidence of deaths-15 in 1947 as opposed to one known in herbivores. in 1975? Schantz has reported on investigations that wae The knowledge of thr biology and epidemiology initiated to determine the dimensions of the problem of trichinosis is still far from complete. However, in- of pork-contaminated ground beef.2 New Jersey offi- formation that is available is very interesting. For cials found pork in 388 of ground beef samples from example, it is estimated that the prevalence of trichi- three of the four stores associated with 28 of the 197.3 nosis in grain-fed swine in the United States is 0.125% hamburger cases. In addition pork was found in 20% and 0.5% in those fed garbage.$ About 1%of market of ground beef samples from five of ten randomly swine are fed garbage. chosen stores in central New Jersey. As a followup, the Center for Disease Control co- In 1975, 73 million head of swine were slaughtered ordinated a preliminary survey that examined two under federal inspection.4 With a prevalence of 0.125% packaged ground beef samples from ten supermarkets approximately. 90,000 animals would have been in- in greater metropolitan areas of each of twelve states. fected. An average butcher hog is estimated to pro- This included 231 samples from 136 stores. Six per- vide 360 servings of muscle tissue of 0.11 kg (0.2.5 cent of the samples contained pork. Eight percent 111) cach.5.6 Thus 90,000 infectcd swine provided po- of the stores had at least one pork contaminated sam- ple. The Minnesota State Department of Agriculture, "1. C. LElGHTY in a similar survey, found 3%of 213 grouiicl beef sam- Food Safet!y and Qzuility Seruice, USDA, Witsh- ples adulterated with pork. ington, D.C. 20250 - 177- AMERICAN MEAT SCIENCE ASSOCIATION tentially 32.4 million human exposures in 1975 which A number of characteristics have been established resulted in only 284 reported clinical cases. as highly desirable : These 284 reported cases may represent only a The cost per animal must be very low fraction of the aotual clinical and subclinical cases The test must be compatible with the slangh- that occurred. Difficulty in diagnosing clinical cases tering rates and implant practiccs of the in- may contribute to the low number of reported cases. dustry. While outbreaks involving more than one case arc rather likely to be correotly diagnosed, sporadic in- The sensitivity must be adequate to detect ani- fections, especially if mild, are usually not recog- mals that may be health hazards. nized.? The specificity must prevent unnecessary costs Another factor that must be considered is that that could result from a large false positive rate. many human infections may be caused by larval The technology must be within the capability doses too low to cause significant illness. In a recent of program inspection personnel. study of 20,003 farm-raised swine 2.5 were found to lie infected. Of these 68% contained less than one That the test should be capable of detecting trichina per gram of diaphragm muscle. It is believeJ more than one agent of importance. that approximately 70 live trichina must be ingested by a human to produce symptoms of infection.7 After careful examination of curreiitly available Further evidence for the possibility that a large diagnostic systems for trichinosis it was determined numiber of subclinical infections may occur is found that both trichinoscopic and digestion techniques fail in another recent study of human diaphragms.5~6,411 in a number of respects to meet Program require- diaphragms in which live larvae were found, indi- ments. Serological systems were studied with the cating recent infection, contained less than ten larvae conclusion that both the Soluble Antigen Fluorescent per gram. Thirty-two of 42 of those with live larvae Antibody Test and the Enzyme Labeled Antibody had less than one cyst per gram. Levels of less than Test offer the required characteristics. Finally the one cyst per gram are believed to cause either negli- ELA Test was chosen for development and automa- gible or no symptoms of infection.7 tion. That work is now being carried out under the direction of Dr. Dale Holm of the Los Alamos Sci- The human study provided rather convincing evi- entific Laboratories of the Energy Resources Devel- dence that from 149,000 to 298,OOO human trichinosis opment Agency at Los Alamos, New Mexico. The infections may occur each ear.^.^ If that is true principal scientists involved are George C. Saunders, widespread low-levcl infections in swine may be very Elva H. Clinard, Mary Louise Bartlett and Mort important in causing subclinical human infections. Sanders. A major objective of the Federal Meat and Poul- The test is capable of screening for any agent that try Inspection Program is to prevent the tranymission elicits humoral immune responses provided the caus- of toxic or infectious disease agents from meat to ative antigen can be absorbed or otherwise bound humans. Disease agents like Trichinella spiralis obvi- to a suitable test vehicle. The time required for its ously make that objectivt very difficult to achieve. completion is about 15 minutes. Whole blood or Consider that the Program must inspect each of ap- serum can be tested. Reagent cost is \7ery low. The proximately 120 million mammalian and three billion sensitivity is far superior to other systc>ms and no avian food animals annually. Any system that would insurmountable specificity problems have yet been attempt to apply other than organoleptic inspection noted. Finally, it appears that equipment exists that techniques would be extremely complicated. How- can be modified to automate the test. ever, agents like T. spiralis, that produce no overt Currently the testing system-reagents and equip- signs of disease in the affected animal cannot be de- ment-are being readied for a field trial. Thc purpose tected by such gross examination. will be to identify and characterize any problemJ Taking up the challenge, the Program set out in that may occur when testing commcrcial swine. Ap- 1972 to develop an inspection system capable of de- proximately 80,OOO porcine serum samples. from tecbing animals that bear certain agents of signifi- plants slaughtering garbage-fed swine, will be tested cance to human health but show no gross evidence in an effort to identify 400 positive animals. Did- of disease. Trichinosis was chosen as the model dis- phragin samples will be examined by the pooled sam- ease for the system. ple digestion technique for control purposes. When 178 - AMERICAN MEAT SCIENCE ASSOCIATION anomolous results, such as sero-negative digestion the species of wild animals involved in trichinosis and positive animals are found further studies will be what the geographical location of these animals are? ccnducted on tissue or serum in an attempt to under- JL4CI(LEIGHTY: I .iin not familiar with all of thc. stand the basis for the problem. species that were invclved in 1975. Gcncrally, as you Beyond the field trial much work rcmains to be \\wild suspect, it is largely bear meat. They are all done before the system is ready for practical use.
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