New insights on serodiagnosis of trichinellosis during window period:early diagnostic antigens from Trichinella spiralis intestinal worms

The clinical diagnosis of trichinellosis is difficult because its clinical manifestations are nonspecific.Detection of anti-Trichinella IgG by ELISA using T.spiralis muscle larval excretory-secretory(ES)antigens is the most commonly used serological method for diagnosis of trichinellosis,but the main disadvantage is false negativity during the early stage of infection.There is an obvious window period between Trichinella infection and antibody positivity.During the intestinal stage of Trichinella infection,the ES antigens of intestinal worms(intestinal infective larvae and adults)are exposed to host’s immune system at the earliest time and elicit the production of specific anti-Trichinella antibodies.Anti-Trichinella IgG antibodies in infected mice were detectable by ELISA with ES antigens of intestinal worms as soon as 8-10 days post infection(dpi),but ELISA with muscle larval ES antigens did not permit detection of infected mice before 12 dpi.Therefore,the new early antigens from T.spiralis intestinal worms should be screened,identified and characterized for early serodiagnosis of trichinellosis.

FOUR OUTBREAKS OF HUMAN TRICHINELLOSIS IN HENAN PROVINCE

Four outbreaks of human trichinellosis caused by eating pork together had occurred successively in two rural areas and two cities of Henan Province, where the disease is endemic. Of the 110 persons involved, 54 had the onset. AH of them had the history of eating pork. In the outbreak of Dengzhou, in those persons who dined together, men were all uninfected and 13 women were infected. The difference found between sexes was suggested to be related with spirit drinking. In these 54 patients, the latent period ranged from 3 to 28 days. The relevant clinical symptoms and signs were fever, edema, myalgia, rash, headache, nausea, abdominal pain and diarrhea. Vomiting was uncommon. Most patients were hospitalized and all cases recovered in two weeks after proper treatment with albendazole.

Cultural drivers and health-seeking behaviours that impact on the transmission of pig-associated zoonoses in Lao People’s Democratic Republic

Pig rearing is an important income source in the Lao People’s Democratic Republic(PDR),with many smallholder farmers using traditional free-range pig production systems.Despite the potentially significant health risks posed by pig production regarding pig-associated zoonoses,information on the sociocultural drivers of these zoonoses is significantly lacking.This review summarises the existing sociocultural knowledge on eight pig-associated zoonoses suspected to be endemic in Southeast Asia:brucellosis,Q fever(Coxiella burnetii),trichinellosis,hepatitis E virus,leptospirosis,Japanese encephalitis,Streptococcus suis and Taenia solium taeniasis-cysticercosis.It summarises current knowledge on these diseases grouped according to their clinical manifestations in humans to highlight the propensity for underreporting.A literature search was conducted across multiple databases for publications from 1990 to the present day related to the eight pig-associated zoonoses and the risk and impact connected with them,with Lao PDR as a case study.Many of these pig-associated zoonoses have similar presentations and are often diagnosed as clinical syndromes.Misdiagnosis and underreporting are,therefore,substantial and emphasise the need for more robust diagnostics and appropriate surveillance systems.While some reports exist in other countries in the region,information is significantly lacking in Lao PDR with existing information coming mainly from the capital,Vientiane.The disease burden imposed by these zoonoses is not only characterised by morbidity and mortality,but directly impacts on livelihoods through income reduction and production losses,and indirectly through treatment costs and lost work opportunities.Other factors crucial to understanding and controlling these diseases are the influence of ethnicity and culture on food-consumption practices,pig rearing and slaughter practices,hygiene and sanitation,health-seeking behaviours and,therefore,risk factors for disease transmission.Published information on the knowledge,attitudes and beliefs of people regarding pig zoonoses and their risk factors is also extremely limited in Lao PDR and the broader Southeast Asian region.The need for more transdisciplinary research,using a One Health approach,in order to understand the underlining social determinants of health and their impacts on health-seeking behaviours,disease transmission and,ultimately,disease reporting,cannot be more emphasized.