Human Trichinellosis in Italy: an epidemiological review since 1989

OBJECTIVES: Trichinellosis is a worldwide zooantroponosis caused by a nematode of the genus Trichinella that can pose a risk to human health. Among the species of Trichinella, T. Spiralis is the most common represented. The main source of human infection is the consumption of raw or undercooked meat (especially from pigs, wild boars and horses). Infection with Trichinella was one of the most frequent parasitic diseases in Italy until 1959 when obligatory screening for these parasites in slaughtered swines was introduced. As the last review on this topic was performed in 1989, the aim of our study was to describe the epidemiology of Trichinellosis in Italy from 1989 to 2017. STUDY DESIGN: We performed a systematic research in Pubmed (MEDLINE). METHODS: We included in our review studies that were published in the peer reviewed literature using the MESH terms “Trichinellosis” and “Italy”. The only restrictions were the language (articles should be in English, Italian, Spanish or French) and the date of publication: from 1989 to March 2017. We excluded all the articles which referred to trichinellosis in the animals or which focused only on molecular biology of trichinella or on diagnostic techniques. RESULTS: We found 56 studies, but only 8 were considered eligible. During the study period, 764 cases of Trichinellosis occurred in Italy: 13.7% caused by T. Britovi and 84.4% by T. spiralis; in 14 cases the identification of the parasite was not performed. The outbreaks occurred in Umbria, Piedmont, Apulia (500 cases in 1990, by T. spiralis), Basilicata, Tuscany, Abruzzo, Emilia Romagna, Sardinia. In 2001 and in 2008 two outbreaks occurred in Lazio and Veneto respectively, but imported from abroad. The most important sources of infections were: horse meat (82.2%); wild boar meat (11.9%); pig meat (5.9%). CONCLUSIONS: Trichinellosis is still present in Italy, but often forgotten by general practitioners and infectious diseases specialists. It’s pivotal to improve awareness about this parasitic disease in Physicians and veterinarians. A strict surveillance, especially on meat products from endemic countries or from wild animals is necessary to considerably reduce the risk of acquiring the infection.