George River, Northern Quebec, Canada from black bear meat
Date: September 26, 2005
Location of outbreak: intersection of the George river with the 57°North
Source: Dr. Thierry Ancelle <email@example.com>, Dr. Aymeric De Bruyne <firstname.lastname@example.org>, Professor Jean Dupouy-Camet <email@example.com>, Centre National de Reference des Trichinella Hopital Cochin / Universite R. DESCARTES 27 Fbrg St. Jacques, 75014, Paris, France
The French National Reference Center on trichinellosis was informed on 23 Sep 2005 of suspected cases of trichinellosis in a group of 10 hunters returning from a trip in Canada.
On 30 Aug 2005, these hunters ate barbecued meat from a black bear killed the same day in Northern Quebec. The 1st signs and symptoms (fever, myalgia, facial edema, increased levels of muscular enzymes in the serum, high levels of blood eosinophils) were observed 10-15 days after the consumption of the meat in 9 hunters. Interestingly, 2 hunters brought back bear meat that was shared with relatives. One meal involved, 2 Sep, 9 consumers (including 3 hunters previously contaminated); 3 additional patients acquired the disease during this meal. A 2nd meal involved, 6 Sep, 8 consumers (including 1 hunter previously contaminated); these consumers are still symptom-less and were informed of the potential risk of trichinellosis. Biological tests are in progress, and their physicians were advised to give them a prophylactic regimen of albendazole. So far, 12 patients (of whom 7 are hospitalized) have typical symptoms. Epidemiological and biological investigations are in progress in the 11 other consumers.
Organized travel for hunting in northern Canada are becoming more and more popular. Participants in such travels should be informed of the risk of acquiring trichinellosis by consuming raw or rare meat of wild carnivores. In 2004, an isolated case of trichinellosis was reported to the French national Reference center after consumption of black bear, also in northern Quebec.
Trichinellosis in this region is particularly frequent, and black bear meat is a frequent source of outbreaks in northern Canada (see: Schellenberg RS et al. An outbreak of trichinellosis due to consumption of bear meat infected with Trichinella nativa, in 2 northern Saskatchewan communities. J Infect Dis. 2003;188:835-43).
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Canada - Repulse Bay
5 Feb 2003
Source: Nunatsiaq News, Canada
Trichinellosis, Repulse Bay, Nunavut. After a significant outbreak of trichinosis in Repulse Bay, Nunavut's department of health is establishing a program to test walrusmeat for the parasite that causes the disease. John Raven, an environmental health officer based in Rankin Inlet, said that after 16 people contracted the disease in Repulse Bay in December, the department decided to use that community in a pilot project.
Hunters will soon be able to send the tongues of walrus they harvest to the lab in Rankin Inlet and find out within 24 hours whether the meat is infected or safe to eat. "The tongue has the highest concentration of trichinosis," Raven explained. "A walrus can have light infection, moderate, heavy, whatever, and if there's any infection in a walrus it will appear in the tongue." Raven said hunters from other communities can also submit walrus tongues to be tested, but the department is focusing its efforts on Repulse Bay this year. Because of the outbreak there, he said, people in the community are very sensitive to the seriousness of the disease and want to stop any further spread. Raven will be traveling to meet with residents in early February to explain the program.
When infected, uncooked meat of a carnivore, such as a polar bear, walrus, or pig, is eaten, a number of cysts are ingested with it. The only way to ensure the parasite is rendered harmless in meat is to cook it, but because of the traditions of eating country food, Raven said there are outbreaks of the disease every year in Nunavut. "I found it pretty amazing that the Keewatin has the highest rate of trichinosis in Canada and even the entire United States. We have more trichinosis in Nunavut than the United States does." The cost of one case of trichinosis in an individual is also extremely high. Medication can cost more than $800 per infection.
The department is getting a helping hand in setting up its program from scientists at the Nunavik Research Centre, who struggled to organize their own program in the 1990s. The centre's Dr. Bill Doidge said after persuading the federal government that trichinosis was indeed a public health issue in Nunavik, a specific test for walrus meat was developed.
"Walrus is where there's a health issue. Trichinella worms are also in polar bear, but the traditional knowledge is that you need to cook polar bear meat so it's not really a health issue," he said. Scientists initially tested about 100 seals and didn't find any positive samples, he said, so it doesn't seem to be a problem, although it has been reported in scientific literature.
In 1995 they decided to centralize a testing lab in Kuujjuaq, even though many of the cases were coming from Salluit. 7 years later, Doidge said, almost all walrus harvested in Nunavik are tested for the infection. "This year we did 53 walrus for Nunavik and the year before it was 54," he said. "2002 was a good year for walrus hunters, in that only one of the 54 walrus were infected, whereas in 2001, there were more like 7 infected. The program itself has been quite successful in greatly reducing the cases of human trichinellosis." Work is continuing on finding out how walrus, which are mainly bottom-feeders, catch a parasite that is only transmitted by ingesting raw infected meat, and where the hot spots for the infection are.
ProMed: Trichinella infection in walrus is well known in the arctic, and the first outbreak in Canada due to walrus meat was reported in 1982 with 42 cases; another in 1999 included 62 cases [source: Gideon]. Walrus is also a well-known source of trichinella infection in Greenland. The posting states that seals are not an important source of infection, but even with a low frequency of infection in seals, they may still be a source of infection in communities where seals are a major food source and are traditionally eaten without cooking. - Mod.EP