Trichinellosis in Italy: a systematic review

Trichinellosis, caused by the nematode Trichinella, is a worldwide zooantroponosis. The parasite can infect virtually all mammals, birds and reptiles, but the main source of human infection is the consumption of raw or undercooked meat from pig, wild boar and horse. Infection with Trichinella was one of the most frequent parasitic diseases in Italy until 1959, when obligatory screening for these parasites in slaughtered swine was introduced. The aim of our review was to describe the epidemiology of Trichinellosis in Italy, since the last review on this topic was performed in 1989. Methods We performed a systematic research through MEDLINE searching, through the MESH terms “Trichinellosis” and “Italy”, studies published in the peer reviewed literature. From our review we excluded studies referred to outbreaks before 1989, to animals or to molecular biology; or studies written in languages different from English, French or Spanish. Results We found 55 studies, but only 7 studies were considered for the analysis. 759 total cases of Trichinellosis occurred in Italy since the 1990: 100 (13.18%) caused by T. Britovi and 645 (84.98%) by T. spiralis; in 14 cases the identification of the parasite wasn’t performed. The outbreaks involved Umbria, Piedmont, Basilicata, Tuscany, Abruzzo, Emilia Romagna, Sardinia, Apulia (500 cases in 1990, by T. spiralis). In Lazio (2001) and in Veneto (2008) two epidemics were caused by food coming from abroad. Horse (82.74%), wild boar (11.33%), and pig (5.93%) meat were the most important sources of infection. Conclusions 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: in fact it is impossible to define a region with a negligible risk, and physicians and veterinarians should be regularly trained about this old disease, but still present in our country. Key messages: Our review showed that in the last 26 years 759 cases of trichinellosis occurred in Italy and were often caused by horse, wild boar or pig meat. It is fundamental to continue a strict surveillance on this disease because it is not possible to define a region with a negligible risk