Trichinosis: a prospective controlled study of patients ten years after acute infection

The existence of chronic trichinosis as a disease entity is still a matter of debate. For 10 years after an outbreak of infection with Trichinella spiralis, we conducted a prospective controlled study of the patients involved. At the termination of this investigation, we undertook clinical, biochemical, serological, immunologic, neuroradiological, radiological, and psychological studies of 128 originally infected persons and 16 controls. The categories of symptoms most often documented in persons who had been infected were muscular (90%), ocular (59%), neurological (52%), and psychological (52%). Impaired muscle strength (56%), conjunctivitis (55%), and impaired coordination (32%) were the clinical manifestations most frequently encountered. Thirty-eight percent of the 128 originally infected patients still had IgG antibodies to T. spiralis after 10 years. Magnetic resonance imaging of the brain revealed no abnormalities. No calcifications of residual larvae were detected by mammography or muscle biopsy. The level of performance in psychometric tests was lower in the originally infected population than in the general population. Although patients who had had trichinosis differed significantly from controls in terms of a variety of parameters even after 10 years, we found insufficient evidence on which to conclude that chronic trichinosis exists as a distinct entity.