title: Outbreak of Trichinella spiralis infections associated with a wild boar hunted at a game farm in Iowa.
abstract: BACKGROUND
  Rates of trichinellosis have declined significantly in the United States due to improved pork production practices and public awareness of the danger of eating raw or undercooked pork. In April 2011, the Minnesota Department of Health received a report of presumptive trichinellosis in a 50-year-old man with a history of wild boar consumption. A public health investigation was initiated.
  
  
  METHODS
  Medical record reviews and patient and family interviews were conducted. Trichinella species serology was performed on patient and family serum samples, and larval identification was attempted on clinical specimens and meat samples.
  
  
  RESULTS
  The index patient harvested a wild boar from an Iowa game farm; he processed the meat after returning home and developed gastrointestinal symptoms 2 days later. Four days after his illness onset, all 5 family members consumed a roast from the boar. The index patient sought healthcare 4 times after illness onset before being definitively diagnosed with trichinellosis. Following initiation of albendazole therapy, the index patient developed atrial fibrillation. One additional family member who processed the raw meat was diagnosed with trichinellosis. Trichinella spiralis larvae were identified in wild boar meat samples.
  
  
  CONCLUSIONS
  Trichinellosis has long been recognized as a potential hazard of consuming undercooked wild carnivore meat, and historically has been associated with consumption of pork from domestic swine, but may be unfamiliar to practicing clinicians in the United States. Education of hunters and the broader population on the potential for trichinellosis and the importance of proper handling and cooking meat from wild or free-range animals needs to be reinforced.
authors.affiliation: Division of State and Local Readiness, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia Minnesota Department of Health, Saint Paul.
authors.forename: Stacy M
authors.initials: SM
authors.lastname: Holzbauer
authors.affiliation: Infectious Disease and Microbiology, Gundersen Medical Foundation, La Crosse, Wisconsin.
authors.forename: William A
authors.initials: WA
authors.lastname: Agger
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Hall
authors.affiliation: Iowa Department of Agriculture and Land Stewardship.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Johnson
authors.affiliation: Iowa Department of Agriculture and Land Stewardship.
authors.forename: David
authors.initials: D
authors.lastname: Schmitt
authors.affiliation: Iowa Department of Public Health, Des Moines.
authors.forename: Ann
authors.initials: A
authors.lastname: Garvey
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Henry S
authors.initials: HS
authors.lastname: Bishop
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Hilda
authors.initials: H
authors.lastname: Rivera
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Marcos E
authors.initials: ME
authors.lastname: de Almeida
authors.affiliation: Agriculture Research Service, US Department of Agriculture, Beltsville, Maryland.
authors.forename: Dolores
authors.initials: D
authors.lastname: Hill
authors.affiliation: Department of Veterinary and Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul.
authors.forename: Bert E
authors.initials: BE
authors.lastname: Stromberg
authors.affiliation: Minnesota Department of Health, Saint Paul.
authors.forename: Ruth
authors.initials: R
authors.lastname: Lynfield
authors.affiliation: Minnesota Department of Health, Saint Paul.
authors.forename: Kirk E
authors.initials: KE
authors.lastname: Smith
mesh_terms: D000818:Animals; D004196:Disease Outbreaks; D006801:Humans; D007484:Iowa; D008297:Male; D008460:Meat / Q000469:parasitology*; D008875:Middle Aged; D013552:Swine; D017160:Trichinella spiralis / Q000472:pathogenicity*; D014235:Trichinellosis / Q000175:diagnosis* / Q000209:etiology
keywords: Trichinella spiralis; human trichinellosis; outbreak; pork; wild boar