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Trichinosis - Treatment and Prevention
Last reviewed: 06.07.2025
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Drug treatment of trichinosis
Antiparasitic treatment of trichinellosis is aimed at destroying intestinal trichinella, stopping the production of larvae, disrupting the encapsulation process and increasing the death rate of muscle trichinella. Albendazole and mebendazole are used for these purposes.
Albendazole is prescribed orally after meals at 400 mg twice a day for patients weighing 60 kg or more, or at 15 mg/kg per day in two doses for patients weighing less than 60 kg. The duration of treatment is 14 days.
Mebendazole is administered orally 20-30 minutes after meals at a dose of 10 mg/kg per day in 3 doses. The duration of the course of treatment is 14 days.
In mild cases of the disease, the same drugs are prescribed for a course of up to 7 days. Preventive antiparasitic treatment of trichinellosis in persons who have eaten infested meat products is carried out with albendazole in the same doses for 5-7 days. Etiotropic therapy is most effective during the incubation period, when clinical manifestations can be prevented, or in the first days of the disease, when trichinella are still in the intestine. During the muscular stage of the disease and encapsulation, the effectiveness of etiotropic therapy is significantly lower, and its use during this period can even contribute to an exacerbation of the disease.
Patients are prescribed antihistamines, prostaglandin inhibitors, NSAIDs. In severe invasion with neurological disorders, myocarditis, ISS, pulmonary insufficiency, glucocorticoids are used: usually prednisolone in a daily dose of 20-60 (according to indications up to 80) mg orally for 5-7 days. Due to the fact that glucocorticoids can prolong the period and amount of larvae production in the intestine, it is recommended to prescribe antiparasitic drugs (albendazole or mebendazole) during the entire period of glucocorticoid use and for several days after their cancellation. Possible ulcerative lesions of the intestine in combination with disorders in the hemostasis system also pose a danger. In such patients, the risk of ulcerogenic action of glucocorticoids increases sharply, especially with the simultaneous administration of NSAIDs (indomethacin, diclofenac, etc.). In these cases, proton pump inhibitors (omeprazole, etc.) are recommended for the prevention of ulcerative lesions in the gastrointestinal tract. Treatment of severe trichinellosis with generalized edema (due to accelerated protein catabolism and hypoproteinemia) consists of infusion therapy with the introduction of detoxifying agents and drugs for parenteral protein nutrition.
Trichinosis: prognosis
The prognosis for trichinellosis is favorable in mild and moderate forms of invasion. A short-term resumption of some clinical manifestations is possible: myalgia, moderate edema, eosinophilia in blood tests. In severe forms with complications, the prognosis is serious: with late diagnosis and delayed antiparasitic treatment, a fatal outcome is possible: in the case of a malignant course, it can occur already in the first days of the disease.
Approximate periods of incapacity for work
Working capacity is restored within 2-6 months, in severe forms of trichinosis - only after 6-12 months.
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Clinical examination
The dispensary of those who have recovered is carried out by an infectious disease specialist or a local therapist for 6 months or more, depending on the severity of the course and the presence of complications. Convalescents are examined 2 weeks, 1-2 and 5-6 months after discharge from the hospital, clinical and biochemical blood tests are mandatory, as well as an ECG for those who have recovered from a severe form of the disease. The presence of changes in the ECG and other residual manifestations is the basis for extending the observation period to 1 year.
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How to prevent trichinosis?
Prevention of trichinellosis is based on veterinary and sanitary supervision and sanitary and educational work. To prevent human disease, the most important thing is mandatory veterinary examination of meat used for food, which is allowed to be sold only after trichinelloscopy. Carcasses of wild animals obtained during hunting are also subject to examination. Of great importance is informing the population through the media about helminthiasis and the ways of its spread, as well as disseminating zootechnical knowledge among people keeping pigs on their personal farms. For each case of trichinellosis, an urgent epidemiological investigation is carried out in order to identify the source of the invasion and prevent its spread. All persons who knowingly consumed meat products infested with trichinella are given preventive treatment for trichinellosis.