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Trichinosis - Treatment and Prevention
Last reviewed: 20.11.2021
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Drug treatment of trichinosis
Antiparasitic treatment of trichinosis is aimed at destruction of intestinal trichinella, suppression of larvae production, violation of encapsulation process and growth of death of muscle trichinella. Albendazole and mebendazole are used for these purposes.
Albendazole is prescribed inside after meals 400 mg twice a day for patients with a body weight of 60 kg or more or 15 mg / kg per day in two doses to patients with a body weight of less than 60 kg. Duration of treatment is 14 days.
Mebendazole is administered internally after 20-30 minutes after meals at a dose of 10 mg / kg per day in 3 doses. Duration of treatment 14 days.
With a mild course of the disease, the same drugs are prescribed for a course of up to 7 days. Preventive antiparasitic treatment of trichinosis by persons who consumed invasive meat products is carried out with albendazole at the same doses for 5-7 days. The most effective etiotropic therapy in the incubation period, when it is possible to prevent clinical manifestations, or in the early days of the disease, when Trichinella is still in the intestine. During the muscular stage of the disease and encapsulation, the effectiveness of etiotropic therapy is much lower, and its use during this period may even contribute to exacerbation of the disease.
Patients prescribed antihistamines, inhibitors of prostaglandins, NSAIDs. With severe invasion with neurological disorders, myocarditis, ITH. Pulmonary insufficiency is used glucocorticoids: usually prednisolone in a daily dose of 20-60 (according to the indications to 80) mg inside for 5-7 days. In connection with the fact that glucocorticoids can prolong the period and the amount of larvoprodukia in the intestine, it is recommended to prescribe antiparasitic drugs (albendazole or mebendazole) during the entire period of glucocorticoid application and several days after their cancellation. Danger is also possible ulcers of the intestine in combination with disorders in the hemostatic system. In such patients, the risk of ulcerogenic action of glucocorticoids increases dramatically. Especially with concurrent administration of NSAIDs (indomethacin, diclofenac, etc.). In these cases, prophylaxis of ulcerative lesions in the gastrointestinal tract is recommended using proton pump inhibitors (omeprazole, etc.). Treatment of trichinosis of severe course with generalized edema (due to accelerated protein catabolism and hypoproteinemia) consists in infusion therapy with the introduction of detoxification agents and preparations for parenteral protein nutrition.
[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14]
Trichinosis: prognosis
The prognosis of trichinosis is favorable for a mild and moderate form of invasion. Perhaps a brief resumption of certain clinical manifestations: myalgia, moderate edema, eosinophilia in blood tests. In severe form with complications, the prognosis is serious: with late diagnosis and delayed antiparasitic treatment, a lethal outcome is possible: in malignant course it can already occur in the first days of the disease.
Approximate terms of incapacity for work
The ability to work is restored within 2-6 months, with a severe form of trichinosis - only after 6-12 months.
[15]
Clinical examination
Dispenserization of the sick is performed by an infectious disease doctor or a local therapist for 6 months or more, depending on the severity of the course and the complications. Reconvalvesent examination after 2 weeks. 1-2 and 5-6 months after discharge from the hospital, necessarily perform clinical and biochemical blood tests, as well as ECG recurred in severe form. The presence of changes on the ECG and other residual manifestations is the basis for extending the period of observation to 1 year.
[16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27]
How to prevent trichinosis?
Prophylaxis of trichinosis is based on the provision of veterinary and sanitary supervision and sanitary and educational work. To prevent human disease, the most important is the mandatory veterinary examination of meat used for food, which is allowed for sale only after trichinoscopy. Studies are also carried out on carcasses of wild animals caught in the hunt. Of great importance is informing the population through the mass media about helminthiosis and the ways of its spreading, as well as dissemination of zootechnical knowledge among persons containing pigs in the personal economy. For each case of trichinosis, an emergency epidemiological investigation is conducted to identify the source of infestation and prevent its spread. To all persons who knowingly consumed meat products invaded with trichinella, they carry out preventive treatment of trichinosis.