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Bulletin No. 1 Presently, this Section is continuing an investigation of an outbreak of trichinosis we became aware of on January 2, 1979. On this date we received a call from a physician at the Alaska Native Medical Center to report a case of trichinosis. A short conversation convinced us of a relationship between this case and a similar case reported to us by health authorities in Los Angeles involving a patient who apparently acquired trichinosis from bear meat eaten in Anchorage. A complete investigation was begun centering around the case at the Native Medical Center. Since that time we have uncovered 13 cases and a total of 46 people in Alaska having possible contact with the infected bear meat. A portion of the meat was also taken to Los Angeles where at least 9 more people were exposed and 3 possible cases have occurred. Samples of the bear meat were examined in the USDA laboratory in Palmer and found to have 1200 larvae/gram ? an extremely infected sample. Trichinosis is caused by the migration of Trichinella spiralis larvae through the body and their subsequent encystment in muscle. These organisms enter the human body following ingestion of raw or insufficiently cooked, infected meat. Pork is commonly infected meat, but bear, walrus, and other carnivores may become infected. In Alaska it is estimated that approximately 25% of black bears, 50% of brown bears, and as many as 75% of polar bears are infected. Clinical disease is variable, but usually a mild febrile illness with myalgias is reported. Gastrointestinal symptoms such as diarrhea precede systemic symptoms such as fever, myalgias, chills and periorbital edema. This clinical picture following a known exposure combined with eosinophilia makes the diagnosis probable. Confirmatory serologic testing is available also. Prevention depends largely upon knowledge of adequate cooking procedures. Pork should be cooked until all parts reach 65.6°C (105°F) or until the meat changes color from pink to gray. Bear meat should always be thoroughly cooked. Freezing at home freezer temperatures for at least 20 days kills most trichinae. However, the arctic variety is more cold stable. INFLUENZA Widespread reports of influenza-like illness are being reported throughout southeastern and central portions of Alaska. Confirmed Russian influenza (A/USSR) isolates have been obtained from patients in Fairbanks, Anchorage (Elmendorf AFB), Juneau, and St. Paul. It is likely that the majority of the State will have had similar disease activity by February 1. Attempts should be made to adequately immunize high-risk individuals as soon as possible if this has not been done. SEXUALLY TRANSMITTED DISEASE The Bulletin will carry brief review and current recommended treatment schedules of the key sexually-transmitted diseases beginning with the next issue. Due to space limitations the larger subjects such as gonorrhea may be discussed in two or more Bulletins so it would be wise to save these issues for reference. |
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