Trichinosis outbreak among Thai Immigrant workers in the Hadera sub-district

Introduction: Trichinosis also referred to as Trichinelliasis or Trichiniasis occurs sporadically in Israel and is not prevalent. Most reported cases have occurred in foreign born residents who were infected outside of Israel or in foreign workers who have eaten raw or undercooked meat. We report an outbreak of Trichinosis in Thai agricultural workers that occurred in February-March 2002. Of 120 workers in Moshav Sde Yitzchak, 30 became ill with thrichinosis. To the best of our knowledge, this is the largest outbreak of its kind reported in Israel. Objectives: To alert physicians in hospitals and clinics to consider the possibility of trichinosis in their differential diagnosis in light of the substantial population of foreign born workers in Israel, currently estimated at 238,000. We describe the outbreak and review the symptoms and signs of the disease, as well as the modes of transmission and treatment. Results: Eosinophilia was found in 22 (73.3%) of the cases. The average CPK level in 27 of the cases was 1312. Antibodies to trichinella were positive in the 12 persons who agreed to be tested. Conclusion: The demographic changes in Israel over the past years should lead physicians to consider trichinosis in their differential diagnosis when presented with a patient with a suggestive history as well as compatible signs and symptoms. The physician has a legal obligation to report outbreaks of trichinosis to the District Health Office. Health education for at-risk populations is indicated.