Uncertainties in diagnosis, treatment and prevention of trichinellosis.

This review summarizes expert opinion and evidence on the diagnosis, treatment and prevention of trichinellosis. Laboratory test results are not sufficiently sensitive for the diagnosis of individual patients when outbreaks are suspected. A likely diagnosis depends on identifying a potential common source of exposure supported by detection of antibodies to Trichinella antigens in a higher than expected proportion of exposed patients. Expert opinion is discordant, but for patients with symptomatic disease, there are theoretical reasons to recommend treatment with albendazole (rather than mebendazole) taken with fatty meals and prednisone. Education of the public is probably not a reliable way to prevent trichinellosis and when feasible should be augmented with mandatory testing of all potentially infected meat.