Trichinellosis, a Romanian never-ending story. An overview of traditions, culinary customs, and public health conditions.

Over the years, pork was the most frequent source of human trichinellosis in Romania. Cases generally occurred in foci, family, and group clusters and were rarely aggregated in extensive outbreaks. A study regarding the social consequences of trichinellosis in humans concluded that 84.8% of the patients diagnosed with the condition required an average of 53 days of sick leave. Cardiac complications are the most frequent causes of significant health status impairment. "Pig's alms," a specific custom representing the thanksgiving meal offered to relatives, friends, or neighbors who participated in the slaughtering process may be a very good source of infection with Trichinella parasites, leading to unfortunate consequences, especially when animals are not veterinary tested. Beside pork, other concerns for acquiring the disease are represented by game meat and horsemeat, the latter was introduced in public consumption in 2001. Although in Romania Trichinella sp. infection was documented for the first time in horses in 1993, no consequent human cases were detected at that time. Numerous trichinellosis outbreaks involve individuals from the gipsy community, most of whom are very poor, illiterate, unemployed, and live in unsanitary conditions raising backyard pigs without any compliance with hygienic rules. Measures aimed at limiting the spread of the infection in humans and animals should be widely available to be known, understood, and adequately applied by the great mass of pig breeders, hunters, and consumers.