It’s tricky. To eat some bear meat that’s not fully cooked until it’s done. It’s tricky. That’s not exactly how the Run DMC song goes but undercooked bear meat could have live Trichinella parasites in it, which when ingested can lead to trichinellosis, otherwise known trichinosis. And serving undercooked undercooked bear meat is what likely led to an outbreak of 10 probable trichinellosis cases in western North Carolina, according to the latest Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, otherwise known as the MMWR.
The North Carolina Division of Public Health first became aware on November 29, 2023 that something tricky was going on when they were notified of someone who had experienced flu-like symptoms and swelling in the face. Further investigation revealed that this person had attended a gathering earlier that month where undercooked bear meat was served. This was bear meat that hadn’t been heated to at least 165°F (74°C) in case you aren’t in the habit of cooking bear meat. That’s the temperature needed to kill Trichinella.
Public health officials ended up surveying 34 attendees of this gathering and found that 22 (65%) of them had consumed such bear meat there and 10 (45%) had subsequently experienced clinical signs and symptoms that qualified them as “probable” trichinellosis cases. Nine of them had experienced facial swelling, six muscle aches and four fevers. Symptoms began appearing seven to 26 days after the bear meat was eaten, with the median being 21 days.
They were deemed probable cases because public health officials had to bear with a limited information situation. The patients didn’t return for the full complement of blood testing to confirm whether they indeed had trichinosis. Most of the cases had received the anti-helminthic medication albendazole. So if their symptoms had resolved, they probably had little incentive to return. Also, there wasn’t any leftover bear meat for laboratory testing.
Of note, ages of the patients ranged from 10 to 40 years with the median being 17 years old and six of them being 18 years old or younger. And getting teens to do stuff like return for appointments and testing isn’t always easy. Therefore, public health officials took what they had and compared the available info to the 2014 Council of State and Territorial Epidemiologists criteria for a probable case of trichinosis.
If you do get trichinosis, this isn’t something that you should just try to walk off and ignore. What happens will depend on how many parasite larvae encased in little cysts were in the meat and subsequently went down your pie hole. You may have no symptoms if there were relatively few larvae. When the cysts travel through your gastrointestinal tract, digestive juices dissolve the sacks surrounding the larvae, allowing them to burrow into the walls of your small intestine. While there, they grow into adults and then mate with each other. This is when you may experience diarrhea, abdominal pain, fatigue, nausea and vomiting.
After the parasite hank panky has gone on in your intestinal walls, the adult female parasites worms begin producing larvae, which then burrow through your intestinal walls into your bloodstream, This essentially gives them a highway to all parts of your body. Typically, they’ll make their way into your muscles, where they will curl up and form cysts around themselves, which may sound adorable but really isn’t. There they can live for months to years.
During this muscle invasion period, which tends to occur two to eight weeks after the initial infection, you may experience muscle pain, tenderness and weakness, which can be so severe that it limits your movement, breathing and speaking, as described by the Mayo Clinic website. You may also suffer joint aches, headaches, high fevers, chills, skin irritation or itchiness, swelling of your eyelids or face, eye redness and pain and sensitivity to light.
Now, it most cases, trichinosis does not lead to severe complications, if you consider a bunch of parasites living in your muscles to not be a complicated situation. But in rare cases when there are lot of roundworm larvae moving through your bloodstream, they can lodge themselves into key parts of your body such as your heart causing myocarditis (inflammation of your heart muscle), your lungs causing pneumonitis (inflammation of your lung tissue), your brain causing encephalitis (inflammation of your brain tissue) or the membranes that wrap around your brain and spinal cord causing meningitis. These are serious complications that can be fatal. Around 0.2% of those with trichinosis end up dying. So while you could just leave the parasites in your body, it’s a good idea to take an antihelminthic medication like albendazole, even though it ain’t cheap, costing about $100 per course.
It’s an even better idea to not get infected in the first place. Avoid eating raw or undercooked bear, cougar, walrus, fox, wild boar or pig meat. Make sure such meat is thoroughly cooked until brown. Use a meat thermometer to check whether the 165°F (74°C) threshold has been reached. Other preparation methods such as smoking, curing, pickling and microwaving probably won’t kill the parasite larvae. Also, make sure that you wash your hands after handling the raw meat. Thoroughly clean everything that may have touched the meat and don’t lick the meat grinder.