Concerns About Eating Undercooked Pork: Do You Need to See an Infectious Disease Specialist?

Eating undercooked pork in barbecue?

When eating barbecue, I thought it was beef and consumed it medium-rare, only to later find out it was pork! Doctor, I have two questions: 1.
Is it necessary to see an infectious disease specialist for this situation? 2.
Is the prevalence of tapeworm disease high in Taiwan? Should I consider preventive medication? The photos of tapeworm disease online are quite alarming, and I'm very worried.
Thank you for your response.

88, 20~29 year old female. Ask Date: 2023/04/25

Dr. Liao Zhongxin reply Internal Medicine

1.
According to the information from the Centers for Disease Control in Taiwan, a member of the indigenous community in Hualien County, Peng Zhaoxi, frequently consumed raw wild boar meat.
Over a month ago, he developed a hard lump on the inner side of his left thigh.
After examination at Min-Sheng Hospital in Taoyuan, it was discovered that the lump was caused by the ingestion of raw pork infected with the pork tapeworm, which had entered his body.
The larvae of the tapeworm migrated into his thigh's striated muscle, forming a four-centimeter larval cyst.
Dr.
Chen Taiqi, the attending surgeon at Min-Sheng Hospital, stated yesterday that it was "a stroke of luck" that the parasite had not migrated to the brain.
After undergoing surgical removal, Peng Zhaoxi remarked, "I won't dare eat raw pork again." The 31-year-old has worked as a truck driver and cargo handler in Taoyuan and Taipei County.
He mentioned that indigenous people often enjoy eating raw wild boar meat.
In the past year or two, he had hunted wild boar in the mountains of Hualien, slaughtered them, and consumed them raw, particularly enjoying the back and leg meat.
Over a month ago, he noticed a painless hard lump on the inner side of his left thigh and sought medical attention, fearing it might be a tumor.
Dr.
Chen performed an ultrasound examination and found an approximately four-centimeter oval cystic mass within the muscle layer of the left thigh.
After surgical removal and biopsy, it was revealed to be caused by cysticercosis due to the pork tapeworm; such parasites were commonly seen in rural areas with poor hygiene in earlier years.
Dr.
Chen explained that the pork tapeworm is a zoonotic parasite, with humans often serving as the definitive host, where the adult worms reside in the intestines.
Once the pork tapeworm enters the human body, it lays eggs, and the hatching larvae can penetrate the intestinal wall, enter the abdominal cavity, and migrate, often residing in striated muscle, and can even reach the brain, eyes, or heart.
If they migrate to the brain, it may cause hydrocephalus, which can be fatal; if they enter the eyes, it can lead to retinal damage and potentially blindness.
The physician considered Peng Zhaoxi fortunate that the larval cyst was located in the striated muscle of his thigh, and after surgical removal and treatment with antiparasitic medication, he is now out of danger.
Dr.
Chen noted that the pork tapeworm primarily resides in pork but can also infect cattle, sheep, and deer.
It is recommended that meat be thoroughly cooked before consumption, ideally at a temperature of 80 to 100 degrees Celsius for at least 15 minutes.
Separate cutting boards should be used for raw and cooked foods to prevent parasitic infections.
2.
Generally, infrequent and minimal consumption of raw meat should not pose significant risks; at most, it may cause mild gastrointestinal upset.
The prevalence of tapeworms in Taiwan is low due to effective public health measures, along with healthy farming practices and vaccination programs.
Vaccination or medication is typically unnecessary; maintaining good hand hygiene and consuming properly cooked food is sufficient.

Reply Date: 2023/04/25

More Info

Eating undercooked pork can indeed raise concerns about potential infections, particularly from parasites such as the pork tapeworm (Taenia solium). This is especially relevant in regions where the prevalence of such infections is higher. In your case, having consumed undercooked pork mistakenly thought to be beef raises valid questions regarding the need for medical evaluation and the risk of infection.

1. Do You Need to See an Infectious Disease Specialist?
If you have consumed undercooked pork, it is advisable to monitor your health closely for any symptoms that may arise. Common symptoms of a parasitic infection can include gastrointestinal issues such as diarrhea, abdominal pain, nausea, and vomiting. If you experience persistent symptoms or any unusual signs, it would be prudent to consult a healthcare professional, preferably an infectious disease specialist. They can evaluate your symptoms, conduct necessary tests, and provide appropriate treatment if needed.

However, if you are currently asymptomatic or only experiencing mild symptoms, immediate consultation may not be necessary. It is essential to differentiate between a mild gastrointestinal upset and a more serious infection. If you have concerns about your health or if symptoms develop, seeking medical advice is always a good practice.

2. Prevalence of Tapeworm Disease in Taiwan:
The prevalence of pork tapeworm infections in Taiwan is relatively low due to improved public health measures, food safety regulations, and health education. The risk of contracting a tapeworm infection from undercooked pork is significantly reduced when proper cooking methods are followed. The Centers for Disease Control (CDC) in Taiwan and other health organizations recommend cooking pork to an internal temperature of at least 145°F (63°C) and allowing it to rest for three minutes before consumption to ensure that any potential parasites are killed.

Regarding preventive measures, routine preventive medication is generally not recommended for the general population unless there is a specific risk factor or outbreak. Maintaining good hygiene practices, such as washing hands before handling food and ensuring that meat is cooked thoroughly, is the best way to prevent infections.

Additional Considerations:
If you have previously noticed unusual objects in your stool, such as segments of a tapeworm, it is crucial to report this to your healthcare provider. They may recommend stool tests to check for the presence of parasites. It is also worth noting that false negatives can occur in stool tests, so if there is a high suspicion of infection, your doctor may suggest repeat testing over several days.

In conclusion, while the risk of infection from consuming undercooked pork exists, the likelihood of contracting a tapeworm infection is relatively low in Taiwan due to effective public health measures. If you remain symptom-free, there may be no immediate need for concern. However, if symptoms arise or if you have specific health worries, consulting with a healthcare professional is the best course of action. Always prioritize food safety by ensuring that all meats are cooked thoroughly to minimize health risks.

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