Undercooked bear meat linked to 2023 Trichinellosis outbreak in North Carolina

A 2023 outbreak of Trichinellosis linked to undercooked bear meat in western North Carolina highlights the ongoing risks associated with consuming wild game, according to a new report from the Centers for Disease Control and Prevention. The report emphasizes the need to educate hunters and the public about safe meat preparation practices to prevent the parasitic disease.

The outbreak in November 2023 involved 10 probable cases of Trichinellosis, a disease caused by consuming raw or undercooked meat containing Trichinella larvae. The CDC’s Morbidity and Mortality Weekly Report detailed how bear meat at a gathering in western North Carolina was not adequately cooked, leading to illness in attendees.

Symptoms and diagnosis challenges
One of the patients was reported to the North Carolina Division of Public Health on Nov. 29, 2023, after experiencing flu-like symptoms typical of Trichinellosis, including muscle pain, fever and facial swelling. Of the 34 attendees at the event, 22 reported eating the bear meat and ten developed symptoms. The affected individuals ranged in age from 10 to 40, with a median age of 17. However, confirmatory tests were challenging despite the clinical symptoms, as none of the patients returned for additional follow-up testing. This, along with the absence of leftover bear meat for laboratory testing, complicated efforts to definitively confirm the outbreak’s source.

The CDC’s report noted that diagnosing trichinellosis is often difficult because the time tests can resolve symptoms are conducted. This issue was also seen in a 2022 outbreak, where six people across Arizona, Minnesota, and South Dakota contracted the disease after consuming bear meat at a family gathering in South Dakota. In that case, Trichinella larvae, specifically the freeze-resistant Trichinella native species, were found in the meat despite the meat being frozen for 45 days before consumption.

Freezing is not enough
Both the 2022 and 2023 outbreaks underscore the importance of thoroughly cooking wild game, especially bear meat. In the 2022 incident, the meat had been frozen based on advice from a hunting outfitter in Saskatchewan, Canada, to kill any parasites. However, Trichinella nativa is resistant to freezing, meaning the meat remained infectious. Two of the infected individuals had only eaten vegetables cooked alongside the bear meat, highlighting the dangers of cross-contamination.

The CDC recommends cooking wild game meat to an internal temperature of at least 165 degrees F (74 degrees C) to kill any Trichinella parasites. Freezing, drying, curing, or smoking meat does not reliably eliminate the parasite. Public health officials stress that hunters and others who consume wild game must be vigilant about proper cooking methods to prevent infection.

Ongoing public health risks
While Trichinellosis is rare in the United States, with about 15 cases reported annually, recent outbreaks linked to bear meat show that the disease remains a concern for those consuming wild game. Public health authorities continue to highlight the importance of food safety education, particularly in regions where bear hunting is common.

In both the 2023 North Carolina outbreak and the 2022 outbreak spanning multiple states, many of those affected were treated with albendazole, an antiparasitic drug. However, the CDC’s report from the North Carolina outbreak noted delays in treatment and the financial burden of the medication, which can cost up to $100 per course.

Prevention and public awareness
The CDC emphasizes that proper food handling and cooking practices is the best way to prevent Trichinellosis. The key recommendations include:

• Cooking wild game to an internal temperature of at least 165 degrees F (74 degrees C).
• Avoiding cross-contamination by using separate cutting boards and utensils for raw and cooked meat.
• Not relying on freezing or other preservation methods to kill Trichinella.

For more information on Trichinellosis, visit the CDC’s website.

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