TWiP 278: Trichinella from eating bear eyeballs

This Week in Parasitism episode 278 opens with a lively discussion of a real-world case involving a young man from Japan who developed fatigue, rash, fever, and muscle pain after consuming raw bear eyeballs during a hunting trip. Despite the bear meat being well-cooked, only the two hunters who ate the raw eyeballs became ill, pointing strongly to Trichinella infection as the culprit. The hosts and listeners analyze the case, with nearly unanimous agreement that Trichinella, a parasitic roundworm commonly found in bear muscle tissue—including the extraocular muscles—was responsible. The episode highlights the risks of consuming raw or undercooked wild game, especially organs like the eye, and references a published case report confirming the diagnosis via serology. The discussion then shifts to a tribute to Sir Nicholas White, a pioneering tropical medicine researcher who revolutionized global malaria treatment through his work on artemisinin-based therapies and built research capacity across Southeast Asia. The episode closes with a dramatic ER case of a three-year-old child from Central America presenting with acute abdominal pain, where an ultrasound revealed a large, wiggling worm in the appendix—likely a nematode such as Ascaris lumbricoides—prompting urgent surgical consideration.