Epidemiology and risk factors of trichinellosis in Bosnia and Herzegovina from 1961 to 2021

This study is a retrospective analysis of social, economic, political, and cultural events on the annual incidence of trichinellosis in Bosnia and Herzegovina (BiH). It highlights the importance of specific regulations, which have been incorporated into developing preventive protection against this human disease for the last 61 years since it has been monitored by law. In the period, 1961-2021, 3828 people became infected. The first outbreak of trichinellosis was documented in 1965, and the incidence peaked during the war and post-war period at the end of the twentieth century. At that time, outbreaks with hundreds of cases and five deaths were recorded. In the first decade of the twenty-first century, the incidence decreased, and at the end of the second decade, two consecutive years without trichinellosis cases were finally registered. The analysis shows that a significantly higher incidence rate was recorded between the two political entities of BiH, the Republic of Srpska (4.97% 000) versus the Federation of BiH (0.9% 000) and that the occurrence of trichinellosis in humans in BiH is related to the presence of Trichinella spp. in animals, of a degree of biosecurity on pig farms, population's awareness of safe food, the impact of tradition and religion on eating habits, doctors' awareness of the symptomatology, and the Trichinella spp. larva detection method in muscle samples. The spread risk of trichinellosis requires meat inspection for Trichinella spp. larvae to be mandatory in BiH.