The United States Trypanosoma cruzi Infection Study: evidence for vector-borne transmission of the parasite that causes Chagas disease among United States blood donors

The vector-borne parasite Trypanosoma cruzi infects seven million individuals globally and causes chronic cardiomyopathy and gastrointestinal diseases. Recently, T. cruzi has emerged in the southern United States. It is crucial for disease surveillance efforts to detail regions that present favorable climatic conditions for T. cruzi and vector establishment. We used MaxEnt to develop an ecological niche model for T. cruzi and five widespread Triatoma vectors based on 546 published localities within the United States. We modeled regions of current potential T. cruzi and Triatoma distribution and then regions projected to have suitable climatic conditions by 2070. Regions with suitable climatic conditions for the study organisms are predicted to increase within the United States. Our findings agree with the hypothesis that climate change will facilitate the expansion of tropical diseases throughout temperate regions and suggest climate change will influence the expansion of T. cruzi and Triatoma vectors in the United States.

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Disagreement between PCR and serological diagnosis of Trypanosoma cruzi infection in blood donors from a Colombian endemic region

Biomédica ◽

10.7705/biomedica.5441 ◽

2021 ◽

Vol 41 (Supl. 1) ◽

pp. 47-59

Author(s):

Liliana Torcoroma García Sánchez ◽

Jhancy Rocío Aguilar Jiménez ◽

Marly Yojhana Bueno ◽

Erika Marcela Moreno Moreno ◽

Herminia Ramírez ◽

...

Keyword(s):

Trypanosoma Cruzi ◽

Chagas Disease ◽

Blood Donors ◽

False Negative ◽

Chronic Phase ◽

Antibody Detection ◽

Low Grade ◽

Endemic Region ◽

Infected People ◽

Cruzi Infection

Introduction: Chagas’ disease is the leading cause of infectious myocarditis worldwide. This infection caused by Trypanosoma cruzi is usually life-long and asymptomatic; however, the third part of infected people can develop severe or even fatal cardiomyopathy. As the parasitemia in the chronic phase is both low-grade and intermittent, T. cruzi infection is principally detected by serology, although this method has sensitivity and specificity limitations.Objective: To determine the level of agreement between serologic and molecular tests in 658 voluntary blood donors from six provinces in the Colombian department of Santander.Materials and methods: We evaluated an array of diagnostic technologies by cross-section sampling performing a serological double diagnostic test for T. cruzi antibody detection (Chagas III ELISA™, BiosChile Group, and ARCHITECT Chagas CMIA™, Abbott), and DNA detection by polymerase chain reaction (PCR). We collected the demographic, clinical, and epidemiological information of participants. The sample size was calculated using Epidat™ and the statistical analysis was done with Stata 12.1™.Results: PCR was six times more sensitive in detecting T. cruzi infection than ELISA/CMIA with prevalence values of 1.8% (12/658) and 0.3% (2/658), respectively, and kappa=0.28 (95%CI: -0.03 - 0.59). In contrast, serology showed a sensitivity of 16.7% (95%CI: 2.09 - 48.4) and a specificity of 100% (95%CI: 99.4 - 100). All seropositive samples were found to be positive by PCR.Conclusions: The implementation of PCR as a complementary method for screening donors could reduce the probability of false negative and the consequent risk of transfusional-transmission of Chagas’ disease, especially in endemic regions.

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1357. A Combination of Itraconazole and Amiodarone Is Highly Effective Against Trypanosoma cruzi Infection of Human Stem Cell-Derived Cardiomyocytes

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.1188 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S415-S416

Author(s):

Gabriele Sass ◽

Roy Madigan ◽

Adriana Bozzi ◽

Nazish Sayed ◽

Joseph Wu ◽

...

Keyword(s):

Trypanosoma Cruzi ◽

Chagas Disease ◽

Cell Metabolism ◽

Vero Cells ◽

The United States ◽

Etiologic Agent ◽

Sterol Synthesis ◽

Xtt Assay ◽

Cruzi Infection

Abstract Background Trypanosoma cruzi is the etiologic agent of Chagas disease, which can result in severe cardiomyopathy. Trypanosoma cruzi is endemic to the Americas, and of particular importance in Latin America. In the United States and other nonendemic countries, rising case numbers have been observed. The only drugs available so far are benznidazole and nifurtimox, which have limited efficacy during chronic infection. We repurposed itraconazole, originally an antifungal, in combination with amiodarone, an antiarrhythmic, with the goal to interfere with Tc infection. Both drugs inhibit sterol synthesis, while amiodarone also inhibits calcium metabolism of Trypanosoma cruzi. Methods Human pluripotent stem cells (HiPSC) were differentiated to cardiomyocytes (HiPSC-CM). Vero cells or HiPSC-CM were infected with the T. cruzi trypomastigotes Y strain in the presence of itraconazole and/or amiodarone. After 48 hours, infection and multiplication were evaluated by Giemsa stain. Benznidazole was used as a reference compound. Cell viability was verified by XTT assay. Results Itraconazole and amiodarone showed dose-dependent interference with T. cruzi infection of Vero cells or HiPSC-CM. The combination of itraconazole and amiodarone was more potent than the single substances, or benznidazole at therapeutic concentrations, without affecting host cell metabolism. In addition to effects on infection, itraconazole, or amiodarone affected T. cruzi multiplication. Here, itraconazole/amiodarone combinations were more potent than either alone, both, in Vero cells, and HiPSC-CM. Conclusion Our in vitro data suggest that a combination of itraconazole and amiodarone might serve as an effective new treatment option for Chagas disease, particularly cardiac involvement, in human and animal patients. Disclosures All authors: No reported disclosures.

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A Southwestern United States Pilot Investigation of Triatomine–Mite Prevalence

Insects ◽

10.3390/insects12090811 ◽

2021 ◽

Vol 12 (9) ◽

pp. 811

Author(s):

Kyndall C. Dye-Braumuller ◽

Hanna Waltz ◽

Mary K. Lynn ◽

Stephen A. Klotz ◽

Justin O. Schmidt ◽

...

Keyword(s):

United States ◽

Chagas Disease ◽

Disease Transmission ◽

Western Hemisphere ◽

Common Finding ◽

Southwestern United States ◽

Pilot Investigation ◽

Vector Borne ◽

Cruzi Infection

Background: Chagas disease is a leading cause of cardiac failure in Latin America. Due to poor safety profiles and efficacy of currently available therapeutics, prevention is a priority for the millions living at risk for acquiring this clinically important vector-borne disease. Triatomine vectors of the Chagas disease parasite, Trypanosoma cruzi, are found in the southwestern United States, but risk for autochthonous transmission is thought to be low. The role of ectoparasitic mites is under-explored regarding the ecology of triatomines and Chagas disease transmission. Methods: Triatomine collections were performed using three common entomologic techniques in 2020–2021 from four different locations in southern Arizona and New Mexico. Triatomines were analyzed visually under a 112.5× microscope for the presence of externally attached mites. Following mite removal, triatomines were tested for T. cruzi infection by PCR. Results: Approximately 13% of the collected triatomines had mites securely attached to their head, thorax, abdomen, and legs. More than one mite attached was a common finding among ectoparasitized triatomines. Mite presence, however, did not statistically influence triatomine T. cruzi status. Conclusions: Our findings add to a growing body of literature demonstrating the sustainability of mite-infested triatomine populations throughout the Western Hemisphere. Future investigations are warranted to better understand the biologic impact of triatomine mites and their potential to serve as a potential biological control tool.

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Eastern Bloodsucking Conenose, Triatoma sanguisuga (LeConte) (Hemiptera: Reduviidae: Triatominae)

EDIS ◽

10.32473/edis-in1018-2013 ◽

2013 ◽

Vol 2013 (10) ◽

Author(s):

John L. Capinera

Keyword(s):

United States ◽

South America ◽

Trypanosoma Cruzi ◽

Central America ◽

Chagas Disease ◽

The United States ◽

American Trypanosomiasis ◽

Fact Sheet ◽

Blood Meals

The eastern bloodsucking conenose belongs to the subfamily Triatominae, known as the kissing bugs. Despite their affectionate vernacular name, they are particularly threatening “assassin bugs” who require blood meals to survive and reproduce. They are a known vector of American trypanosomiasis (or Chagas Disease) in South America, a debilitating illness caused by the parasite Trypanosoma cruzi. This disease is a problem in South and Central America and has been detected in the United States, but has not been found in Florida. This 4-page fact sheet was written by John L. Capinera, and published by the UF Department of Entomology and Nematology, November 2013. http://edis.ifas.ufl.edu/in1018

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Chagas Disease Ecology in the United States: Recent Advances in Understanding Trypanosoma cruzi Transmission Among Triatomines, Wildlife, and Domestic Animals and a Quantitative Synthesis of Vector–Host Interactions

Annual Review of Animal Biosciences ◽

10.1146/annurev-animal-013120-043949 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Rachel E. Busselman ◽

Sarah A. Hamer

Keyword(s):

United States ◽

Trypanosoma Cruzi ◽

Chagas Disease ◽

Disease Ecology ◽

The United States ◽

Diagnostic Tools ◽

Annual Review ◽

Publication Date ◽

Quantitative Synthesis ◽

Management Approaches

Chagas disease, a neglected tropical disease present in the Americas, is caused by the parasite Trypanosoma cruzi and is transmitted by triatomine kissing bug vectors. Hundreds of vertebrate host species are involved in the ecology of Chagas disease. The sylvatic nature of most triatomines found in the United States accounts for high levels of animal infections but few reports of human infections. This review focuses on triatomine distributions and animal infections in the southern United States. A quantitative synthesis of available US data from triatomine bloodmeal analysis studies shows that dogs, humans, and rodents are key taxa for feeding triatomines. Imperfect and unvalidated diagnostic tools in wildlife complicate the study of animal T. cruzi infections, and integrated vector management approaches are needed to reduce parasite transmission in nature. The diversity of animal species involved in Chagas disease ecology underscores the importance of a One Health approach for disease research and management. Expected final online publication date for the Annual Review of Animal Biosciences, Volume 10 is February 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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Impact of one-time testing for Trypanosoma cruzi antibodies among blood donors in the United States

Transfusion ◽

10.1111/trf.15118 ◽

2018 ◽

Vol 59 (3) ◽

pp. 1016-1023 ◽

Cited By ~ 7

Author(s):

Roger Y. Dodd ◽

Jamel A. Groves ◽

Rebecca L. Townsend ◽

Edward P. Notari ◽

Gregory A. Foster ◽

...

Keyword(s):

United States ◽

Trypanosoma Cruzi ◽

Blood Donors ◽

The United States

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Trypanosoma cruzi and Chagas' Disease in the United States

Clinical Microbiology Reviews ◽

10.1128/cmr.00005-11 ◽

2011 ◽

Vol 24 (4) ◽

pp. 655-681 ◽

Cited By ~ 413

Author(s):

C. Bern ◽

S. Kjos ◽

M. J. Yabsley ◽

S. P. Montgomery

Keyword(s):

United States ◽

Trypanosoma Cruzi ◽

Chagas Disease ◽

The United States

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Surveillance of Trypanosoma cruzi infection in Triatomine vectors, feral dogs and cats, and wild animals in and around El Paso county, Texas, and New Mexico

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009147 ◽

2021 ◽

Vol 15 (2) ◽

pp. e0009147

Author(s):

Felipe Rodriguez ◽

Brenda S. Luna ◽

Olivia Calderon ◽

Claudia Manriquez-Roman ◽

Karsten Amezcua-Winter ◽

...

Keyword(s):

United States ◽

New Mexico ◽

Trypanosoma Cruzi ◽

Chagas Disease ◽

El Paso ◽

The United States ◽

Wild Animals ◽

Feral Cats ◽

Feral Dogs ◽

El Paso County

The causative agent of Chagas disease, Trypanosoma cruzi, is transmitted by triatomine vectors. The insect is endemic in the Americas, including the United States, where epidemiological studies are limited, particularly in the Southwestern region. Here, we have determined the prevalence of T. cruzi in triatomines, and feral cats and dogs, and wild animals, the infecting parasite genotypes and the mammalian host bloodmeal sources of the triatomines at four different geographical sites in the U.S.-Mexico border, including El Paso County, Texas, and nearby cities in New Mexico. Using qualitative polymerase chain reaction to detect T. cruzi infections, we found 66.4% (n = 225) of triatomines, 45.3% (n = 95) of feral dogs, 39.2% (n = 24) of feral cats, and 71.4% (n = 7) of wild animals positive for T. cruzi. Over 95% of T. cruzi genotypes or discrete typing units (DTUs) identified were TcI and some TcIV. Furthermore, Triatoma rubida was the triatomine species most frequently (98.2%) collected in all samples analyzed. These findings suggest a high prevalence of T. cruzi infections among triatomines, and feral and wild animals in the studied sites. Therefore, our results underscore the urgent need for implementation of a systematic epidemiological surveillance program for T. cruzi infections in insect vectors, and feral and wild animals, and Chagas disease in the human population in the southwestern region of the United States.

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Transmission of Donor-Derived Trypanosoma cruzi and Subsequent Development of Chagas Disease in a Lung Transplant Recipient

Case Reports in Infectious Diseases ◽

10.1155/2017/5381072 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

A. B. Corey ◽

D. Sonetti ◽

J. D. Maloney ◽

S. P. Montgomery ◽

B. L. Rademacher ◽

...

Keyword(s):

United States ◽

Transplant Recipient ◽

Trypanosoma Cruzi ◽

Chagas Disease ◽

Lung Transplant ◽

Organ Transplant ◽

Subsequent Development ◽

The United States ◽

Infection Status ◽

Targeted Screening

Donor infection status should be considered when accepting an organ for transplant. Here we present a case of Chagas disease developing after a lung transplant where the donor was known to be Trypanosoma cruzi antibody positive. The recipient developed acute Trypanosoma cruzi infection with reactivation after treatment. Chagas disease-positive donors are likely to be encountered in the United States; donor targeted screening is needed to guide decisions regarding organ transplant and posttransplant monitoring.

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