Outbreak of acute Chagas disease associated with oral transmission in the Rio Negro region, Brazilian Amazon

Two serological surveys for Chagas' infection were carried out, in 1991 and 1993, respectively, using a conglomerate family samples from the residents in the town of Barcelos (in the northern part of the State of Amazonas, on the right bank of the Rio Negro, 490 Km up-river from Manaus), using indirect immunofluorescent tests for anti-T. cruzi antibodies. In the first survey (1991), 628 blood samples from the residents of 142 dwellings were tested, showing positive in 12.7% for anti-T. cruzi antibodies and in 1993 an other 658 samples from residents of 171 dwellings showed positive in 13.7% of the tests, thus confirming the previous results. From 170 individuals with positive serology for T. cruzi antibodies, 112 (66%) were interviewed and submitted to electrocardiographic and clinical examinations; 82 (73.2%) of them gave consent for xenodiagnosis. From the 112 interviewed 52 (46.4%) recognized the triatomines as "piaçavas' lice", 48 (42.8%) knew the bugs from their work places being gatherers of piaçava fibers in rural areas and 19 (16.9%) said that have been bitten by bugs in their huts. Only 2 (2.4%) of 82 xenodiagnosis applied were positive for T. cruzi and 9 (8%) of the ECG had alterations compatible with Chagas' disease.

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Possible oral transmission of acute Chagas' disease in Brazil

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46651991000500003 ◽

1991 ◽

Vol 33 (5) ◽

pp. 351-357 ◽

Cited By ~ 89

Author(s):

M.A. Shikanai-Yasuda ◽

C. Brisola Marcondes ◽

L. A. Guedes ◽

G.S. Siqueira ◽

A.A. Barone ◽

...

Keyword(s):

Trypanosoma Cruzi ◽

Chagas Disease ◽

Fatal Case ◽

Febrile Illness ◽

Epidemiological Survey ◽

High Rate ◽

Oral Transmission ◽

Chagas Cardiomyopathy ◽

Limb Edema ◽

Acute Chagas Disease

In October, 1986, 7 to 22 days after a meeting at a farm in Paraíba state, 26 individuals presented with a febrile illness associated with bilateral eyelid and lower limb edema, mild hepatosplenomegaly, lymphadenopathy and, occasionally a skin rash. A 11-year-old boy exhibited atrial premature complexes and a 74-year-old patient developed acute heart failure. In two patients hospitalized in São Paulo city, acute Chagas' disease was diagnosed by the demonstration of circulating Trypanosoma cruzi. At autopsy in a fatal case, acute Chagas' cardiomyopathy was demonstrated. Xenodiagnosis were positive in 9 out of 14 tested patients. A specific IgG immune response was found in all patients and specific IgM antibodies were identified in 20 out of 22 tested patients. A epidemiological survey showed the existence of Triatoma brasiliensis in the outbuildings of this farm, but none in the house where most of the guests stayed. A high rate of infection with Trypanosoma cruzi was found in opossums. These observations together with those related to the food consumed by the patients, lead the authors to suggest that the human infections resulted from oral contamination probably originating from naturally infected marsupials in the area or crushed infected bugs.

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Acute Chagas disease outbreak associated with oral transmission

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822008000300014 ◽

2008 ◽

Vol 41 (3) ◽

pp. 296-300 ◽

Cited By ~ 65

Author(s):

Juarez Pereira Dias ◽

Claudilson Bastos ◽

Eline Araújo ◽

Ana Verônica Mascarenhas ◽

Eduardo Martins Netto ◽

...

Keyword(s):

Trypanosoma Cruzi ◽

Chagas Disease ◽

Disease Outbreak ◽

Serological Tests ◽

Oral Transmission ◽

Triatoma Sordida ◽

Acute Chagas Disease

Seven individuals living in a town in the Southwest of Bahia developed sudden signs of cardiac and systemic impairment, with lethality of 28.6%. Serological tests were positive at least in one test in the five patients examined. Forty percent of the Triatoma sordida mynphs found inside or around Trypanosoma cruzi were found by blood culturig in there out five cases the homes of these cases were positive for Trypanosoma cruzi. Transmission probably occurred through consumption of water contaminated with triatomine feces. These findings emphasize the necessity to evaluation the importance of vectors like Triatoma sordida in maintaining the endemicity of this disease.

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Atrial fibrillation in acute Chagas disease acquired via oral transmission: a case report

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/0037-8682-0296-2017 ◽

2018 ◽

Vol 51 (3) ◽

pp. 397-400 ◽

Cited By ~ 2

Author(s):

Paulo Fernando Pimenta de Souza ◽

Rosane Cheble Domingues Pine ◽

Francisco Lúzio de Paula Ramos ◽

Ana Yecê das Neves Pinto

Keyword(s):

Atrial Fibrillation ◽

Case Report ◽

Chagas Disease ◽

Oral Transmission ◽

Acute Chagas Disease

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Congenital and oral transmission of American trypanosomiasis: an overview of physiopathogenic aspects

Parasitology ◽

10.1017/s0031182012001394 ◽

2012 ◽

Vol 140 (2) ◽

pp. 147-159 ◽

Cited By ~ 40

Author(s):

LAURA VIVIANA SÁNCHEZ ◽

JUAN DAVID RAMÍREZ

Keyword(s):

Chagas Disease ◽

Disease Transmission ◽

The United States ◽

Oral Route ◽

Diagnostic Features ◽

American Trypanosomiasis ◽

Oral Transmission ◽

Host Pathogen Interaction ◽

Multiple Routes ◽

Acute Chagas Disease

SUMMARYChagas disease or American trypanosomiasis is a pathology affecting about 8–11 million people in Mexico, Central America, and South America, more than 300 000 persons in the United States as well as an indeterminate number of people in other non-endemic countries such as USA, Spain, Canada and Switzerland. The aetiological agent isTrypanosoma cruzi, a protozoan transmitted by multiple routes; among them, congenital route emerges as one of the most important mechanisms of spreading Chagas disease worldwide even in non-endemic countries and the oral route as the responsible of multiple outbreaks of acute Chagas disease in regions where the vectorial route has been interrupted. The aim of this review is to illustrate the recent research and advances in host-pathogen interaction making a model of how the virulence factors of the parasite would interact with the physiology and immune system components of the placental barrier and gastrointestinal tract in order to establish a response againstT. cruziinfection. This review also presents the epidemiological, clinical and diagnostic features of congenital and oral Chagas disease in order to update the reader about the emerging scenarios of Chagas disease transmission.

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