1
|
Davila E, Fernandez-Santos NA, Estrada-Franco JG, Wei L, Velázquez-Ramírez DD, García-Miranda R, Irecta Nájera C, Cruz-Cadena R, Guichard-Romero C, Rodriguez C, Tarleton R, Rodríguez-Pérez MA, Ochoa-Díaz-López H, Hamer GL, Hamer SA. Domestic Dog Infection with Trypanosoma cruzi from Northern and Southern Regions of Mexico. Vector Borne Zoonotic Dis 2024; 24:510-519. [PMID: 38949980 DOI: 10.1089/vbz.2023.0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024] Open
Abstract
Background: Chagas disease or American trypanosomiasis, caused by Trypanosoma cruzi and vectored by triatomines, affects millions of people worldwide. In endemic countries including Mexico, infections in domestic animals, such as dogs, may affect the risk of human disease when they serve as a source of infection to vectors that subsequently infect humans. Materials and Methods: We conducted a cross-sectional study of 296 dogs from two cities near the northern and southern borders of Mexico: Reynosa, Tamaulipas, and Tuxtla Gutierrez, Chiapas. Infection was measured based on testing of blood using T. cruzi quantitative PCR (qPCR) and up to three antibody detection assays. The StatPak immunochromatographic assay was used to screen samples and the indirect fluorescent antibody (IFA) and multiplex microsphere immunoassay (MIA) tests were used as secondary tests on all samples that screened positive and a subset of negatives. Serologic positivity was defined based on reactivity on at least two independent tests. Results: Of the 280 samples tested for parasite DNA, two (0.7%) were positive, one of which (0.4%) was confirmed as T. cruzi discrete typing unit TcIV. Overall, 72 (24.3%) samples were reactive for T. cruzi antibodies via StatPak of which 8 were also positive using MIA and 2 were also positive using IFA (including one of the PCR-positive dogs). Overall, nine dogs (3.4%) met study criteria of positivity based on either/both serology or PCR tests. Positive dogs were found in both regions of Mexico; five (2.7%) from Reynosa and four (3.6%) from Tuxtla Gutierrez. We found no association between infection status and state of origin, sex, age group, breed group, neighborhood, and whether other pets lived in the home. Conclusion: Our results re-emphasize dogs' utility as sentinels for T. cruzi in Mexico and underscore the need for improved veterinary diagnostic tests and parasite surveillance at the household level in endemic countries.
Collapse
Affiliation(s)
- Edward Davila
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, USA
| | - Nadia A Fernandez-Santos
- Department of Entomology, Texas A&M University, College Station, Texas, USA
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Laboratorio de Biomedicina Molecular, Reynosa, Tamaulipas, Mexico
| | - José Guillermo Estrada-Franco
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Laboratorio de Biomedicina Molecular, Reynosa, Tamaulipas, Mexico
| | - Lihua Wei
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Laboratorio de Biomedicina Molecular, Reynosa, Tamaulipas, Mexico
| | | | - Rosario García-Miranda
- Departamento de Salud, El Colegio de la Frontera Sur (ECOSUR), San Cristóbal de Las Casas, México
- Escuela de Lenguas, Universidad Autónoma de Chiapas (UNACH), San Cristóbal de Las Casas, México
| | - Cesar Irecta Nájera
- Departamento de Salud, El Colegio de la Frontera Sur (ECOSUR), Villahermosa, México
| | - Raúl Cruz-Cadena
- Escuela de Ciencias Químicas, Universidad Autónoma de Chiapas (UNACH), Ocozocoautla de Espinosa, México
| | | | - Carlos Rodriguez
- Texas A&M Veterinary Medical Diagnostic Laboratory, College Station, Texas, USA
| | - Rick Tarleton
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia, USA
- Department of Cellular Biology, University of Georgia, Athens, Georgia, USA
| | - Mario A Rodríguez-Pérez
- Instituto Politécnico Nacional, Centro de Biotecnología Genómica, Laboratorio de Biomedicina Molecular, Reynosa, Tamaulipas, Mexico
| | - Héctor Ochoa-Díaz-López
- Departamento de Salud, El Colegio de la Frontera Sur (ECOSUR), San Cristóbal de Las Casas, México
| | - Gabriel L Hamer
- Department of Entomology, Texas A&M University, College Station, Texas, USA
| | - Sarah A Hamer
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, USA
| |
Collapse
|
2
|
Martinez Ibarra JA, Martinez BO, Rodas Martinez AZ, Flores RA, Garcia CIM, Franco ER, Villalobos G, Martinez Hernandez F. Trypanosoma cruzi in Wild and Synanthropic Mammals in Two Regions of Mexico: A Fieldwork and Genetic Discrete Typing Unit Review. Vector Borne Zoonotic Dis 2024; 24:499-509. [PMID: 38836751 DOI: 10.1089/vbz.2023.0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
Background: Marsupials and rodents are the most important wild and synanthropic hosts of Trypanosoma cruzi due to the high frequency of infection, maintenance of diverse genetic populations of the parasite, and their close proximity to interact with both transmission cycles, sylvatic and peridomestic. Our aim was to identify the discrete typing units (DTU) of T. cruzi from different wild and synanthropic hosts in two regions of Mexico and to carry out a review of historical data focusing on current knowledge on the diversity and T. cruzi DTUs of host species. Materials and Methods: One hundred fifteen samples were obtained from two areas in Tabasco and Nayarit state. The presence of T. cruzi was evaluated by PCR. Results: The 12.6% (12/95) of samples from Tabasco and 65% (13/20) from Nayarit were found to be positive for parasite DNA. All the sequences analyzed were grouped in T. cruzi DTU I; low nucleotide diversity was observed in Tabasco (π = 0.00566, and ϴ = 0.00632), while high genetic diversity was observed in Nayarit sequences, up to 8.63 (π) to 11.10 (ϴ) times greater than Tabasco sequences. Genetic flow and migration between Tabasco, and Nayarit were scarce (FST = 0.37329 and Nm = 0.42), and genetic exchange was observed only between nearby areas. The bibliographic review of hosts in Mexico, together with our data, shows a heterogeneous T. cruzi prevalence in Chiroptera and domestic animals. For Atelidae and Canids, prevalence is generally below 25%. However, a high prevalence, greater than 25% and up to 100%, was recorded in Didelphimorphia, and Rodentia. Few studies in regions of Mexico have been described as infected with the parasite; in these, the genetic group with the highest prevalence is the DTU I. Conclusion: Marsupials and rodents are important reservoirs of T. cruzi; DTU I was frequently reported; however, recent genetic and reservoir studies have demonstrated the presence of greater diversity of genetic groups.
Collapse
Affiliation(s)
| | - Brizia Oria Martinez
- Departamento de Ecología de Agentes Patógenos, Hospital General "Dr. Manuel Gea González," Mexico City, Mexico
| | | | - Rafael Avila Flores
- División Académica de Ciencias Biológicas, Universidad Juárez Autónoma de Tabasco, Villahermosa, México
| | | | - Emilio Rendon Franco
- Departamento de Producción Agrícola y Animal, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Guiehdani Villalobos
- Departamento de Producción Agrícola y Animal, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Fernando Martinez Hernandez
- Departamento de Ecología de Agentes Patógenos, Hospital General "Dr. Manuel Gea González," Mexico City, Mexico
| |
Collapse
|
3
|
Gulas-Wroblewski BE, Gorchakov R, Kairis RB, Dowler RC, Murray KO. Prevalence of Trypanosoma cruzi, the Etiologic Agent of Chagas Disease, Infection in Texas Skunks (Mammalia: Mephitidae). Vector Borne Zoonotic Dis 2023; 23:18-28. [PMID: 36633561 PMCID: PMC10024073 DOI: 10.1089/vbz.2022.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background: Chagas disease is one of the world's most neglected tropical diseases, infecting over six million people across the Americas. The hemoparasite Trypanosoma cruzi is the etiological agent for the disease, circulating in domestic, peridomestic, and sylvatic transmission cycles that are maintained by triatomine vectors and a diversity of wild and synanthropic hosts. Public health and wildlife management interventions targeting the interruption of T. cruzi transmission rely on an understanding of the dynamics driving the ecology of this zoonotic pathogen. One wildlife host that purportedly plays a role in the transmission of Chagas disease within the southern United States is the striped skunk (Mephitis mephitis), although infection prevalence in this species is poorly understood. Materials and Methods: To this end, we conducted a PCR-based surveillance of T. cruzi in 235 wild skunks, representing 4 species, across 76 counties and 10 ecoregions in Texas, United States, along with an evaluation of risk factors associated with the infection. Results: We recovered an overall T. cruzi prevalence of 17.9% for all mephitid taxa aggregated, ranging between 6.7% for plains spotted skunks (Spilogale putorius interrupta) and 42.9% for western spotted skunks (Spilogale gracilis). We report the first cases of T. cruzi infection in plains spotted and American hog-nosed skunks (Conepatus leuconotus), of important note for conservation medicine since populations of both species are declining within Texas. Although not statistically significant, we also detected trends for juveniles to exhibit greater infection risk than adults and for differential sex biases in T. cruzi prevalence between taxa, which align with variations in species-specific seasonal activity patterns. No geographic or taxonomic risk factors were identified. Conclusion: Our study contributed key data for population viability analyses and epidemiologic models in addition to providing a baseline for future T. cruzi surveillance among skunks and other wildlife species.
Collapse
Affiliation(s)
- Bonnie E. Gulas-Wroblewski
- Division of Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
- Texas A&M Natural Resources Institute, College Station, Texas, USA
| | - Rodion Gorchakov
- Division of Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
| | - Rebecca B. Kairis
- Division of Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
- William T. Shearer Center for Human Immunobiology, Texas Children's Hospital, Houston, Texas, USA
| | - Robert C. Dowler
- Department of Biology, Angelo State University, San Angelo, Texas, USA
| | - Kristy O. Murray
- Division of Tropical Medicine, Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA
- William T. Shearer Center for Human Immunobiology, Texas Children's Hospital, Houston, Texas, USA
| |
Collapse
|
4
|
Velázquez-Ramírez DD, Pérez de Léon AA, Ochoa-Díaz-López H. Review of American Trypanosomiasis in Southern Mexico Highlights Opportunity for Surveillance Research to Advance Control Through the One Health Approach. Front Public Health 2022; 10:838949. [PMID: 35372189 PMCID: PMC8964530 DOI: 10.3389/fpubh.2022.838949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Adalberto A Pérez de Léon
- USDA-ARS San Joaquin Valley Agricultural Sciences Center, Parlier, CA, United States.,Veterinary Pest Genomics Center, Kerrville, TX, United States
| | | |
Collapse
|
5
|
Busselman RE, Meyers AC, Zecca IB, Auckland LD, Castro AH, Dowd RE, Curtis-Robles R, Hodo CL, Saunders AB, Hamer SA. High incidence of Trypanosoma cruzi infections in dogs directly detected through longitudinal tracking at 10 multi-dog kennels, Texas, USA. PLoS Negl Trop Dis 2021; 15:e0009935. [PMID: 34758049 PMCID: PMC8631682 DOI: 10.1371/journal.pntd.0009935] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/30/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
Canine Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, is increasingly recognized as a health concern for dogs in the USA, and infected dogs may signal geographic regions of risk for human disease. Dogs living in multi-dog kennel environments (kennels with more than one dog) where triatomine vectors are endemic may be at high risk for infection. We monitored a cohort of 64 T. cruzi-infected and uninfected dogs across 10 kennels in Texas, USA, to characterize changes in infection status over one year. We used robust diagnostic criteria in which reactivity on multiple independent platforms was required to be considered positive. Among the 30 dogs enrolled as serologically- and/or PCR-positive, all but one dog showed sustained positive T. cruzi diagnostic results over time. Among the 34 dogs enrolled as serologically- and PCR-negative, 10 new T. cruzi infections were recorded over a 12-month period. The resulting incidence rate for dogs initially enrolled as T. cruzi-negative was 30.7 T. cruzi infections per 100 dogs per year. This study highlights the risk of T. cruzi infection to dogs in kennel environments. To protect both dog and human health, there is an urgent need to develop more integrated vector control methods as well as prophylactic and curative antiparasitic treatment options for T. cruzi infection in dogs.
Collapse
Affiliation(s)
- Rachel E. Busselman
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Alyssa C. Meyers
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Italo B. Zecca
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Lisa D. Auckland
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Andres H. Castro
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Rebecca E. Dowd
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Rachel Curtis-Robles
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
| | - Carolyn L. Hodo
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
- The University of Texas MD Anderson Cancer Center, Michale E. Keeling Center for Comparative Medicine and Research, Bastrop, Texas, United States of America
| | - Ashley B. Saunders
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, United States of America
| | - Sarah A. Hamer
- Department of Veterinary Integrative Biosciences, Texas A&M University, College Station, Texas, United States of America
- * E-mail:
| |
Collapse
|
6
|
Noguera Zayas LP, Rüegg S, Torgerson P. The burden of zoonoses in Paraguay: A systematic review. PLoS Negl Trop Dis 2021; 15:e0009909. [PMID: 34727113 PMCID: PMC8589157 DOI: 10.1371/journal.pntd.0009909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/12/2021] [Accepted: 10/15/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Underestimation of zoonoses is exacerbated in low and middle-income countries due mainly to inequalities with serious consequences in healthcare. This is difficult to gauge and reduce the impact of those diseases. Our study focuses on Paraguay, where the livestock industry is one of the major components of the country's economy. Therefore, the rationale of this study was to develop a case study in Paraguay to estimate the dual impact of zoonotic diseases on both the human health and animal health sector and thus determine the societal burden of such diseases. METHODOLOGY/PRINCIPAL FINDINGS We conducted a systemic review (including a meta-analysis) to assess the burden of zoonoses in Paraguay, including official reports and grey literature of disease incidence and prevalence. We estimated the Disability Adjusted Life Years (DALYs) and Zoonosis Disability Adjusted Life Years (zDALYs) to measure the difference between the current health status and the desired health situation of animals and the Paraguayan population based on 50 zoonotic diseases suggested by the WHO (World Health Organization), OIE (World Organization for Animal Health) and the National Health in Paraguay. The total DALYs represent 19,384 (95% CI: from 15,805 to 29,733), and zDALYs, 62,178 (95% CI: from 48,696 to 77,188). According to the results, the priority pathogens for DALYs are E. coli, Trypanosoma cruzi, Leishmania spp, and Toxoplasma gondii. When we include the additional animal health burden, the most important pathogens are Brucella spp, E. coli, Trypanosoma cruzi, and Fasciola hepatica for zDALYs. CONCLUSION/SIGNIFICANCE This is the first study to integrate DALYs and zDALYs with important clues related to the health status of Paraguay. Through DALYs and zDALYs, our perspective becomes more complete because we consider not only human health but also animal health. This is important for setting priorities in disease control, especially in a society where livestock contribute significantly to the economy and to human well-being.
Collapse
Affiliation(s)
- Liz Paola Noguera Zayas
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
- Epidemiology and Biostatistics, Life Science Zürich Graduate School, University of Zürich, Zürich, Switzerland
| | - Simon Rüegg
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Paul Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| |
Collapse
|
7
|
Didelphis spp. opossums and their parasites in the Americas: A One Health perspective. Parasitol Res 2021; 120:4091-4111. [PMID: 33788021 PMCID: PMC8599228 DOI: 10.1007/s00436-021-07072-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 01/26/2021] [Indexed: 12/16/2022]
Abstract
Medium sized opossums (Didelphis spp.) are among the most fascinating mammals of the Americas, playing important ecological roles (e.g., dispersal of seeds and control of insect populations) in the environment they inhabit. Nevertheless, as synanthropic animals, they are well adapted to human dwellings, occupying shelters within the cities, peripheral areas, and rural settings. These marsupials can harbor numerous pathogens, which may affect people, pets, and livestock. Among those, some protozoa (e.g., Leishmania infantum, Trypanosoma cruzi, Toxoplasma gondii), helminths (e.g., Ancylostoma caninum, Trichinella spiralis, Alaria marcianae, Paragonimus spp.) and arthropods (e.g., ticks, fleas) present substantial public health and veterinary importance, due to their capacity to cause disease in humans, domestic animals, and wildlife. Here, we reviewed the role played by opossums on the spreading of zoonotic parasites, vectors, and vector-borne pathogens, highlighting the risks of pathogens transmission due to the direct and indirect interaction of humans and domestic animals with Didelphis spp. in the Americas.
Collapse
|
8
|
DNA Vaccine Treatment in Dogs Experimentally Infected with Trypanosoma cruzi. J Immunol Res 2020; 2020:9794575. [PMID: 32455143 PMCID: PMC7222601 DOI: 10.1155/2020/9794575] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/08/2020] [Accepted: 04/06/2020] [Indexed: 02/06/2023] Open
Abstract
Chagas disease is a chronic and potentially lethal disorder caused by the parasite Trypanosoma cruzi, and an effective treatment has not been developed for chronic Chagas disease. The objective of this study was to determine the effectiveness of a therapeutic DNA vaccine containing T. cruzi genes in dogs with experimentally induced Chagas disease through clinical, pathological, and immunological analyses. Infection of Beagle dogs with the H8 T. cruzi strain was performed intraperitoneally with 3500 metacyclic trypomastigotes/kg body weight. Two weeks after infection, plasmid DNA immunotherapy was administered thrice at 15-day intervals. The clinical (physical and cabinet studies), immunological (antibody and cytokine profiles and lymphoproliferation), and macro- and microscopic pathological findings were described. A significant increase in IgG and cell proliferation was recorded after immunotherapy, and the highest stimulation index (3.02) was observed in dogs treated with the pBCSSP4 plasmid. The second treatment with both plasmids induced an increase in IL-1, and the third treatment with the pBCSSP4 plasmid induced an increase in IL-6. The pBCSP plasmid had a good Th1 response regulated by high levels of IFN-gamma and TNF-alpha, whereas the combination of the two plasmids did not have a synergistic effect. Electrocardiographic studies registered lower abnormalities and the lowest number of individuals with abnormalities in each group treated with the therapeutic vaccine. Echocardiograms showed that the pBCSSP4 plasmid immunotherapy preserved cardiac structure and function to a greater extent and prevented cardiomegaly. The two plasmids alone controlled the infection moderately by a reduction in the inflammatory infiltrates in heart tissue. The immunotherapy was able to reduce the magnitude of cardiac lesions and modulate the cellular immune response; the pBCSP treatment showed a clear Th1 response; and pBCSSP4 induced a balanced Th1/Th2 immune response that prevented severe cardiac involvement. The pBCSSP4 plasmid had a better effect on most of the parameters evaluated in this study; therefore, this plasmid can be considered an optional treatment against Chagas disease in naturally infected dogs.
Collapse
|
9
|
Nolan MS, Aguilar D, Brown EL, Gunter SM, Ronca SE, Hanis CL, Murray KO. Continuing evidence of Chagas disease along the Texas-Mexico border. PLoS Negl Trop Dis 2018; 12:e0006899. [PMID: 30427833 PMCID: PMC6261633 DOI: 10.1371/journal.pntd.0006899] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 11/28/2018] [Accepted: 10/04/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Chagas disease is a chronic parasitic infection that progresses to dilated cardiomyopathy in 30% of human cases. Public health efforts target diagnosing asymptomatic cases, as therapeutic efficacy diminishes as irreversible tissue damage progresses. Physician diagnosis of Chagas disease cases in the United States is low, partially due to lack of awareness of the potential burden in the United States. METHODOLOGY/PRINCIPAL FINDINGS The current study tested a patient cohort of 1,196 Starr County, Texas residents using the Hemagen Chagas ELISA Kit as a preliminary screening assay. Samples testing positive using the Hemagen test were subjected to additional confirmatory tests. Two patients (0.17%) without previous Chagas disease diagnosis were identified; both had evidence of acquiring disease in the United States or along the Texas-Mexico border. CONCLUSIONS/SIGNIFICANCE The Texas-Mexico border is a foci of Chagas disease human cases, with a local disease burden potentially twice the national estimate of Hispanic populations. It is imperative that physicians consider persons with residential histories along the Texas-Mexico border for Chagas disease testing.
Collapse
Affiliation(s)
- Melissa S. Nolan
- Department of Pediatric Tropical Medicine, Baylor College of Medicine, Houston, TX, United States of America
| | - David Aguilar
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States of America
- Department of Cardiology, Baylor College of Medicine, Houston, TX, United States of America
| | - Eric L. Brown
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Sarah M. Gunter
- Department of Pediatric Tropical Medicine, Baylor College of Medicine, Houston, TX, United States of America
| | - Shannon E. Ronca
- Department of Pediatric Tropical Medicine, Baylor College of Medicine, Houston, TX, United States of America
| | - Craig L. Hanis
- Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston, Houston, TX, United States of America
| | - Kristy O. Murray
- Department of Pediatric Tropical Medicine, Baylor College of Medicine, Houston, TX, United States of America
| |
Collapse
|