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Simões-Neto EA, Santos DWDCL, Bomfim MRQ, Costa JML, Simões AF, Vasconcelos LD, Sodré DC, Costa ACM, Dumont SVR, de Oliveira de Melo B, de Azevedo CDMPES. Oral Chagas disease outbreak by bacaba juice ingestion: A century after Carlos Chagas' discovery, the disease is still hard to manage. PLoS Negl Trop Dis 2024; 18:e0012225. [PMID: 39292716 DOI: 10.1371/journal.pntd.0012225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 07/24/2024] [Indexed: 09/20/2024] Open
Abstract
BACKGROUND Orally transmitted acute Chagas disease (ACD) primarily affects low-visibility and low-income individuals in tropical and subtropical zones. Managing ACD remains challenging even after more than 100 years of its discovery. Its spread to non-endemic areas has made it a global health issue. The aim of this work is to demonstrate the difficulties encountered in handling a real-life situation. METHODOLOGY AND FINDINGS This report examines an outbreak of 39 cases of ACD due to oral transmission by bacaba juice ingestion that occurred in Pedro do Rosário, Maranhão, Brazil. A clinical and epidemiological investigation, including an entomological search, was conducted. Diagnosis criteria included positive peripheral blood smear (PBS), seroconversion of IgG, and a two-fold increase in IgG titer (laboratory criteria); and clinical findings, epidemiological exposure, and at least one positive IgG test (clinical-epidemiological criteria). In-house conventional polymerase chain reaction (PCR) was performed on 33 samples. All patients were treated with benznidazole. After 4.5 years, IgG levels were reassessed in 26 individuals. The mean age was 33.6 years, with no gender difference. The mean incubation period was 13.8 days, and the mean between symptom onset and treatment was 16.6 days. The most common symptoms were fever and lymphadenopathy (90%). Diagnostic success rates were 66.6% (laboratory criteria), 23% (clinical-epidemiological criteria), and 10.2% (high clinical suspicion despite negative tests). Test positivity rates were 69.7% (PBS), 91.4% (serology), and 100% (PCR). There were no deaths. Serological cure was achieved in 34.6% of cases, and IgG titers decreased in 15.3%. CONCLUSIONS AND SIGNIFICANCE We encountered several barriers in managing ACD, including population vulnerability, reliance on outdated diagnostic techniques, lack of standardized molecular biology methods, and limited therapeutic options. This report underscores the importance of rapid surveillance and early treatment to prevent fatalities. We recommend the standardization of conventional PCR in diagnostic routines.
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Affiliation(s)
| | - Daniel Wagner de Castro Lima Santos
- Presidente Dutra University Hospital (HU-UPD), Brazilian Company of Hospital Services (EBSERH), Federal University of Maranhão (UFMA), São Luís, Brazil
- D'or Research and Teaching Institute (IDOR), São Luís, Brazil
| | | | | | - Amanda Ferreira Simões
- Brasília University Hospital (HUB), Brazilian Company of Hospital Services (EBSERH), Brasília University (UnB), Brasília, Brazil
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2
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Robertson LJ, Havelaar AH, Keddy KH, Devleesschauwer B, Sripa B, Torgerson PR. The importance of estimating the burden of disease from foodborne transmission of Trypanosoma cruzi. PLoS Negl Trop Dis 2024; 18:e0011898. [PMID: 38329945 PMCID: PMC10852316 DOI: 10.1371/journal.pntd.0011898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
Chagas disease (ChD), caused by infection with the flagellated protozoan, Trypanosoma cruzi, has a complicated transmission cycle with many infection routes. These include vector-borne (via the triatomine (reduviid bug) vector defecating into a skin abrasion, usually following a blood meal), transplacental transmission, blood transfusion, organ transplant, laboratory accident, and foodborne transmission. Foodborne transmission may occur due to ingestion of meat or blood from infected animals or from ingestion of other foods (often fruit juice) contaminated by infected vectors or secretions from reservoir hosts. Despite the high disease burden associated with ChD, it was omitted from the original World Health Organization estimates of foodborne disease burden that were published in 2015. As these estimates are currently being updated, this review presents arguments for including ChD in new estimates of the global burden of foodborne disease. Preliminary calculations suggest a burden of at least 137,000 Disability Adjusted Life Years, but this does not take into account the greater symptom severity associated with foodborne transmission. Thus, we also provide information regarding the greater health burden in endemic areas associated with foodborne infection compared with vector-borne infection, with higher mortality and more severe symptoms. We therefore suggest that it is insufficient to use source attribution alone to determine the foodborne proportion of current burden estimates, as this may underestimate the higher disability and mortality associated with the foodborne infection route.
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Affiliation(s)
- Lucy J. Robertson
- Parasitology, Department of Paraclinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Arie H. Havelaar
- Emerging Pathogens Institute, Global Food Systems Institute, Animal Sciences Department, University of Florida, Gainesville, Florida, United States of America
| | | | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Banchob Sripa
- Tropical Disease Research Center, Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Paul R. Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
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3
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Gutiérrez SA, Jaimes-Dueñez J, Cruz-Saavedra L, Hernández C, Cantillo-Barraza O, Álvarez F, Blanco M, Leal B, Martínez L, Medina M, Medina M, Valdivieso S, Ramírez JD. An Outbreak of Acute Chagas Disease Possibly Spread through Oral Transmission Involving Animal Reservoirs in Eastern Colombia. Am J Trop Med Hyg 2024; 110:36-39. [PMID: 37956445 PMCID: PMC10793000 DOI: 10.4269/ajtmh.23-0380] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 07/13/2023] [Indexed: 11/15/2023] Open
Abstract
Chagas disease (CD) is a parasitic infection caused by the parasite Trypanosoma cruzi. Reports of CD cases associated with oral transmission have increased, particularly in Colombia, Brazil, and Venezuela. In this investigation, parasitological, serological, and molecular tests were conducted on samples obtained from humans, mammal reservoirs, and hosts involved in the assessment of a suspected oral transmission outbreak in Cubara, Boyaca, Colombia. Seropositivity was observed in 60% (3 of 5) of index patients and 6.4% (5 of 78) of close contacts. Trypanosoma cruzi DNA was detected by quantitative polymerase chain reaction in 100% of index cases, 6.4% (5 of 78) of close contacts, 60% (6 of 10) of canines, and 100% (5 of 5) of opossums. In all index cases, the TcI lineage was identified, along with two cases of mixed infection (TcI/TcII-TcVI). Hemoculture revealed a flagellate presence in 80% of opossums, whereas all triatomine bugs tested negative. Our findings suggest a potential oral transmission route through contamination with opossum secretions.
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Affiliation(s)
- Stivenn A. Gutiérrez
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
| | - Jeiczon Jaimes-Dueñez
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
- Grupo de Investigación en Ciencias Animales, Facultad de Medicina Veterinaria y Zootecnia, Universidad Cooperativa de Colombia, Bucaramanga, Colombia
| | - Lissa Cruz-Saavedra
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
| | - Carolina Hernández
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
- Centro de Tecnología en Salud, Innovaseq SAS, Bogota, Colombia
| | | | - Francisco Álvarez
- Programa de Control de ETV, Secretaría de Salud de Boyacá, Tunja, Colombia
| | - María Blanco
- Secretaría Departamental de Salud de Arauca, Arauca, Colombia
| | - Bernardo Leal
- Programa de Control de ETV, Secretaría de Salud de Boyacá, Tunja, Colombia
| | - Lida Martínez
- Grupo de Vigilancia en Salud Pública, Secretaría de Salud de Boyacá, Colombia
| | - Manuel Medina
- Programa de Control de ETV, Secretaría de Salud de Boyacá, Tunja, Colombia
| | - Mabel Medina
- Programa de Control de ETV, Secretaría de Salud de Boyacá, Tunja, Colombia
| | | | - Juan David Ramírez
- Centro de Investigaciones en Microbiología y Biotecnología-UR, Facultad de Ciencias Naturales, Universidad del Rosario, Bogota, Colombia
- Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
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4
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de Freitas VLT, Piotto MR, Esper HR, Nakanishi EYS, Fonseca CDA, Assy JGPL, Berreta OCP, França FODS, Lopes MH. Detection of Trypanosoma cruzi DTUs TcI and TcIV in two outbreaks of orally-transmitted Chagas disease in the Northern region of Brazil. Rev Inst Med Trop Sao Paulo 2023; 65:e7. [PMID: 36651468 PMCID: PMC9870254 DOI: 10.1590/s1678-9946202365007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/05/2022] [Indexed: 01/19/2023] Open
Abstract
This study describes the laboratory investigation of two acute Chagas disease outbreaks that occurred in the riverside communities of Marimarituba and Cachoeira do Arua, in the Santarem municipality, Para State, located in the Northern region of Brazil, and occurred in March 2016 and August 2017, respectively. The generation of data regarding the diversity of Trypanosoma cruzi parasites circulating in the Amazon region is key for understanding the emergence and expansion of Chagas disease. This study aimed to identify T. cruzi Discrete Typing Units (DTUs) involved in two outbreaks of acute Chagas disease (ACD) directly from the patient's biological sample. Nested and multiplex PCR targeting the 24Sα (rRNA) and mini-exon genes, respectively, were used to identify T. cruzi DTU in blood samples from patients diagnosed with ACD. The samples with positive cPCR were submitted for analysis for T. cruzi DTUs, which included 13 samples from the patients with ACD by oral transmission and two samples collected from two newborns of two women with ACD, from Marimarituba and Cachoeira do Arua. The samples were classified as T. cruzi TcIV, from Marimarituba's outbreak, and T. cruzi TcI, from Cachoeira do Arua's outbreak. The molecular identification of T. cruzi may increase understanding of the role of this parasite in Chagas disease's emergence within the Amazon region, contributing to the improvement of the management of this important, but also neglected, disease.
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Affiliation(s)
- Vera Lúcia Teixeira de Freitas
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
| | - Mariana Ramos Piotto
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil
| | - Helena Rangel Esper
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, Pará, Brazil
| | - Erika Yoshie Shimoda Nakanishi
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM48), São Paulo, São Paulo, Brazil
| | - Claudia de Abreu Fonseca
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM48), São Paulo, São Paulo, Brazil
| | - João Guilherme Pontes Lima Assy
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, Pará, Brazil
| | - Olívia Campos Pinheiro Berreta
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, Pará, Brazil
| | - Francisco Oscar de Siqueira França
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil,Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM48), São Paulo, São Paulo, Brazil
| | - Marta Heloísa Lopes
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM48), São Paulo, São Paulo, Brazil
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5
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Julião GR, Bragança MAH, Torres PG, Lima L, Neves RDA, Nobre JMS, Vergara-Meza JG, Basano SDA, Moraes FA, Baldez MADG, Tada MS, Lima AAD, Costa JDN, Gil LHS, Cunha AEFLD, Camargo EP, Teixeira MMG. Acute Chagas Disease Caused by Trypanosoma cruzi TcIV and Transmitted by Panstrongylus geniculatus: Molecular Epidemiological Insights Provided by the First Documented Autochthonous Case in Rondônia, Southwestern Amazonia, Brazil. Vector Borne Zoonotic Dis 2022; 22:244-251. [DOI: 10.1089/vbz.2021.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Genimar Rebouças Julião
- Fundação Oswaldo Cruz, Fiocruz Rondônia, Laboratório de Entomologia-I, Porto Velho, Brasil
- Instituto Nacional de Epidemiologia da Amazônia Ocidental—INCT EpiAmO, Fiocruz Rondônia, Porto Velho, Brasil
| | | | | | - Luciana Lima
- Instituto Nacional de Epidemiologia da Amazônia Ocidental—INCT EpiAmO, Fiocruz Rondônia, Porto Velho, Brasil
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brasil
| | | | | | - José Gabriel Vergara-Meza
- Instituto Nacional de Epidemiologia da Amazônia Ocidental—INCT EpiAmO, Fiocruz Rondônia, Porto Velho, Brasil
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brasil
| | - Sérgio de Almeida Basano
- Centro de Medicina Tropical de Rondônia, Porto Velho, Brasil
- Centro Universitário São Lucas, Porto Velho, Brasil
| | | | | | - Mauro Shugiro Tada
- Instituto Nacional de Epidemiologia da Amazônia Ocidental—INCT EpiAmO, Fiocruz Rondônia, Porto Velho, Brasil
- Centro de Pesquisa em Medicina Tropical de Rondônia, Porto Velho, Brasil
- Instituto de Pesquisa em Patologias Tropicais de Rondônia, Porto Velho, Brasil
| | - Alzemar Alves de Lima
- Centro Universitário São Lucas, Porto Velho, Brasil
- Centro de Pesquisa em Medicina Tropical de Rondônia, Porto Velho, Brasil
| | - Joana D'Arc Neves Costa
- Agência Estadual de Vigilância em Saúde de Rondônia, Porto Velho, Brasil
- Centro de Pesquisa em Medicina Tropical de Rondônia, Porto Velho, Brasil
| | | | | | - Erney Plessmann Camargo
- Instituto Nacional de Epidemiologia da Amazônia Ocidental—INCT EpiAmO, Fiocruz Rondônia, Porto Velho, Brasil
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brasil
| | - Marta Maria Geraldes Teixeira
- Instituto Nacional de Epidemiologia da Amazônia Ocidental—INCT EpiAmO, Fiocruz Rondônia, Porto Velho, Brasil
- Departamento de Parasitologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brasil
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6
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Gual-Gonzalez L, Arango-Ferreira C, Lopera-Restrepo LC, Cantillo-Barraza O, Marín DV, Bustamante NR, Triana-Chavez O, Nolan MS. Acute Pediatric Chagas Disease in Antioquia, Colombia: A Geographic Location of Suspected Oral Transmission. Microorganisms 2021; 10:8. [PMID: 35056459 PMCID: PMC8781947 DOI: 10.3390/microorganisms10010008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/16/2022] Open
Abstract
Chagas disease, Trypanosoma cruzi infection, is an insidious cause of heart failure in Latin America. Early diagnosis and treatment are critical to prevent irreversible myocardial damage that progressively accumulates over decades. Several structural barriers account for the less than 1% of cases in Colombia being treated, including poor physician knowledge, especially considering that some regions are considered non-endemic. The two cases reported here represent an emerging epidemiologic scenario associated with pediatric Chagas disease. Both cases are suspected oral transmitted parasitic infection in a geographic region of Colombia (Andean region of Antioquia) where no previous oral transmission of Chagas disease had been reported. Their clinical histories and course of disease are presented here to increase physician awareness of the epidemiologic risk factors and clinical manifestations associated with pediatric oral Chagas disease in Antioquia department, Colombia.
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Affiliation(s)
- Lídia Gual-Gonzalez
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Catalina Arango-Ferreira
- Departamento de Pediatría Hospital San Vicente Fundación, Medellin 050010, Colombia;
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | | | - Omar Cantillo-Barraza
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellin 050010, Colombia; (O.C.-B.); (O.T.-C.)
| | - Daniela Velásquez Marín
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | - Natalia Restrepo Bustamante
- Departamento de Pediatría, Facultad de Medicina, Universidad de Antioquia, MMedellin 050010, Colombia; (D.V.M.); (N.R.B.)
| | - Omar Triana-Chavez
- Grupo Biología y Control de Enfermedades Infecciosas, Universidad de Antioquia, Medellin 050010, Colombia; (O.C.-B.); (O.T.-C.)
| | - Melissa S. Nolan
- Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
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7
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Freitas VLTD, Esper HR, Nakanishi ES, Piotto MR, Assy JGPL, Berreta OCP, Said RDC, Segurado AAC, Carvalho NB, França FODS, Lopes MH. Suspected vertical transmission of Chagas disease caused by DTU TcIV in an infection probably transmitted orally, during anoutbreak in the Brazilian Amazon. Rev Inst Med Trop Sao Paulo 2021; 63:e48. [PMID: 34161554 PMCID: PMC8216691 DOI: 10.1590/s1678-9946202163048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 11/22/2022] Open
Abstract
This study describes difficulties in the monitoring of a child born during an
oral outbreak of Chagas disease, in which there are several indications that the
transmission occurred through the congenital route: 1. the mother was in the
third trimester of pregnancy when she was infected; 2. She presented high
parasitemia at the time of delivery; 3. In both, the mother and her daughter,
T. cruzi was classified as DTU TcIV. The parasites were not
found in the blood at birth and the infection was detected only three months
later in an asymptomatic infant. As the mother and her child live in a highly
endemic area, vector transmission could not be excluded during this period.
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Affiliation(s)
| | - Helena Rangel Esper
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, São Paulo, Brazil.,Hospital Municipal de Santarém, Núcleo de Medicina Tropical, Santarém, Pará, Brazil
| | - Erika Shimoda Nakanishi
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil
| | | | | | | | - Renato do Carmo Said
- Hospital Municipal de Santarém, Núcleo de Medicina Tropical, Santarém, Pará, Brazil
| | - Aluisio Augusto Cotrim Segurado
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil
| | - Noemia Barbosa Carvalho
- Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil
| | - Francisco Oscar de Siqueira França
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil
| | - Marta Heloísa Lopes
- Universidade de São Paulo, Faculdade de Medicina, São Paulo, São Paulo, Brazil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo, São Paulo, Brazil
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8
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Said RDC, Assy JGPL, Silva KV, Brandão ADS, Pinheiro OC, Esper HR, Gryschek ALDFPL, Bertolozzi MR, Amato VS, Boulos M, Segurado AAC, Gryschek RCB, França FODS. Twenty years of successful academic outreach at Núcleo de Medicina Tropical (NACE-NUMETROP/USP) in Santarém, Pará. Rev Soc Bras Med Trop 2021; 54:e0404-2020. [PMID: 33759918 PMCID: PMC8008915 DOI: 10.1590/0037-8682-0404-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/07/2020] [Indexed: 11/21/2022] Open
Affiliation(s)
- Renato do Carmo Said
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, PA, Brasil
| | - João Guilherme Pontes Lima Assy
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, PA, Brasil
| | - Kamila Vieira Silva
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil
| | - Alisson Dos Santos Brandão
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, PA, Brasil
| | - Olívia Campos Pinheiro
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Secretaria Municipal de Saúde de Santarém, Hospital Municipal de Santarém, Santarém, PA, Brasil
| | - Helena Rangel Esper
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil
| | | | - Maria Rita Bertolozzi
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem em Saúde Coletiva, São Paulo, SP, Brasil
| | - Valdir Sabbaga Amato
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil
| | - Marcos Boulos
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil
| | - Aluísio Augusto Cotrim Segurado
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Protozoologia, Bacteriologia e Resistência Antimicrobiana (LIM49-IMT2), São Paulo, SP, Brasil
| | - Ronaldo César Borges Gryschek
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Imunopatologia da Esquistossomose e outras Parasitoses (LIM06-IMT2), São Paulo, SP, Brasil
| | - Francisco Oscar de Siqueira França
- Universidade de São Paulo, Faculdade de Medicina, Núcleo de Medicina Tropical, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, SP, Brasil.,Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Laboratório de Investigação Médica em Imunologia (LIM48-IMT2), São Paulo, SP, Brasil
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9
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Oral Trypanosoma cruzi Transmission Resulting in Advanced Chagasic Cardiomyopathy in an 11-Month-Old Male. Case Rep Infect Dis 2020; 2020:8828950. [PMID: 33123392 PMCID: PMC7586178 DOI: 10.1155/2020/8828950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/09/2020] [Accepted: 10/03/2020] [Indexed: 12/02/2022] Open
Abstract
Our case report describes the youngest clinical acute Chagas disease case and their unusual disease presentation of cardiac failure. In parts of the Brazilian Amazon, cultural practices include weaning infants from breastmilk to solid foods with açaí consumption serving as an intermediary. This practice could place infants at an increased risk of oral Trypanosoma cruzi infection and severe Chagasic cardiac disease.
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10
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Santos-Miranda A, Joviano-Santos JV, Ribeiro GA, Botelho AFM, Rocha P, Vieira LQ, Cruz JS, Roman-Campos D. Reactive oxygen species and nitric oxide imbalances lead to in vivo and in vitro arrhythmogenic phenotype in acute phase of experimental Chagas disease. PLoS Pathog 2020; 16:e1008379. [PMID: 32160269 PMCID: PMC7089563 DOI: 10.1371/journal.ppat.1008379] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/23/2020] [Accepted: 02/04/2020] [Indexed: 12/03/2022] Open
Abstract
Chagas Disease (CD) is one of the leading causes of heart failure and sudden death in Latin America. Treatments with antioxidants have provided promising alternatives to ameliorate CD. However, the specific roles of major reactive oxygen species (ROS) sources, including NADPH-oxidase 2 (NOX2), mitochondrial-derived ROS and nitric oxide (NO) in the progression or resolution of CD are yet to be elucidated. We used C57BL/6 (WT) and a gp91PHOX knockout mice (PHOX-/-), lacking functional NOX2, to investigate the effects of ablation of NOX2-derived ROS production on the outcome of acute chagasic cardiomyopathy. Infected PHOX-/- cardiomyocytes displayed an overall pro-arrhythmic phenotype, notably with higher arrhythmia incidence on ECG that was followed by higher number of early afterdepolarizations (EAD) and 2.5-fold increase in action potential (AP) duration alternans, compared to AP from infected WT mice. Furthermore, infected PHOX-/- cardiomyocytes display increased diastolic [Ca2+], aberrant Ca2+ transient and reduced Ca2+ transient amplitude. Cardiomyocyte contraction is reduced in infected WT and PHOX-/- mice, to a similar extent. Nevertheless, only infected PHOX-/- isolated cardiomyocytes displayed significant increase in non-triggered extra contractions (appearing in ~75% of cells). Electro-mechanical remodeling of infected PHOX-/-cardiomyocytes is associated with increase in NO and mitochondria-derived ROS production. Notably, EADs, AP duration alternans and in vivo arrhythmias were reverted by pre-incubation with nitric oxide synthase inhibitor L-NAME. Overall our data show for the first time that lack of NOX2-derived ROS promoted a pro-arrhythmic phenotype in the heart, in which the crosstalk between ROS and NO could play an important role in regulating cardiomyocyte electro-mechanical function during acute CD. Future studies designed to evaluate the potential role of NOX2-derived ROS in the chronic phase of CD could open new and more specific therapeutic strategies to treat CD and prevent deaths due to heart complications.
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Affiliation(s)
- Artur Santos-Miranda
- Department of Biochemistry and Immunology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Department of Biophysics, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Grazielle Alves Ribeiro
- Department of Biochemistry and Immunology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Flávia M. Botelho
- Department of Veterinary Medicine, Escola de Veterinária e Zootecnia, Universidade Federal de Goiás, Goiânia, Brazil
| | - Peter Rocha
- Department of Biochemistry and Immunology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leda Quercia Vieira
- Department of Biochemistry and Immunology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Jader Santos Cruz
- Department of Biochemistry and Immunology, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Danilo Roman-Campos
- Department of Biophysics, Universidade Federal de São Paulo, São Paulo, Brazil
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11
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Franco-Paredes C, Villamil-Gómez WE, Schultz J, Henao-Martínez AF, Parra-Henao G, Rassi A, Rodríguez-Morales AJ, Suarez JA. A deadly feast: Elucidating the burden of orally acquired acute Chagas disease in Latin America - Public health and travel medicine importance. Travel Med Infect Dis 2020; 36:101565. [PMID: 32004732 DOI: 10.1016/j.tmaid.2020.101565] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/24/2020] [Accepted: 01/27/2020] [Indexed: 01/27/2023]
Abstract
Over the past two decades, several countries in Latin American, particularly Brazil, Venezuela, and Colombia, have experienced multiple outbreaks of oral Chagas disease. Transmission occurs secondary to contamination of food or beverages by triatomine (kissing bug) feces containing infective Trypanosoma cruzi metacyclic trypomastigotes. Orally transmitted infections are acute and potentially fatal. Oral Chagas transmission carries important clinical implications from management to public health policies compared to vector-borne transmission. This review aims to discuss the contemporary situation of orally acquired Chagas disease, and its eco-epidemiology, pathogenesis, and clinical management. We also propose preventive public health interventions to reduce the burden of disease and provide important perspectives for travel medicine. Travel health advisors need to counsel intending travellers to South America on avoidance of "deadly feasts" - risky beverages such as fruit juices including guava juice, bacaba, babaçu and palm wine (vino de palma), açai pulp, sugar cane juice and foodstuffs such as wild animal meats that may be contaminated with T. cruzi.
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Affiliation(s)
- Carlos Franco-Paredes
- Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, CO, USA; Hospital Infantil de México Federico Gómez, México City, Mexico; Committe on Travel Medicine, Pan-American Association of Infectious Diseases (API), Panama City, Panama
| | - Wilmer E Villamil-Gómez
- Committe on Travel Medicine, Pan-American Association of Infectious Diseases (API), Panama City, Panama; Committe on Tropical Medicine, Zoonoses and Travel Medicine, Colombian Association of Infectious Diseases (ACIN), Bogota, Colombia; Infectious Diseases and Infection Control Research Group, Hospital Universitario de Sincelejo, Sincelejo, Sucre, Colombia; Programa del Doctorado de Medicina Tropical, SUE Caribe, Universidad del Atlántico, Barranquilla, Colombia
| | - Jonathan Schultz
- Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - Andrés F Henao-Martínez
- Division of Infectious Diseases, Department of Medicine, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - Gabriel Parra-Henao
- National Institute of Health, Bogota, Colombia; Centro de Investigación en Salud para el Trópico (CIST), Universidad Cooperativa de Colombia, Santa Marta, Colombia
| | - Anis Rassi
- Division of Cardiology, Anis Rassi Heart Hospital, Goiânia, GO, Brazil
| | - Alfonso J Rodríguez-Morales
- Committe on Travel Medicine, Pan-American Association of Infectious Diseases (API), Panama City, Panama; Committe on Tropical Medicine, Zoonoses and Travel Medicine, Colombian Association of Infectious Diseases (ACIN), Bogota, Colombia; Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia; Universidad Franz Tamayo/UNIFRANZ, Cochabamba, Bolivia; Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira, Risaralda, Colombia.
| | - José Antonio Suarez
- Committe on Travel Medicine, Pan-American Association of Infectious Diseases (API), Panama City, Panama; Investigador SNI Senacyt Panamá, Clinical Research Deparment, Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá City, Panama
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