21 Chagas disease is caused by the parasite Trypanosoma cruzi and it is transmitted to 22 humans by the triatomine bug Rhodnius prolixus. The main insect vector in the Andean 23 countries presents sylvatic and domestic cycles involving humans, insects and 24 reservoirs (e.g small mammals). It is commonly assumed that vectorial transmission is 25 the main route for parasite spread between hosts. Recent studies have reported high 26 percentages (21-80%) of infected opossums (Didelphis marsupialis) in the sylvatic 27 cycle, raising the question of whether such a high proportion of infected could be only 28 maintained by vectorial transmission, a seemingly inefficient pathway. To address this 29 question, we formulated a mathematical model that describes the sylvatic transmission 30 dynamics considering vectors and hosts and parametrized with field data. Our results 31 show that vectorial transmission it is not sufficient to explain such high percentages of 32 infected host-mammals reported in the literature. Here we propose oral transmission 33 as an alternate route of transmission that may increase the number of infected 34 individuals found in field studies. 35 36 3 37 Introduction 38 The transmission of the parasite Trypanosoma cruzi, etiological agent of Chagas 39 disease, involves several pathways and results in 6 million infected people in Latin 40 America [1]. Human infections are caused by multiple routes, the main suggested 41 mechanism is vectorial transmission that occurs when triatomine insects feed on host 42 blood (Sylvatic mammals and humand after a short period, the vector defecates 43 releasing large amounts of parasites in the skin close to the wound allowing the 44 parasite to reach the bloodstream [2][3][4]. Vertical transmission occurs in humans from 45 an infected mother to a child; however, the ability of the parasite to cross the placenta 46 of sylvatic reservoirs has not been fully demonstrated yet. Oral transmission has been 47 proved to cause more aggressive clinical symptoms in humans and to have a high 48 mortality rate (8-35% compared to 5-10% by vectorial transmission) only two weeks 49 post infection [5]. In sylvatic mammals, oral transmission has been reported when 50 mammals feed on Rhodnius prolixus infected with T. cruzi were ingested [6]. Recent 51 studies in central Brazil have demonstrated that both vertical and oral transmission are 52 not a rare event in this biological system. In fact, a recent study in the Pantanal Region 53 of Brazil, have demonstrated that both the vertical an oral transmission are likely to 54 occur, depending on the encounter possibilities of the mammals and vectors [7].
5556 In sylvatic mammals, particularly of the family Didelphidae, it has also been suggested 57 that spraying from anal glands could be playing an important role in the transmission 58 of T. cruzi. Opossums, mainly of the species D. marsupialis, have been proposed not 59 only as a reservoir but also as a T. cruzi vector, since the parasite can multiply 60 extracellularly in the anal gla...