A Family Cluster of Chagas Disease Detected through Selective Screening of Blood Donors: A Case Report and Brief Review

Abstract

Chagas disease is rare in Canada, and is most frequently observed among individuals who have resided in Latin America. The disease can enter a prolonged asymptomatic phase during which infected individuals do not experience symptoms, thus hindering its diagnosis – particularly in nonendemic regions such as Canada. This article describes a cluster of cases of Chagas disease among a single family, which was discovered on screening after two affected members of the family donated blood. The current state of screening programs for Trypanosoma cruzi are discussed, and suggestions for future directions are included.

Congenitally transmitted Chagas disease in Canada: a family cluster

“…Congenitally acquired Chagas disease has rarely been reported in Canada. 1,2 Although it is difficult to confirm, we hypothesized that these three adults with polymerase chain reaction-positive, indeterminate Chagas disease acquired their infection congenitally, as they were born in Canada, spent small periods of time in an endemic area (fewer than three months cumulatively) and were born to a mother who was parasitemic and never treated for Chagas disease.…”

“…3,9 Since Canadian Blood Services and Héma-Québec began screening for Chagas disease less than a decade ago, an increasing number of people with newly diagnosed Chagas disease have been identified. 1,2 Given the substantial numbers of Latin American immigrants from endemic countries, there are likely thousands of undiagnosed, chronically infected persons with Chagas disease in Canada, 8 with only a small minority discovered via blood donation. With large numbers of undiagnosed, foreignborn Canadians and the risk of congenital transmission through multiple generations, a high index of suspicion is needed for screening of Chagas disease in asymptomatic immigrants from Chagas disease-endemic countries, including screening offspring born of women who have received a diagnosis of Chagas disease.…”

A Mother’s Gift: Congenital Transmission of Trypanosoma and Leishmania Species

“…In Latin America, this results in an estimated 8,700 to 15,000 annual congenital cases of CD [ 2 , 5 , 6 , 10 ]. Interestingly, there have been several cases of vertical transmission occurring in familial clusters [ 11 , 12 ]. Fourteen cases of T .…”

“…These case reports, along with a survey of United States obstetrician-gynecologists with 70% of respondents having “very limited” knowledge of CD, highlight the need for awareness of congenital CD for better diagnosis and to prevent additional occurrence of congenital CD from any infected mother [ 11 – 14 ]. Diagnosis of congenital CD is complicated.…”