From an epidemiological point of view, Chagas disease and its reservoirs and vectors
can present the following characteristics: (i) enzooty, maintained by wild animals
and vectors, with broad occurrence from southern United States of America (USA) to
southern Argentina and Chile (42ºN 49ºS), (ii) anthropozoonosis, when man invades the
wild ecotope and becomes infected with Trypanosoma cruzi from wild
animals or vectors or when the vectors and wild animals, especially marsupials,
invade the human domicile and infect man, (iii) zoonosis-amphixenosis and exchanged
infection between animals and humans by domestic vectors in endemic areas and (iv)
zooanthroponosis, infection that is transmitted from man to animals, by means of
domestic vectors, which is the rarest situation in areas endemic for Chagas disease.
The characteristics of Chagas disease as an enzooty of wild animals and as an
anthropozoonosis are seen most frequently in the Brazilian Amazon and in the
Pan-Amazon region as a whole, where there are 33 species of six genera of wild
animals: Marsupialia, Chiroptera, Rodentia, Edentata (Xenarthra), Carnivora and
Primata and 27 species of triatomines, most of which infected with T.
cruzi . These conditions place the resident populations of this area or
its visitors - tourists, hunters, fishermen and especially the people whose
livelihood involves plant extraction - at risk of being affected by Chagas disease.
On the other hand, there has been an exponential increase in the acute cases of
Chagas disease in that region through oral transmission of T. cruzi
, causing outbreaks of the disease. In four seroepidemiological surveys that were
carried out in areas of the microregion of the Negro River, state of Amazonas, in
1991, 1993, 1997 and 2010, we found large numbers of people who were serologically
positive for T. cruzi infection. The majority of them and/or their
relatives worked in piassava extraction and had come into contact with and were stung
by wild triatomines in that area. Finally, a characteristic that is greatly in
evidence currently is the migration of people with Chagas disease from endemic areas
of Latin America to non-endemic countries. This has created a new dilemma for these
countries: the risk of transmission through blood transfusion and the onus of
controlling donors and treating migrants with the disease. As an enzooty of wild
animals and vectors, and as an anthropozoonosis, Chagas disease cannot be eradicated,
but it must be controlled by transmission elimination to man.