First Report of Acute Chagas Disease by Vector Transmission in Rio De Janeiro State, Brazil

Abstract

SUMMARYChagas disease (CD) is an endemic anthropozoonosis from Latin America of which the main means of transmission is the contact of skin lesions or mucosa with the feces of triatomine bugs infected by Trypanosoma cruzi. In this article, we describe the first acute CD case acquired by vector transmission in the Rio de Janeiro State and confirmed by parasitological, serological and PCR tests. The patient presented acute cardiomyopathy and pericardial effusion without cardiac tamponade. Together with fever and malaise, a 3 cm wide erythematous, non-pruritic, papule compatible with a "chagoma" was found on his left wrist. This case report draws attention to the possible transmission of CD by non-domiciled native vectors in non-endemic areas. Therefore, acute CD should be included in the diagnostic workout of febrile diseases and acute myopericarditis in Rio de Janeiro.

Drivers of house invasion by sylvatic Chagas disease vectors in the Amazon-Cerrado transition: A multi-year, state-wide assessment of municipality-aggregated surveillance data

“…Sylvatic transmission cycles involving wild triatomines and mammals are probably widespread in the state, and infection of domestic dogs can be locally common [ 34 , 35 ]. Importantly, most new cases of human Chagas disease in Tocantins are reported from northern municipalities [ 25 , 29 – 31 ], where triatomines seldom colonize in man-made structures; these cases are therefore most likely linked to sylvatic vectors that invade houses and transmit the parasite either directly [ 16 , 17 ] or by contaminating food or beverages [ 18 – 21 ].…”

“…Domestic T . cruzi transmission is thus possible even in the absence of house colonization; it can occur either through direct vector-human contact (i.e., classical stercorarian transmission) [ 16 , 17 ] or through the contamination of food or beverages by infected vectors, which may lead to oral transmission [ 18 ]. This latter mechanism has been implicated in outbreaks of acute, often severe Chagas disease reported (with increasing frequency since about 2005) from across South America [ 3 , 19 – 21 ].…”

Seroprevalence of Trypanosoma cruzi infection among blood donors in the state of Bahia, Brazil

“…cruzi infection occurs predominantly in individuals living in rural areas 8 . However, the epidemiological status of CD has changed as a consequence of migration flows from rural areas to the periphery of large cities, where the presence of forest remnants increases the risk of disease transmission [14][15][16][17] .…”

Trypanosoma Species in Small Nonflying Mammals in an Area With a Single Previous Chagas Disease Case

“…All the specimens were identified as Triatoma tibiamaculata, and only one specimen (2012) was infected by T. cruzi, as detected by the intestinal content exam, and it was characterized as T. cruzi DTU TcI (Roque ALR, personal communication). We hypothesize that the infected T. tibiamaculata (Sangenis et al, 2015) involved in the human case probably became infected and moved further away from the study area. This observation raises the question concerning the displacement capacity of triatomines that, in addition to flying, can also travel by air currents.…”

“…It occupies a 356 km² area, and its estimated population was 41,557 inhabitants in 2016, according to the Instituto Brasileiro de Geografia e Estatıśtica (IBGE). In 2012, an acute case of CD confirmed by parasitological, serological, and molecular tests was reported (Sangenis et al, 2015). The case was acquired through the contaminative route by a man who slept in a hammock.…”