Oral transmission of Chagas disease from a One Health approach: A systematic review

Abstract

ObjectiveTo analyse acute Chagas disease (CD) outbreaks through a qualitative systematic review and discuss the determinants for its prevention and control.MethodsReview of studies in which clinical cases of oral transmission were confirmed by parasitological and/or serological tests that included an epidemiological investigation of sources of infection, vectors and reservoirs.ResultsThirty‐two outbreaks (1965–2022) were analysed. The main foods involved in oral transmission outbreaks are homemade fruit juices. Different species of vectors were identified. Reservoirs were mainly dogs, rodents and large American opossums (didelphids).ConclusionUnder a One Health approach, environmental changes are one of the factors responsible of the rise of oral transmission of CD. Entomological surveillance of vectors and control of the changes in wild and domestic reservoirs and reinforcement of hygiene measures around food in domestic and commercial sites are needed.

Human Trypanosoma cruzi infection in the Argentinean Chaco: risk factors and identification of households with infected children for treatment

“…Our preliminary estimate of the probability of vertical transmission (2%) is similar to the ones recorded in other regions [ 81 ].]. Oral transmission appears to be negligible in our study area and elsewhere in Argentina, where no oral outbreak of human T. cruzi infection has been reported so far [ 8 ].…”

“…Trypanosoma cruzi , the etiological agent of Chagas disease, is transmitted by several routes: triatomine insects, which is the most important route in endemic regions [ 5 ]; transplacental or vertical route, the main source of new cases in non-endemic areas [ 6 ]; ingestion of food or beverages contaminated with infected triatomine feces [ 7 ], never reported in Argentina so far [ 8 ]; and blood transfusion and organ transplant, which have been blocked in the Americas by strict donor control [ 9 ]. Prevention of vector-borne transmission has mostly relied on insecticide spraying of houses since the 1950s [ 10 – 12 ].…”

The End Justifies the Means: Chagas Disease from a Perspective of the Host–Trypanosoma cruzi Interaction

“…In addition to vector transmission, in recent decades outbreaks of oral transmission of CD have been frequently described and can reach up to 70% of cases in some regions [2]. These outbreaks were associated with the consumption of contaminated food/drinks such as bushmeat, vegetables, sugar cane extract, and açaí pulp, among others [3]. The mortality rate in patients infected orally is reported to be higher (8-35%) when compared to classical vector transmission through vector excreta (<5-10%) [4].…”