Trypanosoma cruzi and Chagas' Disease in the United States

Abstract

SUMMARY Chagas' disease is caused by the protozoan parasite Trypanosoma cruzi and causes potentially life-threatening disease of the heart and gastrointestinal tract. The southern half of the United States contains enzootic cycles of T. cruzi , involving 11 recognized triatomine vector species. The greatest vector diversity and density occur in the western United States, where woodrats are the most common reservoir; other rodents, raccoons, skunks, and coyotes are also infected with T. cruzi. In the eastern United States, the prevalence of T. cruzi is highest in raccoons, opossums, armadillos, and skunks. A total of 7 autochthonous vector-borne human infections have been reported in Texas, California, Tennessee, and Louisiana; many others are thought to go unrecognized. Nevertheless, most T. cruzi -infected individuals in the United States are immigrants from areas of endemicity in Latin America. Seven transfusion-associated and 6 organ donor-derived T. cruzi infections have been documented in the United States and Canada. As improved control of vector- and blood-borne T. cruzi transmission decreases the burden in countries where the disease is historically endemic and imported Chagas' disease is increasingly recognized outside Latin America, the United States can play an important role in addressing the altered epidemiology of Chagas' disease in the 21st century.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…From this and other studies, the most recent estimates in Brazil regarding the number of people infected by T. cruzi vary from 1.9 million to 4.6 million people (35) (36) (37) , probably closer now to 1.0-2.4% of the population.…”

Transmisión oral de Trypanosoma cruzi: un nuevo escenario epidemiológico de la enfermedad de Chagas en Colombia y otros países suramericanos

“…Aunque se desconocen las cifras concretas, en los países europeos se estima que alrededor del 2 % de los inmigrantes latinos están infectados con T. cruzi y que podrían actuar como donadores de sangre (10). En Estados Unidos, se han documentado cinco casos de infección por T. cruzi asociados a transfusiones de sangre desde la década de los ochenta, y entre 2006 y 2011 se reportaron 1.459 donaciones seropositivas para T. cruzi (11). Con la tamización en bancos de sangre en Latinoamérica desde 1993, se ha disminuido la prevalencia de la infección por transfusiones (12).…”

Kinetics, subcellular localization, and contribution to parasite virulence of a Trypanosoma cruzi hybrid type A heme peroxidase ( Tc APx-CcP)

“…In contrast to most eukaryotes, T. cruzi lacks catalase and selenium-dependent glutathione peroxidases, which are enzymes capable of rapidly metabolizing high levels of H 2 O 2 (8,9). Instead, it expresses an array of complex enzyme-mediated mechanisms in which the trypanosomatid-specific thiol trypanothione ([T(SH) 2 ], N 1 ,N 8 -bisglutathionylspermidine) plays a central role in the funneling of reducing equivalents to the different peroxidase antioxidant systems (10). Two typical 2-Cys peroxiredoxins are located in the cytosol (CPX) and in the mitochondrial matrix (MPX), respectively, and efficiently scavenge H 2 O 2 , peroxynitrite, and smallchain organic hydroperoxides (11)(12)(13).…”

“…Up to 10 million people across Latin America are infected with this protozoan parasite, a distribution range that is expanding driven by migration of infected insects and hosts, with CD now emerging as a public health problem at nonendemic sites (1,2). T. cruzi strains are heterogeneous, exhibiting a high degree of biochemical and genetic variability.…”