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Chagas Disease pp 225-241 | Cite as

Orally Transmitted Chagas Disease: Biology, Epidemiology, and Clinical Aspects of a Foodborne Infection

  • Belkisyolé Alarcón de Noya
  • Oscar Noya González
Chapter
Part of the Birkhäuser Advances in Infectious Diseases book series (BAID)

Abstract

Chagas disease has been one of the great neglected infectious pathologies, affecting not only developing countries but also the most vulnerable sectors of the population with greater intensity. In the spectrum of its mechanisms of infection, the most forgotten, unknown, and underestimated is the oral infection. Despite being the usual form of infection among mammals and the increasing frequency of oral Trypanosoma cruzi-transmitted outbreaks since 1967, many aspects about the physiopathology, the histotropism, clinical evolution, evasion mechanisms of Trypanosoma cruzi, the consequent host immune response, and the therapeutic efficacy are still unknown. However, nowadays we already know, and are discussed in this chapter, the risk factors, the clinical aspects, the incriminated vectors, the ideal diagnostic methods, and the therapeutic approach primarily applicable to the acute phase.

Keywords

Chagas disease Oral transmission Foodborne Epidemiology Clinic Diagnosis Treatment Venezuela 

References

  1. 1.
    Yoshida N. Molecular mechanisms of Trypanosoma cruzi infection by oral route. Mem Inst Oswaldo Cruz. 2009;104:101–7.CrossRefGoogle Scholar
  2. 2.
    Deane MP, Lenzi HL, Jansen A. Trypanosoma cruzi: vertebrate and invertebrate cycles in the same mammal host, the opossum Didelphis marsupialis. Mem Inst Oswaldo Cruz. 1964;79:113–5.Google Scholar
  3. 3.
    Guhl F, Jaramillo C, Yockteng R, Cárdenas-Arroyo F. Trypanosoma cruzi DNA in human mummies. Lancet. 1997;349:1370.PubMedCrossRefGoogle Scholar
  4. 4.
    Chagas C. Nova tripanosomiase humana, Estudo sobre a morfologia e o ciclo evolutivo do Schizotrypanum cruzi. Gen.Sp. Agente etiologico de uma nova entidade morbida do homem. Mem Inst Oswaldo Cruz. 1909;1:159–218.Google Scholar
  5. 5.
    Rassi A Jr, Rassi A, Marin Neto JA. Chagas disease. Lancet. 2010;375:1388–402.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Robertson LJ, Devleesschauwer B, Alarcón de Noya B, Noya González O, Torgerson PR. Trypanosoma cruzi: time for international recognition as a foodborne parasite. PLoS Negl Trop Dis. 2016;10(6):1–6.CrossRefGoogle Scholar
  7. 7.
    Ruiz-Guevara R, Noya O, Alarcón de Noya B. Documented outbreaks of foodborne Chagas disease. In: Alarcón de Noya B, Noya O, Robertson LJ, editors. Trypanosoma cruzi as a foodborne pathogen, Springer briefs in food, health and nutrition. New York, NY: Springer; 2015. p. 53–71.CrossRefGoogle Scholar
  8. 8.
    Alarcón de Noya B, Díaz-Bello Z, Colmenares C, Ruiz-Guevara R, Mauriello L, Muñoz-Calderón A, Noya O. Update on oral Chagas disease outbreaks in Venezuela: epidemiological, clinical and diagnostic approaches. Mem Inst Oswaldo Cruz. 2015;110(3):377–86.CrossRefGoogle Scholar
  9. 9.
    Ruiz-Guevara R, Muñoz-Calderón A, Alarcón de Noya B, Redondo C, Pulido L, Beitia Y, Mauriello L, Rojas D, Muñoz J, Navarro E, Reyes-Lugo M. Brote familiar de Enfermedad de Chagas por transmisión oral en Yaguapita, Estado Miranda, Venezuela. Bol. Mal. Salud Amb. En prensa. 2018.Google Scholar
  10. 10.
    Alarcón de Noya B, Díaz-Bello Z, Colmenares C, Ruiz-Guevara R, Mauriello L, Zavala-Jaspe R, Suárez JA, Abate T, Naranjo L, Paiva M, Rivas L, Castro J, Márques J, Mendoza I, Acquatella H, Torres J, Noya O. Large urban outbreak of orally-acquired acute Chagas disease, at a school in Caracas, Venezuela. J Infect Dis. 2010;201:1308–15.PubMedCrossRefGoogle Scholar
  11. 11.
    Añez N, Crisante G, Parada H. Nuevos casos de enfermedad de Chagas en el Occidente de Venezuela. Salus. 2007;11:87–90.Google Scholar
  12. 12.
    OMS/OPS/TDR. Reporte sobre la Enfermedad de Chagas. Grupo de Trabajo Científico. Eds. Felipe Guhl and Janis Lazdins. 2007. pp 1–96.Google Scholar
  13. 13.
    Pinto AYN, Valente SA, Valente VC, Ferreira AG, Coura JR. Fase aguda da doença de Chagas na Amazônia brasileira. Estudo de 233 casos do Pará, Amapá e Maranhão observados entre 1988 e 2005. Rev Soc Bras Med Trop. 2008;41:602–14.PubMedCrossRefGoogle Scholar
  14. 14.
    Shikanai-Yasuda MA, Carvalho NB. Oral transmission of Chagas disease. Clin Infect Dis. 2012;54:845–52.PubMedCrossRefGoogle Scholar
  15. 15.
    Briceño-León R. La Enfermedad de Chagas en las Américas: una perspectiva de ecosalud. Cad Saude Publica. 2009;25:S71–82.PubMedCrossRefGoogle Scholar
  16. 16.
    World Bank. 2013. http//ata.worldbank.org
  17. 17.
    Noya O, Alarcón de Noya B, Robertson L. Epidemiological factors related in foodborne transmission of Chagas disease. In: Alarcón de Noya B, Noya O, Robertson LJ, editors. Trypanosoma cruzi as a foodborne pathogen, Springer Briefs in Food, Health and Nutrition. New York, NY: Springer; 2015. p. 41–51.CrossRefGoogle Scholar
  18. 18.
    Reyes-Lugo M. Panstrongylus geniculatus Latreille 1811 (Hemiptera: Reduviidae: Triatominae), vector de la enfermedad de Chagas en el ambiente domiciliario del centro-norte de Venezuela. Rev Biomed. 2009;20:180–205.Google Scholar
  19. 19.
    Coura JR, Albajar-Viñas P, Junqueira ACV. Ecoepidemiology, short history and control of Chagas disease in the endemic countries and the new challenge for nonendemic countries. Mem Inst Oswaldo Cruz. 2014;109:856–62.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Alarcón de Noya B, Noya O. Clinical aspects in foodborne Chagas disease. In: Alarcón de Noya B, Noya O, Robertson LJ, editors. Trypanosoma cruzi as a foodborne pathogen, Springer Briefs in Food, Health and Nutrition. New York, NY: Springer; 2015. p. 33–40.CrossRefGoogle Scholar
  21. 21.
    Guhl F. Enfermedad de Chagas: realidad y perspectivas. Rev Biomed. 2009;20:228–3.Google Scholar
  22. 22.
    Bern C, Kjos S, Yabsley MJ, Montgomery SP. Trypanosoma cruzi and Chagas disease in the United States. Clin Microbiol Rev. 2011;24:655–81.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Díaz-Bello Z, Zavala-Jaspe R, Reyes-Lugo M, Colmenares C, Noya-Alarcón O, Noya O, Herrera L, Alarcón de Noya B. Urban Trypanosoma cruzi oral transmission: from a zoonotic founder focus to the largest microepidemic of Chagas disease. SOJ Microbiol Infect Dis. 2016;4(1):1–9.Google Scholar
  24. 24.
    Alarcón de Noya B, Noya-González O. An ecological overview on the factors that drives to Trypanosoma cruzi oral transmission. Acta Trop. 2015;151:94–102.CrossRefGoogle Scholar
  25. 25.
    Shaub GA. Trypanosoma cruzi: quantitative studies of development of two strains in small intestine and rectum of the vector Triatoma infestans. Exp Parasitol. 1989;68:260–27.CrossRefGoogle Scholar
  26. 26.
    Martín A, Alarcón de Noya B, Montero R, Rojas C, Garrido E, Ruiz-Guevara R, Díaz-Bello Z. Epidemia de Chagas agudo adquirido por vía oral en una escuela de Caracas: descripción del caso índice. Arch Venez Ped Puericult. 2009;72(3):97–100.Google Scholar
  27. 27.
    Alarcón de Noya B, Díaz-Bello Z, Colmenares C, Ruiz-Guevara R, Noya O. Enfermedad de Chagas de transmisión oral: vinculación del caso índice con una microepidemia urbana en Venezuela. Bol Mal Salud Amb. 2010;60:135–8.Google Scholar
  28. 28.
    Morocoima A, Tineo Brito EJ, Ferrer E, Herrera L, Nuñez M. Enfermedad de Chagas en el estado Anzoátegui, Venezuela: registro de un caso agudo y caracterización parasitológica y molecular del aislado. Bol Mal Salud Amb. 2008;48(2):121–6.Google Scholar
  29. 29.
    Zuleta-Dueñas LP, López-Quiroga ÁJ, Torres-Torres F, Castañeda-Porras O. Posible transmisión oral de la enfermedad de Chagas en trabajadores del sector de los hidrocarburos en Casanare, Colombia 2014. Biomédica. 2017;37:218–32.PubMedCrossRefGoogle Scholar
  30. 30.
    Alarcón de Noya B, Colmenares C, Díaz-Bello Z, Ruiz-Guevara R, Medina K, Muñoz-Calderón A, Mauriello L, Cabrera E, Montiel L, Losada S, Martínez J, Espinosa R, Abate T. Orally-transmitted Chagas disease: epidemiological, clinical, serological and molecular outcomes of a school microepidemic in Chichiriviche de la Costa, Venezuela. Parasite Epid Control. 2016;1:188–98.CrossRefGoogle Scholar
  31. 31.
    Ríos JF, Arboleda M, Montoya AN, Alarcón EP, Parra-Henao GJ. Probable outbreak of oral transmission of Chagas disease in Turbo, Antioquia. Biomédica. 2011;31:185–95.PubMedCrossRefGoogle Scholar
  32. 32.
    Hernández LM, Ramírez A, Cucunubá Z, Zambrano P. Brote de Chagas agudo en Lebrija, Santander, 2008. Rev Observ Salud Púb Santander. 2009;4:28–33.Google Scholar
  33. 33.
    Noya O, Ruiz-Guevara R, Díaz-Bello Z, Alarcón de Noya B. Epidemiología y clínica de la transmisión oral de Trypanosoma cruzi. Rev Esp Epidem: XI workshop on chagas disease, Barcelona Spain. 2015. pp. 23–34.Google Scholar
  34. 34.
    Bastos CJC, Aras R, Mota G, Reis F, Dias JP, Silva de Jesús R, Silva Freire MG, de Araújo E, Prazeres J, MF RG. Clinical outcomes of thirteen patients with acute Chagas Disease acquired through oral transmission from two urban outbreaks in northeastern Brazil. PLoS Negl Trop Dis. 2010;4(6):e711.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Marques J, Mendoza I, Noya B, Acquatella H, Palacios I, Marques-Mejias M. ECG manifestations of the biggest outbreak of Chagas disease due to oral infection in Latin-America. Arq Bras Cardiol. 2013;101:249–54.PubMedPubMedCentralCrossRefGoogle Scholar
  36. 36.
    Alarcón de Noya B, Veas J, Ruiz-Guevara R, Martín A, Rojas C, Machado I, Telo C, Henao L, Díaz-Bello Z, Noya O. Evaluación clínica y de laboratorio de pacientes hospitalizados durante el primer brote urbano de Enfermedad de Chagas de transmisión oral en Venezuela. Rev Patol Trop. 2013;42(2):177–86.CrossRefGoogle Scholar
  37. 37.
    Suárez J, B de Suárez C, Alarcón de Noya B, Espinosa R, Chiurillo MA, Villaroel A, De Martín F, Paiva M, Díaz-Bello Z, Valderrama E, Estrada D, Vivas E. Enfermedad de Chagas sistémico en fase aguda por transmisión oral: diagnóstico integral de un caso autopsiado. Gac Méd Caracas. 2010;118(3):212–22.Google Scholar
  38. 38.
    Alarcón de Noya B, Pérez-Chacón G, Díaz-Bello Z, Dickson S, Muñoz-Calderón A, Hernández C, Pérez Y, Mauriello L, Moronta E. Description of an oral Chagas disease outbreak in Venezuela, including a vertically transmitted case. Mem Inst Oswaldo Cruz. 2017;112:569–71.CrossRefGoogle Scholar
  39. 39.
    Pinto AY, Valente VC, Valente SA, Figueiras AC. Congenital Chagas disease due to acute maternal Trypanosoma cruzi infection transmitted by the oral route. Rev Pan-Amaz Saude. 2011;2(1):89–94.CrossRefGoogle Scholar
  40. 40.
    Andrade JP, Marin-Neto JA, Paola AA, Vilas-Boas F, Oliveira GM, Bacal F, Bocchi EA, Almeida DR, Fragata Filho AA, Moreira da MC, Xavier SS, Oliveira Junior WA, Dias JC, Sociedade Brasileira de Cardiologia. I Diretriz Latino Americana para o Diagnóstico e Tratamento da Cardiopatia Chagásica. Arq Bras Cardiol. 2011;97(2 Suppl 3):1–48.PubMedGoogle Scholar
  41. 41.
    WHO. Control of Chagas disease. Second report of the WHO expert committee. WHO technical report series no 905. Geneva: World Health Organization; 2002.Google Scholar
  42. 42.
    Alarcón de Noya B, Díaz-Bello Z, Colmenares C, Zavala-Jaspe R, Abate T, Contreras R, Losada S, Artigas D, Mauriello L, Ruiz-Guevara R, Noya O. The performance of laboratory tests in the management of a large outbreak of orally transmitted Chagas disease. Mem Inst Oswaldo Cruz. 2012;107:893–8.CrossRefGoogle Scholar
  43. 43.
    Freilij H, Muller L, González-Cappa M. Direct micromethod for diagnosis of acute and congenital Chagas’ disease. J Clin Microbiol. 1983;18:327–30.Google Scholar
  44. 44.
    Díaz-Bello Z, Thomas MC, López MC, Zavala-Jaspe R, Noya O, Alarcón de Noya B, Abate T. Trypanosoma cruzi genotyping supports a common source of infection in a school-related oral outbreak of acute Chagas disease in Venezuela. Epidemiol Infect. 2014;142(1):156–62.PubMedCrossRefGoogle Scholar
  45. 45.
    Rueda K, Trujillo JE, Carranza JC, Vallejo GA. Transmisión oral de Trypanosoma cruzi: una nueva situación epidemiológica de la enfermedad de Chagas en Colombia y otros países suramericanos. Biomedica. 2014;34:631–41.PubMedCrossRefGoogle Scholar
  46. 46.
    Duffy T, Cura CI, Ramirez JC, Abate T, Cayo NM, Parrado R, Díaz-Bello Z, Velazquez E, Muñoz-Calderon A, Juiz NA, Basile J, Garcia L, Riarte a NJR, Ocampo SB, Yadon ZE, Torrico F, Alarcón de Noya B, Ribeiro I, Schijman AG. Analytical performance of a multiplex real-time PCR assay using TaqMan probes for quiantification of Trypanosoma cruzi satellite DNA in blood samples. PLoS Negl Trop Dis. 2013;7(1):e2000.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Ramírez JC, Cura CI, da Cruz Moreira O, Lages-Silva E, Juiz N, Velázquez E, Ramírez JD, Alberti A, Pavia P, Flores-Chávez MD, Muñoz-Calderón A, Pérez-Morales D, Santalla J, Marcos da Matta Guedes P, Peneau J, Marcet P, Padilla C, Cruz-Robles D, Valencia E, Crisante GE, Greif G, Zulantay I, Costales JA, Alvarez-Martínez M, Martínez NE, Villarroel R, Villarroel S, Sánchez Z, Bisio M, Parrado R, Maria da Cunha Galvão L, Jácome da Câmara AC, Espinoza B, Alarcón de Noya B, Puerta C, Riarte A, Diosque P, Sosa-Estani S, Guhl F, Ribeiro I, Aznar C, Britto C, Yadón ZE, Schijman AG. Analytical validation of quantitative real-time PCR methods for quantification of Trypanosoma cruzi DNA in Blood samples from Chagas disease patients. J Mol Diagn. 2015;17:605–15.PubMedPubMedCentralCrossRefGoogle Scholar
  48. 48.
    Sales PA, Molina I, Fonseca Murta SM, Sánchez-Montalvá A, Salvador F, Correa-Oliveira R, Martins Carneiro C. Experimental and clinical treatment of Chagas disease: a review. Am J Trop Med Hyg. 2017;97(5):1289–303.CrossRefGoogle Scholar
  49. 49.
    Díaz ML, Leal S, Mantilla JC, Molina-Berríos A, López-Muñoz R, Solari A, Escobar P, González-Rugeles CI. Acute Chagas outbreaks: molecular and biological features of Trypanosoma cruzi isolates, and clinical aspects of acute cases in Santander, Colombia. Parasit Vectors. 2015;8:608–22.PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Urbina JA, Docampo R. Specific chemotherapy of Chagas disease: controversies and advances. Trends Parasitol. 2003;19(11):495–501.PubMedCrossRefGoogle Scholar
  51. 51.
    Coura JR, Castro SL. A critical review of Chagas disease chemotherapy. Mem Inst Oswaldo Cruz. 2002;97(1):3–24.CrossRefGoogle Scholar
  52. 52.
    Alarcón de Noya B, Ruiz-Guevara R, Noya O, Castro J, Ossenkopp J, Díaz-Bello Z, Colmenares C, Suárez JA, Noya-Alarcón O, Naranjo L, Gutiérrez H, Quinci G, Torres J. Long-term comparative pharmacovigilance of orally transmitted Chagas disease: first report. Expert Rev Anti-Infect Ther. 2017;15(3):319–25.PubMedCrossRefGoogle Scholar
  53. 53.
    Guedes PM, Silva GK, Gutierrez FR, João S, Silva JS. Current status of Chagas disease chemotherapy. Expert Rev Anti-Infect Ther. 2011;9(5):609–20.PubMedCrossRefGoogle Scholar
  54. 54.
    de Andrade AL, Zicker F, de Oliveira RM, Almeida Silva S, Luquetti A, Travassos LR, Almeida IC, de Andrade SS, de Andrade JG, Martelli CM. Randomized trial of efficacy of benznidazole in treatment of early Trypanosoma cruzi infection. Lancet. 1996;348:1407–13.PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Sosa Estani S, Segura EL, Ruiz AM, Velazquez E, Porcel BM, Yampotis C. Efficacy of chemotherapy with benznidazole in children in the indeterminate phase of Chagas disease. Am J Trop Med Hyg. 1998;59:526–9.PubMedPubMedCentralCrossRefGoogle Scholar
  56. 56.
    Alarcón de Noya B, Díaz-Bello Z, Colmenares C, Muñoz A, Ruiz-Guevara R, Balzano L, Campelo R, Abate T, Maniscalchi MT, Ramírez JL, Noya O. Eficacia terapéutica en el primer brote de transmisión oral de la enfermedad de Chagas en Venezuela. Biomedica. 2011;31(3):64–5.Google Scholar
  57. 57.
    Cançado JR. Long term evaluation of etiological treatment of Chagas disease with benznidazole. Rev Inst Med Trop Sao Paulo. 2002;44:29–37.PubMedCrossRefGoogle Scholar
  58. 58.
    Robertson L, Noya O. Prophylactic measures and implementation of control measures in foodborne Chagas disease. In: Alarcón de Noya B, Noya O, Robertson LJ, editors. Trypanosoma cruzi as a foodborne pathogen, Springer briefs in food, health and nutrition. New York, NY: Springer; 2015. p. 81–8.CrossRefGoogle Scholar
  59. 59.
    Xavier SC, Roque ALR, Bilac D, de Araújo VAL, Neto SF, da Silva LFC, Jansen AM. Distantiae transmission of Trypanosoma cruzi: a new epidemiological feature of acute Chagas disease in Brazil. PLoS Negl Trop Dis. 2014;8(5):e2878.PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Valente SAS, Vera da Costa Valente VC, Neto HF. Considerations on the epidemiology and transmission of Chagas disease in the Brazilian Amazon. Mem Inst Oswaldo Cruz. 1999;94(I):395–8.CrossRefGoogle Scholar
  61. 61.
    Añez N, Crisante G, Romero M. Supervivencia e infectividad de formas metacíclicas de Trypanosoma cruzi en alimentos experimentalmente contaminados. Bol Malariol Salud Amb. 2009;49:91–6.Google Scholar
  62. 62.
    Dias GB, Gruendling AP, Marquez S, Gomes ML, Toledo MJ. Evolution of infection in mice inoculated by the oral route with different developmental forms of Trypanosoma cruzi I and II. Exp Parasitol. 2013;135:511–7.PubMedCrossRefGoogle Scholar

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Belkisyolé Alarcón de Noya
    • 1
  • Oscar Noya González
    • 2
    • 3
  1. 1.Facultad de Medicina, Sección de Inmunología, Instituto de Medicina TropicalUniversidad Central de VenezuelaCaracasVenezuela
  2. 2.Facultad de Medicina, Sección de Biohelmintiasis, Instituto de Medicina TropicalUniversidad Central de VenezuelaCaracasVenezuela
  3. 3.Centro para Estudios sobre Malaria, Instituto de Altos Estudios, Dr. Arnoldo GabaldónInstituto Nacional de Higiene Rafael Rangel, MPPSAraguaVenezuela

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