Prophylactic Measures and Implementation of Control Measures in Foodborne Chagas Disease

Abstract

In order to minimize the likelihood of foodborne infection with Chagas disease the whole food-chain, from production to consumption, needs to be considered using a Hazard Analysis and Critical Control Point (HACCP) approach in order to identify where control measures can be most usefully implemented that will have the greatest effect at reducing risk. Legislation regarding food control in general is in place, and application of the steps of microbial risk assessment is also possible, but, nevertheless, it is clear that foodborne outbreaks of Chagas disease continue to occur in endemic regions. Although the international perspective on outbreaks of orally transmitted Chagas disease is, and unfortunately continues to be, that this is a local and limited problem and without any global impact, it is nevertheless clear that açaí, sugarcane, and fruit juices are ideal food matrices for foodborne transmission; vital risk factors include the crops for these drinks often being grown, harvested, and pressed locally, (with the pressing often occurring at night-time under artificial light), in rural or periurban areas where sylvatic triatomines may be abundant. In this chapter we discuss not only the legislation and tools available to reduce the likelihood of foodborne transmission, but also practical measures that could be implemented at all stages along the food-chain, not forgetting educational measures for the vendors and consumers of the final products.