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Vol.3 , No. 1, Publication Date: Mar. 4, 2016, Page: 29-37
 detected in nine patients involved in the outbreak, together with the absence of Romaña’s sign, strongly indicate simultaneous infections by ingesting <i>T. cruzi</i>-contaminated food. The analysis of the clinical profiles detected in the acute chagasic patients revealed a total of 18 symptoms with an average per patient of 9±4 (range: 5-16) symptoms with 44% lethality. In the four fatal cases hepatomegaly was present (100%) and myocarditis, pericardial effusion and cardiomegaly were respectively detected in 75%, 50% and 25% of them. In all cases, similar values of anti-<i>T. cruzi</i> antibodies, amount of blood circulating trypomastigotes and same DNA bands obtained by combination of sero-parasitological and molecular (Polymerase Chain Reaction-PCR) assays revealed patients with a similar clinical history, which support the oral mode of infection. Histopathological observations revealed the presence of large number of <i>T. cruzi</i>-tissue forms and massive lymphomonocytic infiltration in samples from heart, liver, spleen, skeletal muscle and tongue of a fatal case, which demonstrated the severity of the parasite circulating in the studied area. The epidemiological significance of the findings is discussed, and the alert to clinicians and population on the orally transmitted Chagas disease is provided.&picture=http://www.aascit.org/aascit/decorators/img/journal/906.jpg)
| [1] | Nestor Anez, Center for Parasitological Research “J. F. Torrealba”, Department of Biology, Faculty of Sciences, University of Los Andes, Merida, Venezuela. |
| [2] | Gladys Crisante, Center for Parasitological Research “J. F. Torrealba”, Department of Biology, Faculty of Sciences, University of Los Andes, Merida, Venezuela. |
| [3] | Agustina Rojas, Center for Parasitological Research “J. F. Torrealba”, Department of Biology, Faculty of Sciences, University of Los Andes, Merida, Venezuela. |
| [4] | Rafael O. Rojas, Regional Epidemiology Office, Health Corporation, Ministry of Health, Merida, Venezuela. |
| [5] | Javier Bastidas, Rural Endemic Division, Ministry of Health, Merida, Venezuela. |
A massive, simultaneous and severe acute Chagas disease micro-epidemic outbreak associated with Trypanosoma cruzi oral transmission, detected in a rural locality of Merida, Venezuela, is reported. The presence of similar severe clinical profiles, massive active parasitemia, specific anti-T. cruzi IgM and infection by the same genetic T. cruzi genotype (DTU I) detected in nine patients involved in the outbreak, together with the absence of Romaña’s sign, strongly indicate simultaneous infections by ingesting T. cruzi-contaminated food. The analysis of the clinical profiles detected in the acute chagasic patients revealed a total of 18 symptoms with an average per patient of 9±4 (range: 5-16) symptoms with 44% lethality. In the four fatal cases hepatomegaly was present (100%) and myocarditis, pericardial effusion and cardiomegaly were respectively detected in 75%, 50% and 25% of them. In all cases, similar values of anti-T. cruzi antibodies, amount of blood circulating trypomastigotes and same DNA bands obtained by combination of sero-parasitological and molecular (Polymerase Chain Reaction-PCR) assays revealed patients with a similar clinical history, which support the oral mode of infection. Histopathological observations revealed the presence of large number of T. cruzi-tissue forms and massive lymphomonocytic infiltration in samples from heart, liver, spleen, skeletal muscle and tongue of a fatal case, which demonstrated the severity of the parasite circulating in the studied area. The epidemiological significance of the findings is discussed, and the alert to clinicians and population on the orally transmitted Chagas disease is provided.
Keywords
Chagas Disease, Trypanosoma cruzi, Oral Transmission, Venezuela
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