ABSTRACT
BACKGROUND: In recent decades some outbreaks of food-borne acute Chagas disease (ACD) in humans were identified by clinical and epidemiological characterization after association through the ingestion of açaí pulp probably contaminated with Trypanosoma cruzi. Whereas Belém and Abaetetuba stood out as important risk regions for disease transmission, the importance of Rhodnius pictipes, and Philander opossum for the biological cycle of T. cruzi, and data from agribusiness market of açaí, to study T. cruzi from vector and reservoir of the Brazilian Amazon region is critical for this context. Thus, the purpose of this study was to verify the infective capacity and the virulence of T. cruzi in açaí pulp from vector and reservoir at Pará State experimentally. METHODS: 105T. cruzi I in in natura açaí pulp from Belém at Pará State, at room temperature, after forced sieving, by intraperitoneal, gavage or oral route of inoculation in B6.129S7Rag1-/-tmMom/J Unib allowed food-borne ACD analysis using common light microscopy. PRINCIPAL FINDINGS: T. cruzi in in natura açaí pulp from R. pictipes (Val-De-Cans Forest, Belém, and Ajuaí River, Abaetetuba, Pará), and P. opossum (Combu Island, Belém, Pará) caused ACD and death between 17 and 52 days after experimental infections in murine immunodeficient hosts. CONCLUSIONS: T. cruzi from different sources and locations at Pará State in in natura açaí pulp retained its infective capacity and virulence, and can cause new outbreaks of ACD by oral transmission. Additionally, quality basic education will facilitate efficient hygiene practices throughout the açaí productive chain can eradicate food-borne ACD in the coming decades.
Subject(s)
Chagas Disease/transmission , Euterpe/parasitology , Food Parasitology , Foodborne Diseases/parasitology , Trypanosoma cruzi/pathogenicity , Acute Disease , Animals , Brazil/epidemiology , Chagas Disease/epidemiology , Chagas Disease/parasitology , Disease Reservoirs/parasitology , Disease Vectors , Female , Foodborne Diseases/epidemiology , Insect Vectors/parasitology , Male , Mice , Mice, Inbred Strains , Opossums/parasitology , Parasitemia/epidemiology , Parasitemia/mortality , Rhodnius/parasitology , VirulenceABSTRACT
Fundamentos: A região amazônica sempre foi considerada área de baixo risco para a doença de Chagas (DC). Objetivo: Relatar as alterações eletrocardiográficas observadas na fase aguda da DC transmitida por via oral. Métodos: Foram analisados os traçados eletrocardiográficos de 161 pacientes com quadro clínico, sorológico e parasitológico da DC em sua fase aguda, todos provavelmente contaminados por via oral, de janeiro 2009 a abril 2010, atendidos no Hospital das Clínicas Gaspar Viana, em Belém, PA, Brasil. Resultados: Os resultados mostraram basicamente as mesmas alterações eletrocardiográficas clássicas descritas na fase aguda da doença, sugerindo não haver diferenças significativas entre as miocardites ocasionadas pela transmissão oral em comparação àquelas da transmissão vetorial e sanguínea. Conclusão: As alterações eletrocardiográficas da DC na fase aguda são similares às da doença contraída pela forma vetorial em zonas endêmicas.
Background: The Amazon region has always been rated as a low-risk area for Chagas disease (CD). Objective: To report on electrocardiographic changes observed in the acute phase of orally transmitted CD. Methods: ECG tracings were analyzed for 161patients with clinical, serological and parasitological acute phase CD, all probably infected orally, between January 2009 and April 2010, seen at the Hospital das Clínicas Gaspar Viana in Belém, Pará State, Brazil. Results: The results showed basically the same classic electrocardiographic changes described for the acute phase of the disease, suggesting no significant differences between myocarditis caused by oral transmission compared to blood and vector transmission. Conclusion: Electrocardiographic changes in acute phase CD are similar to those found when this disease is contracted through vectors in endemic areas.
Subject(s)
Humans , Male , Female , Chagas Cardiomyopathy/complications , Chagas Cardiomyopathy/diagnosis , Chagas Disease/complications , Chagas Disease/diagnosis , Electrocardiography/methods , DiagnosisABSTRACT
Acute Chagas disease (ACD) is caused by Trypanosoma cruzi. ACD outbreaks due to probable oral transmission occur regularly in small family gatherings that are exposed to contaminated foods. We studied two cohorts of residents on islands in the Breves and Bagre municipalities, in July and August 2007, to identify risk factors of transmission and to recommend preventative measures. Of the 25 cases identified in both cohorts, 13 (52%) were men, and the most frequent symptoms were fever (96%),asthenia (80%), myalgia (76%), abdominal pain (64%), retro-orbital pain, headaches and asthma (52%). We recommend detailed investigation of future outbreaks and other studies to better understand and control oral transmission of T. cruzi.
Subject(s)
Chagas Disease/epidemiology , Chagas Disease/transmission , Disease Outbreaks , Food Parasitology , Adolescent , Adult , Brazil/epidemiology , Child , Child, Preschool , Cohort Studies , Female , Humans , Male , Young AdultABSTRACT
In 2006, a total of 178 cases of acute Chagas disease were reported from the Amazonian state of Pará, Brazil. Eleven occurred in Barcarena and were confirmed by visualization of parasites on blood smears. Using cohort and case-control studies, we implicated oral transmission by consumption of açaí palm fruit.
Subject(s)
Arecaceae/parasitology , Chagas Disease/epidemiology , Chagas Disease/transmission , Communicable Diseases, Emerging/epidemiology , Communicable Diseases, Emerging/transmission , Disease Outbreaks , Food Parasitology , Animals , Brazil/epidemiology , Case-Control Studies , Chagas Disease/parasitology , Cohort Studies , Communicable Diseases, Emerging/parasitology , Fruit/parasitology , Humans , Retrospective Studies , Trypanosoma cruzi/isolation & purificationABSTRACT
O efeito adverso da primaquina na dose de 0,50mg/kg/dia foi investigado em onze pacientes com malária vivax (três com deficiência de glicose-6-fosfato desidrogenase). Alterações clínicas e laboratoriais indicaram hemólise aguda apenas nos enzimopênicos, o que fez com que o tratamento fosse interrompido. Nossos resultados sugerem a necessidade do emprego de um teste de triagem para a deficiência de G6PD em áreas endêmicas de malária vivax a fim de se evitar complicações causadas pelo uso da primaquina.
Subject(s)
Humans , Animals , Adult , Middle Aged , Adolescent , Antimalarials , Chloroquine , Glucosephosphate Dehydrogenase Deficiency , Hemolysis , Malaria, Vivax , Primaquine , Antimalarials , Malaria, Vivax , PrimaquineABSTRACT
Introdução:Os programas de controle de malária preconizam o uso de esquemas terapêuticos mais operacionais. Objetivos: Avaliar a toxidade de esquemas terapêuticos para malária vivax que resguardem a eficácia do tratamento antimalárico feito antigamente com duração de quatorze dias. Método: Foram avaliados os perfis laboratoriais de sessenta portadores de malária por Plasmodium vivax, em um dos três grupos de tratamento: grupo A: cloroquina 600mg em dose única e primaquina 30mg por dia por cinco dias; grupo B: cloroquina 600mg em dose única e primaquina 30mg por dia durante sete dias. Os pacientes foram submetidos aos seguintes exames: hemograma, reticulocitometria, plaquetometria e dosagens de bilirrubinas, creatinina e aminotransferases no primeiro dia de tratamento, e seguidamente no 3º,7º,9º e 14º dias. Resultados e considerações finais: Os esquemas empregados não demonstraram toxicidade traduzida nos parâmetros avaliados na população estudada, demonstrando melhora destes parâmetros no período pós-tratamento
