ABSTRACT
Chagas disease is a parasitic infection that can result in a progressive dilated cardiomyopathy. Here, we present the epidemiologic details of a suspected locally acquired transmission case originating from the southern United States. This is the first published report of Chagas disease in a young, healthy United States veteran with repeat triatomine exposures in Arizona. Military personnel and Arizona residents should be aware of their Chagas disease transmission risks.
Subject(s)
Chagas Disease/diagnosis , Adult , Animals , Arizona/epidemiology , Chagas Disease/epidemiology , Humans , Insect Vectors , Male , Triatominae/physiologyABSTRACT
Ten months after orthotopic liver transplant, a 53-year-old male patient developed cough and fever. Imaging revealed diffuse ground-glass opacities involving all lobes, and subsequent bronchoscopic washings revealed Scopulariopsis brumptii infection. The patient initially had significant clinical deterioration requiring intubation and extracorporeal membrane oxygenation. However, combination antifungal therapy, including posaconazole and terbinafine, eventually proved successful in eradicating the infection.
Subject(s)
Antifungal Agents/therapeutic use , Liver Transplantation/adverse effects , Mycoses/drug therapy , Mycoses/etiology , Scopulariopsis/isolation & purification , Extracorporeal Membrane Oxygenation , Humans , Immunocompromised Host , Male , Middle AgedABSTRACT
Chagas disease is an important emerging disease in Texas that results in cardiomyopathy in about 30% of those infected with the parasite Trypanosoma cruzi. Between the years 2008 and 2012, about 1/6500 blood donors were T. cruzi antibody-confirmed positive. We found older persons and minority populations, particularly Hispanic, at highest risk for screening positive for T. cruzi antibodies during routine blood donation. Zip code analysis determined that T. cruzi is associated with poverty. Chagas disease has a significant disease burden and is a cause of substantial economic losses in Texas.
Subject(s)
Blood Donors/statistics & numerical data , Chagas Disease/epidemiology , Mass Screening , Trypanosoma cruzi/isolation & purification , Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Protozoan/blood , Chagas Disease/parasitology , Female , Humans , Male , Middle Aged , Prevalence , Risk Factors , Seroepidemiologic Studies , Socioeconomic Factors , Texas/epidemiology , Young AdultABSTRACT
In the poorest regions of the United States, especially along the Gulf Coast and in South Texas, are a group of endemic parasitic and related infections known as the neglected infections of poverty. Such infections are characterized by their chronicity, disabling features, and disproportionate impact on the estimated 46 million people who live below the U.S. poverty line. Today more Americans live in poverty than ever before in the half-century that the Census Bureau has been recording poverty rates. In association with that poverty, a group of major neglected infections of poverty have emerged in the United States. Here we describe the major neglected infections of poverty in the United States, with a brief overview of their significant epidemiological features, their links with poverty, and our approaches to their diagnosis, management, and treatment.
Subject(s)
Disease Management , Parasitic Diseases/therapy , Poverty Areas , Virus Diseases/therapy , Arbovirus Infections/therapy , Chagas Disease/therapy , Cysticercosis/therapy , Dengue/therapy , Humans , Parasitic Diseases/epidemiology , Strongylida Infections/therapy , Texas/epidemiology , Toxocariasis/therapy , United States/epidemiology , Virus Diseases/epidemiology , West Nile Fever/therapyABSTRACT
Individuals with chronic HCV infection have impaired response to vaccine, though the etiology remains to be elucidated. Dendritic cells (DC) and monocytes (MN) provide antigen uptake, processing, presentation, and costimulatory functions necessary to achieve optimal immune responses. The integrity of antigen processing and presentation function within these antigen presenting cells (APC) in the setting of HCV infection has been unclear. We used a novel T cell hybridoma system that specifically measures MHC-II antigen processing and presentation function of human APC. Results demonstrate MHC-II antigen processing and presentation function is preserved in both myeloid DC (mDC) and MN in the peripheral blood of chronically HCV-infected individuals, and indicates that an alteration in this function does not likely underlie the defective HCV-infected host response to vaccination.
