Possible oral transmission of acute Chagas' disease in Brazil Possível transmissão oral de doença de Chagas aguda, no Brasil

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: M.A. Shikanai-Yasuda, C. Brisola Marcondes, L. A. Guedes, G.S. Siqueira, A.A. Barone, J.C.P. Dias, V. Amato Neto, J.E. Tolezano, B.A. Peres, E.R. Arruda Jr., M.H. Lopes, M. Shiroma, E. Chapadeiro
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 1991
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Aguda; Arctic
• Online Access: https://doi.org/10.1590/S0036-46651991000500003; https://doaj.org/article/ceb3026d43ef4e6e85d1b52df3688761

In October, 1986, 7 to 22 days after a meeting at a farm in Paraíba state, 26 individuals presented with a febrile illness associated with bilateral eyelid and lower limb edema, mild hepatosplenomegaly, lymphadenopathy and, occasionally a skin rash. A 11-year-old boy exhibited atrial premature complexes and a 74-year-old patient developed acute heart failure. In two patients hospitalized in São Paulo city, acute Chagas' disease was diagnosed by the demonstration of circulating Trypanosoma cruzi. At autopsy in a fatal case, acute Chagas' cardiomyopathy was demonstrated. Xenodiagnosis were positive in 9 out of 14 tested patients. A specific IgG immune response was found in all patients and specific IgM antibodies were identified in 20 out of 22 tested patients. A epidemiological survey showed the existence of Triatoma brasiliensis in the outbuildings of this farm, but none in the house where most of the guests stayed. A high rate of infection with Trypanosoma cruzi was found in opossums. These observations together with those related to the food consumed by the patients, lead the authors to suggest that the human infections resulted from oral contamination probably originating from naturally infected marsupials in the area or crushed infected bugs. Em outubro de 1986, 7 a 22 dias após uma reunião em uma fazenda no estado da Paraíba, 26 pessoas apresentaram doença febril, associada a edema bipalpebral bilateral, e de membros inferiores, hepatoesplenomegalia leve, linfadenopatia e, mais raramente, a um exantema. Um menino de 11 anos apresentou arritmia atrial ao eletroeardiograma e um paciente de 74 anos desenvolveu insuficiência cardíaca aguda. Em 2 pacientes hospitalizados em São Paulo, foi estabelecido o diagnóstico de Doença de Chagas aguda por observação de T. cruzi em creme leucocitário. Em autópsia de um caso fatal foi demonstrada cardiomiopatia chagásica aguda. O xenodiagnóstico foi positivo em 9 de 14 pacientes testados. Anticorpos específicos de classe IgG foram encontrados em todos os pacientes e da ...