On an acute case of Chagas disease in a region under vector control in the state of São Paulo, Brazil Sobre caso de doença de Chagas aguda em região de vetores controlados no Estado de São Paulo, Brasil

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Dalva M.V. Wanderley, Vera L.C.C. Rodrigues, Ruth Moreira Leite, Sueli Yasumaro Diaz, Maria Esther de Carvalho, Soraya O. Santos, Érica Tatto, Maria Salete Carli, Kunie I.R. Coelho, Paulo Ribeiro da Silva, Sandra Aparecida Túlio, Isaias Ribeiro da Silva, Maria A. Shikanai-Yasuda
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2010
• Subjects: Acute Chagas disease; Clinical features; State of São Paulo; Brazil; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Aguda; Arctic
• Online Access: https://doi.org/10.1590/S0036-46652010000300007; https://doaj.org/article/d985b6064e2d43b6bbb0f706b41d9686

No vector transmitted cases of Chagas disease had been notified in the state of São Paulo since the 1970s. However, in March, 2006, the death of a six-year-old boy from the municipality of Itaporanga was notified to the Center for Epidemiological Survey of the São Paulo State Health Secretariat: an autochthonous case of acute Chagas disease. The postmortem histopathological examination performed in the Hospital das Clínicas of the Botucatu School of Medicine confirmed the diagnosis. Reference to hospital records, consultation with the health professionals involved in the case and interviews with members of the patient's family supplied the basis for this study. We investigated parasite route of transmission, probable local reservoirs and vectors. No further human cases of acute Chagas disease were diagnosed. No locally captured vectors or reservoirs were found infected with Trypanosoma cruzi. Alternative transmission hypotheses - such as the possible ingestion of foods contaminated with vector excreta - are discussed, as well as the need to keep previously endemic regions and infested houses under close surveillance. Clinicians should give due attention to such signs as uni- or bilateral palpebral edema, cardiac failure, myocarditis, pericarditis, anasarca and atypical signs of nephrotic syndrome or nephritis and consider the diagnostic hypothesis of Chagas disease. Desde a década de 1970 não se notificavam casos autóctones de doença de Chagas aguda em São Paulo. Em março de 2006 a Vigilância Epidemiológica registrou óbito por doença de Chagas aguda, em Itaporanga, de paciente de seis anos de idade. Exame histopatológico post mortem realizado no Hospital das Clínicas da Faculdade de Medicina de Botucatu confirmou o diagnóstico. Consultamos prontuários de hospitais e entrevistamos profissionais de saúde envolvidos além de familiares do paciente. Descrevemos medidas adotadas in loco para identificar a via de transmissão, reservatórios e vetores. Discutimos as possíveis fontes de infecção. Na região não foram ...