Chagas disease is also known as Chagas disease, which can be life-threatening infection caused by T. cruzi chronic cardiomyopathy and giant esophagus or Hirschsprung disease, severe cases can be sudden death. The past, mainly in South America, now the United States, Canada and Europe and the Western Pacific countries more and more to find in this case. Disease, mainly through blood transfusion, organ donation, as well as vertical transmission mother to child infection, food contamination is one of the routes of transmission.The most effective way to prevent Chagas disease vector control. If the acute stage of infection, the start of treatment, the disease is completely curable, but the effect is weakened with the prolongation of the time of patients infected, therefore, should treat the infection as soon as possible.
Chagas disease - IntroductionChagas disease Chagas disease is caused by T. cruzi infection chronic cardiomyopathy and giant esophagus or Hirschsprung disease.Chagas disease was discovered in 1909 by a Brazilian doctor Chagas, also known as Chagas disease. It is the parasite Trypanosoma cruzi caused a life-threatening diseases. Was limited to South America, Chagas disease has spread to other parts of the world, currently estimated 1000 million people are infected, but at high risk of more than 2500 people. If the acute stage of infection, the start of treatment, the disease is completely curable, but the effect is weakened with the prolongation of the time of patients infected, therefore, should treat the infection as soon as possible.Chagas disease - Signs and symptomsChagas disease in two phases:The initial acute phase lasted about two months after infection. In the acute stage, a large number of parasites with the blood circulation. Most cases of asymptomatic or symptoms are mild, but may include fever, headache, swollen lymph nodes, pale, muscle pain, difficulty breathing, swelling of the abdomen or chest pain. Typical signs of triatomine bug bites less than 50% of those who, first of all visible lesions or side of the eyelid bruising swelling.In the chronic phase, parasites hidden in the muscle of the heart and digestive tract. Up to 30% of patients with cardiac disorders, up to 10% of the digestive tract (typically the esophagus or colon to expand), neurological or mixed lesions. In the next few years, the infection can lead to sudden death or myocardial damage caused by heart failure.
Chagas disease - diagnosis
Peripheral blood of the acute phase of Trypanosoma high number of thin blood films or thick blood film examination can easily be found. The number of misprision of blood or chronic phase of Trypanosoma rarely required in organs such as blood or lymph node aspirates were cultured to confirm the diagnosis. Other diagnostic methods, there are a host inoculation diagnosis (laboratory-reared triatomine bites suspicious patients, to check the contents of the rectum of triatomine; or suspicious patient's blood injected into experimental animals) or by PCR amplification to detect blood or organization of trypanosome DNA in solution. Serological tests can produce false positive results in visceral leishmaniasis or mucocutaneous leishmaniasis patients.
Route of transmission of Chagas disease:
Infected feces spread mainly by blood-sucking triatomine bugs. These bugs generally live in poor conditions of rural or suburban buildings housing gap. They are usually hidden in the daytime, night out activities, taking a person's blood. They are usually bites the face and other skin exposure, and bug bites near defecation. When people out of bug feces can wipe the bite, eyes, mouth or any skin breakage when the parasite enters the human body.
Chagas disease can also spread through the following means:
1: T. cruzi contaminated food, such as by contact with the feces of triatomine bugs;
2: Use of blood for a blood transfusion of infected blood donors;
3: During pregnancy or childbirth, spread by infected mothers to newborns;
4: infection of donor organs for organ transplants;
5: lab accidents.
Chagas disease - the control and prevention measures
Chagas disease is no vaccine for trypanosomiasis. The most effective way to prevent the disease in South America is the vector control. Prevention of disease through blood transfusion and organ transplantation, the need for blood screening.
Initially (> 9000 years ago), T. cruzi and affects only the wild animals. The disease later spread to domestic animals and humans. The number of T. cruzi in South America's wild animal hosts, which means not eradicate the parasite. Therefore, the control objective is to eliminate the spread and providing health care for the infected and sick people.
T. cruzi can infect certain types of triatomine bugs, most of them found in the Americas. By geographic region, WHO recommends to take the following preventive and control measures:
1: the spraying of insecticides on the housing and the surrounding area;
2: Improved housing prevent vector disaster;
3: Individual preventive measures such as mosquito nets;
4: food preparation, transportation, storage and consumption of good health measures; food contamination can also lead to disease spread, therefore, the most effective prevention and control measures for disease vector control, such as spraying of insecticides in their houses. strengthen the health measures in food preparation, transport and storage.
5: The screening of blood donors;
6: Detection of organ, tissue or cell donors and recipients;
7: the screening of newborns of infected mothers and siblings of infected children in order to provide early diagnosis and treatment.
Chagas disease - the World Health Organization's response
Since the 1990s, Latin America, Southern Cone regions, Central America, Andean Pact and the Pan American Health Organization Amazon basin inter-governmental action has achieved important success in parasites and disease vector control. These multinational operations led to significantly reduce the spread of the domestic vector. In addition, throughout Latin America, significantly reduces the risk of transmission through blood transfusion. Was able to achieve these advances because of the epidemic the firm commitment of the Member States, the strength of its research and control institutions, as well as many international partners.
At the same time, we need to face a series of additional challenges:
1: to have the persistence to maintain and consolidate control of progress;
2: The original idea was that the disease-free areas - such as the Amazon basin, there Chagas disease;
3: In the control has been progress in the region - for example, in Argentina and Bolivia, the Chaco region, the re-emergence of the disease;
4: mainly due to an increasing number of population movements between Latin America and the rest of the world caused by the spread of the disease;
5: the millions of infected patients to diagnosis and treatment.
In order to achieve the elimination of Chagas disease transmission and disease endemic and non endemic countries with HIV / patients with the goal of health care, WHO has sought increased interconnection and cooperation at the global level and to strengthen regional and national capacities, with emphasis on:
1: to strengthen the epidemiological surveillance and information systems;
2: prevention of diseases through blood transfusions and organ transplants spread of disease endemic and non endemic countries;
3: Promote recognition diagnostic test method for screening and diagnosis of infections;
4: expansion of the secondary prevention of congenital transmission and congenital and non congenital infection case management;
5: To promote and to reach a consensus on adequate case management.
