Analysis of an acute Chagas disease outbreak in the Brazilian Amazon: human cases, triatomines, reservoir mammals and parasites

被引：107

作者：

da Silva Valente, Sebastiao Aldo ^{[1
]}

Valente, Vera da Costa ^{[1
]}

das Neves Pinto, Ana Yece ^{[1
]}

Barbosa Cesar, Maria de Jesus ^{[2
]}

dos Santosb, Marivaldo Picanco ^{[2
]}

Sa Miranda, Clovis Omar ^{[2
]}

Cuervo, Patricia ^{[3
]}

Fernandes, Octavio ^{[3
]}

机构：

[1] SVS Inst Evandro Chagas, Belem, Para, Brazil

[2] Secretaria Saude Estado Amapa, Macapa, AP, Brazil

[3] Inst Oswaldo Cruz, BR-20001 Rio De Janeiro, Brazil

来源：

TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE | 2009年 / 103卷 / 03期

关键词：

Chagas disease; Trypanosoma cruzi; Outbreak; Oral transmission; Amazon; Brazil; TRYPANOSOMA-CRUZI; AMERICAN TRYPANOSOMIASIS; TRANSMISSION; VECTORS; RANGELI; SPACER; STATE;

D O I：

10.1016/j.trstmh.2008.10.047

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

An outbreak of Chagas disease occurred in Mazagao, Amapa, Brazilian Amazon in 1996. Seventeen of 26 inhabitants presented symptoms compatible with acute Chagas disease and were submitted to parasitological and serological tests. All 17 were positive in at least one parasitological test and 11 were also IgM or IgG anti-Trypanosoma cruzi positive. The nine asymptomatic patients were negative for parasites and one was positive for IgG anti-T. cruzi. Sixty-eight triatomines were captured (66 Rhodnius pictipes; two Panstrongylus geniculatus); 45 were infected with T cruzi (43 R. pictipes; two P geniculatus). Thirteen trypanosomatid strains were isolated: eight from humans and five from R. pictipes. Four were genotyped as T cruzi I (two from humans; two from R. pictipes), seven as T cruzi Z3 (six from humans; one from R. pictipes) and two as T cruzi Z3 and T rangeli (from R. pictipes). Treatment started for all patients leading to a decrease in parasitaemia in 16 during the follow-up period (6 months, 1, 5 and 7 years). All were serologically negative 7 years post-treatment. There was an overlap of genotypes in the same ecotope, raising the possibility of transmission through the oral route and the need for early therapeutic intervention for better patient management in the Brazilian Amazon. (C) 2008 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

引用

页码：291 / 297

页数：7

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