Chagas Disease and Breast-feeding

Francesca F Norman,Rogelio López-Vélez

doi:10.3201/eid1910.130203

Abstract

Chagas disease (infection by the protozoan Trypanosoma cruzi) is a major parasitic disease of the Americas and one of the main neglected tropical diseases. Although various routes of transmission sre recognized, the risk for transmission of the infection through breast-feeding has not clearly been established. We reviewed the literature on transmission of T. cruzi through breast-feeding to provide breast-feeding mothers with Chagas disease with medical guidance. Although data from animal studies and human studies are scarce, we do not recommend that mothers with Chagas disease discontinue breast-feeding, unless they are experiencing the acute phase of the disease, reactivated disease resulting from immunosuppression, or bleeding nipples. In these cases, thermal treatment of milk before feeding the infant may be considered.

Highlights

Chagas disease is a major parasitic disease of the Americas and one of the main neglected tropical diseases
The increase in mobile populations has led to the emergence of Chagas disease in non–disease-endemic areas where vectors are noncompetent and where the infection may be transmitted by other routes
The risk for congenital transmission from an infected mother may range from 0.13% to 17%, and the likelihood of congenital infection appears to correlate with maternal parasite density [2,3]

Summary

Introduction

Chagas disease (infection by the protozoan Trypanosoma cruzi) is a major parasitic disease of the Americas and one of the main neglected tropical diseases. Data from animal studies and human studies are scarce, we do not recommend that mothers with Chagas disease discontinue breast-feeding, unless they are experiencing the acute phase of the disease, reactivated disease resulting from immunosuppression, or bleeding nipples. In these cases, thermal treatment of milk before feeding the infant may be considered. Some early publications identify breast-feeding as a possible route for T. cruzi infection, such data are scarce, and few animal studies exist [5,6,7,8]. In 1972, Miles examined the milk of mice in the acute phase of the disease and detected T. cruzi trypomastigotes

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Conclusion