Chagas disease in Italy: breaking an epidemiological silence

Martín Tálamo ,Marta Mascarello ,Pedro Albajar-Viñas ,Giorgio Zavarise ,Dora Buonfrate ,Stefania Marocco ,G Graziani,Mariarosaria Di Tommaso ,Andrea Angheben ,Mariella Anselmi ,Giovanni Gaiera ,Zeno Bisoffi ,Ezio Bonifacio ,G Veneruso,Filippo Bartalesi ,Alessandro Bartoloni ,K H Aiello,Federico Gobbi ,Massimiliano Lanzafame ,Gabriella Cancrini ,Stefano Tais ,Marianne Strohmeyer ,Antonia Mantella ,I Spreafico,Marlon Ferrari ,Geraldo Badona Monteiro

doi:10.2807/ese.16.37.19969-en

Abstract

Chagas disease, a neglected tropical disease that due to population movements is no longer limited to Latin America, threatens a wide spectrum of people(travellers, migrants, blood or organ recipients,newborns, adoptees) also in non-endemic countries where it is generally underdiagnosed. In Italy, the available epidemiological data about Chagas disease have been very limited up to now, although the country is second in Europe only to Spain in the number of residents from Latin American. Among 867 at-risk subjectsscreened between 1998 and 2010, the Centre for Tropical Diseases in Negrar (Verona) and the Infectious and Tropical Diseases Unit, University of Florence found 4.2% patients with positive serology for Chagas disease (83.4% of them migrants, 13.8% adoptees).No cases of Chagas disease were identified in blood donors or HIV-positive patients of Latin American origin. Among 214 Latin American pregnant women,three were infected (resulting in abortion in one case).In 2005 a case of acute Chagas disease was recorded in an Italian traveller. Based on our observations, we believe that a wider assessment of the epidemiological situation is urgently required in our country and public health measures preventing transmission and improving access to diagnosis and treatment should be implemented.

Highlights

Chagas disease is a protozoan zoonosis caused by Trypanosoma cruzi, with a widespread distribution from the south of the United States to Mexico and Central and South America
Prevalence estimation of Trypanosoma cruzi infection and Chagas disease in Latin American migrants living in Italy
The expected number of T. cruzi-infected Latin American migrants living in Italy was calculated using the estimated total number of migrants from endemic countries and the average T. cruzi infection rate in the country of birth according to either Schmunis et al [2] or the Panamerican Health Organization (PAHO) [6]

Summary

Introduction

Chagas disease is a protozoan zoonosis caused by Trypanosoma cruzi, with a widespread distribution from the south of the United States to Mexico and Central and South America. In endemic countries it is responsible for the highest estimated burden of neglected tropical diseases, affecting 8 to 10 million people [1]. Has a large number of Latin American resident migrants, second in Europe only to Spain, as a result of various migratory waves to Argentina, Brazil, Chile, Uruguay and Venezuela through the last 200 years, until the direction of migration reversed in the 1970s [3]. For instance most Bolivians live in Bergamo Province, Lombardy, Ecuadorians in Liguria Region and Peruvians in big cities such as Milan, Florence and Rome [4]

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