Abstract
Chagas disease, endemic in Latin America, is an emerging health problem in Europe affecting an estimated 80,000 persons. Around 60,000 Latin American migrants live in Switzerland, and cases of Chagas disease have been reported since 1979. As of June 2011, 258 cases have been diagnosed, mostly adults in the indeterminate phase of the chronic stage of the disease. Vertical transmission has been identified and there is a high potential for blood- and organ-borne transmission in the absence of systematic screening. Major challenges include (i) raising awareness among migrants and healthcare professionals, (ii) developing national protocols for screening and treatment targeting high-risk groups such as pregnant woman, newborns, migrants from highly endemic areas (e.g. Bolivia), and immunocompromised migrants, (iii) preventing blood- and organ-borne transmission by appropriate screening strategies, (iv) taking into account the social vulnerability of individuals at risk in the design and implementation of public health programmes, and (v) facilitating contacts with the communities at risk through outreach programmes, for example in churches and cultural groups.
Highlights
The parasite Trypanosoma cruzi, the causative agent of Chagas disease, has been affecting humans for at least 9,000 years, but Europe has experienced the emergence of this disease as a significant health issue only very recently [1,2]
In 2010, the World Health Organization (WHO) estimated that 80,000 persons could be infected in Europe, making Chagas disease one of the predominant emerging parasitic infections in the continent [2]
We used several sources of information to identify cases and their characteristics before aggregation: (i) the clinical databases of two studies done in Geneva in 2008: a community-based cross-sectional study in adult Latin American immigrants over the age of 16 years [10] and a prospective study in pregnant Latin American women attended at the Geneva University Hospitals [11], (ii) the database of all cases seen at the Geneva University Hospitals and (iii) information collected from the main laboratories performing diagnosis of T. cruzi infection, the major Swiss healthcare institutions and experts active in international health and infectious diseases in Switzerland
Summary
The parasite Trypanosoma cruzi, the causative agent of Chagas disease, has been affecting humans for at least 9,000 years, but Europe has experienced the emergence of this disease as a significant health issue only very recently [1,2]. T. cruzi is responsible for a chronic infection causing potentially lethal cardiac damages in up to 30% of cases. In the absence of T. cruzi vectorial transmission outside Latin America, Chagas disease in non-endemic countries is predominantly an imported infection, affecting migrants more than travellers [4]. In 2010, the World Health Organization (WHO) estimated that 80,000 persons could be infected in Europe, making Chagas disease one of the predominant emerging parasitic infections in the continent [2]
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