Current Public Health Concerns

Abstract

American trypanosomiasis, or Chagas disease, is caused by the protozoan parasite, Trypanosoma cruzi. Sixteen to eighteen million people in Mexico, Central America, and South America are infected with this organism, and 45,000 deaths are attributed to the disease each year. Infection with T. cruzi is life-long, and 10-30 % of persons who harbor the parasite chronically develop cardiac and gastrointestinal problems associated with the parasitosis. Although major progress has been made in recent years in reducing vector-borne and transfusion-associated transmission of T. cruzi, the burden of disability and death in persons chronically infected with the organism continues to be enormous. Congenital Chagas disease also is a public health concern, as 5–10 % of infants born to T. cruzi-infected women are in turn infected, and no medications are available for preventing congenital transmission. T. cruzi can also be transmitted by transplantation of organs harvested from persons with Chagas disease. Eight to ten million persons born in countries in which Chagas disease is endemic currently reside in the United States, and epidemiologic and census data suggest that 50,000–100,000 are chronically infected with T. cruzi. The presence of these infected persons poses a risk of transmission of the parasite here through blood transfusion and organ transplantation, and seven such cases are known to have occurred.