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      Chagas disease in the 21st Century: a public health success or an emerging threat? Translated title: La maladie de Chagas au XXIe siècle : un succès de santé publique ou une menace émergente ?

      1 , *

      Parasite

      EDP Sciences

      Chagas disease, Trypanosoma cruzi, Neglected tropical disease

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          Abstract

          Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, is a major public health burden in Latin America and a potentially serious emerging threat to a number of countries throughout the world. Although public health programs have significantly reduced the prevalence of Chagas disease in Latin America in recent decades, the number of infections in the United States and non-endemic countries in Europe and the Western Pacific Region continues to rise. Moreover, there is still no vaccine or highly effective cure available for the approximately 10 million people currently infected with T. cruzi, a third of which will develop potentially fatal cardiomyopathy and/or severe digestive tract disorders. As Chagas disease becomes an increasingly globalized public health issue in the twenty-first century, continued attentiveness from governmental and health organizations as well as improved diagnostic tools, expanded surveillance and increased research funding will be required to maintain existing public health successes and stymie the spread of the disease to new areas and populations.

          Translated abstract

          La maladie de Chagas, causée par le protozoaire parasite Trypanosoma cruzi, est un problème de santé publique majeur en Amérique latine et une menace émergente potentiellement grave dans un certain nombre de pays à travers le monde. Bien que les programmes de santé publique aient considérablement réduit la prévalence de la maladie de Chagas en Amérique latine au cours des dernières décennies, le nombre d’infections aux États-Unis et les pays non-endémiques d’Europe et de la Région du Pacifique occidental continue d’augmenter. En outre, il n’existe encore aucun vaccin ou remède très efficace disponible pour les quelque 10 millions de personnes actuellement infectées par T. cruzi, dont un tiers va développer une cardiomyopathie potentiellement mortelle et / ou des troubles digestifs sévères. Comme la maladie de Chagas devient un problème de plus en plus globalisé de santé publique au XXIe siècle, une attention continue des organisations gouvernementales et de santé ainsi que des outils de diagnostic améliorés, une surveillance accrue et un financement accru de la recherche seront nécessaires pour maintenir les bons résultats actuels de santé publique et entraver la propagation de la maladie à de nouvelles régions et populations.

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          An estimate of the burden of Chagas disease in the United States.

          Chagas disease causes the highest burden of any parasitic disease in the Western hemisphere. By applying published seroprevalence figures to immigrant populations, we estimate that 300,167 individuals with Trypanosoma cruzi infection live in the United States, with 30,000-45,000 cardiomyopathy cases and 63-315 congenital infections annually. T. cruzi causes a substantial disease burden in the United States.
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            Chagas disease in Spain, the United States and other non-endemic countries.

            Due to recent trends in migration, there are millions of people from Chagas disease-endemic countries now living in North America, Europe, Australia and Japan, including thousands of people with Trypanosoma cruzi infection. Most infected individuals are not aware of their status. Congenital, transfusion- and/or transplant-associated transmission has been documented in the United States, Spain, Canada and Switzerland; most instances likely go undetected. High priorities include the implementation of appropriate screening, evaluation and clinical management, and better assessment of the true burden associated with this disease. 2009 Elsevier B.V. All rights reserved.
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              Oral transmission of Chagas disease.

              Chagas disease is now an active disease in the urban centers of countries of nonendemicity and endemicity because of congenital and blood and/or organ transplantation transmissions and the reactivation of the chronic disease in smaller scale than vectorial transmission, reported as controlled in countries of endemicity. Oral transmission of Chagas disease has emerged in unpredictable situations in the Amazon region and, more rarely, in areas of nonendemicity where the domiciliary triatomine cycle was under control because of exposition of the food to infected triatomine and contaminated secretions of reservoir hosts. Oral transmission of Chagas disease is considered when >1 acute case of febrile disease without other causes is linked to a suspected food and should be confirmed by the presence of the parasite after direct microscopic examination of the blood or other biological fluid sample from the patient.
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                Author and article information

                Journal
                Parasite
                Parasite
                parasite
                Parasite
                EDP Sciences
                1252-607X
                1776-1042
                2014
                10 March 2014
                : 21
                : ( publisher-idID: parasite/2014/01 )
                Affiliations
                [1 ] Department of Biological Sciences, Kingsborough Community College, City University of New York 2001 Oriental Boulevard Brooklyn, New York 11235-2398 USA
                Author notes
                [* ]Corresponding author: kevin.bonney@ 123456kbcc.cuny.edu
                Article
                parasite130096 10.1051/parasite/2014012
                10.1051/parasite/2014012
                3952655
                24626257
                © K.M. Bonney, published by EDP Sciences, 2014

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 0, Tables: 1, Equations: 0, References: 91, Pages: 10
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                Review Article

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