Probable outbreak of oral transmission of Chagas disease in Turbo, Antioquia

Introduction. Chagas' disease is endemic in 21 countries of South and Central America, including Colombia, where 700,000 to 1.2 million persons are infected and eight millions are at risk. In endemic areas, chronic cases are predominant. However, in recent years, increasing reports of acute oral transmission have appeared. Objective. An outbreak of acute Chagas' disease was verified in the municipality of Turbo (Antioquia), and the most probable cause of transmission was determined in order to establish prevention and control measures. Materials and methods. A descriptive study was done. A search for information from local health authorities was conducted to uncover all case reports. Laboratory tests, risk factor analysis and search for vectors and reservoirs were undertaken in Turbo. Results. Of the 156 people evaluated, 11 cases of acute Chagas' disease were identified. Ten had significant titers of IgM and IgG antibodies against the Trypanosoma cruzi parasite by IFAT and Elisa tests; one fatal case was linked epidemiologically. In 3 cases, PCR was positive for T. cruzi, two of which displayed Chagas cardiomyopathy, and one with acute fever. Four cases required specialized health care for acute cardiomyopathy. All positive cases had a common source of food. One specimen of the triatomid vector species, Panstrongylus geniculatus, and one reservoir, the woolly opossum Caluromys lanatus, were collected; both were negative to T. cruzi. Conclusions. An outbreak of acute Chagas' disease occurred in Turbo, Antioquia. The mode of transmission may have occurred by the ingestion of T. cruzi-contaminated food by infected triatomines or opossum feces.