Limits...
Historical Perspectives on the Epidemiology of Human Chagas Disease in Texas and Recommendations for Enhanced Understanding of Clinical Chagas Disease in the Southern United States.

Garcia MN, Woc-Colburn L, Aguilar D, Hotez PJ, Murray KO - PLoS Negl Trop Dis (2015)

Bottom Line: Human reports of triatomine bites and disease exposure were found to be prevalent in Texas.Both imported cases and autochthonous transmission contribute to the historical disease burden in Texas.We end by discussing the current knowledge gaps, and recommend priorities for advancing further epidemiologic studies and their policy implications.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, United States of America.

ABSTRACT
Chagas disease (Trypanosoma cruzi infection) has recently been identified as an important neglected tropical disease in the United States. Anecdotally referred to as a "silent killer," it leads to the development of potentially fatal cardiac disease in approximately 30% of those infected. In an attempt to better understand the potential of Chagas disease as a significant underlying cause of morbidity in Texas, we performed a historical literature review to assess disease burden. Human reports of triatomine bites and disease exposure were found to be prevalent in Texas. Despite current beliefs that Chagas disease is a recently emerging disease, we report historical references dating as far back as 1935. Both imported cases and autochthonous transmission contribute to the historical disease burden in Texas. We end by discussing the current knowledge gaps, and recommend priorities for advancing further epidemiologic studies and their policy implications.

No MeSH data available.


Related in: MedlinePlus

Texas counties of confirmed and/or suspected Chagas infection: publications from 1935–2015.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4634991&req=5

pntd.0003981.g001: Texas counties of confirmed and/or suspected Chagas infection: publications from 1935–2015.

Mentions: T. cruzi exposure from infected vectors to Texas residents dates back to 1935. The scientific literature supports the probability of frequent autochthonous infection in humans, as evidenced by compounding studies demonstrating established transmission cycles that have been occurring for more than half a century (Fig 1) (Table 1). It is imperative that we continue to identify which populations are at highest risk for infection. Texas is just one of 23 states with T. cruzi-infected vectors [2]. Multiple publications have highlighted the southern US as an area where autochthonous infection occurs, especially due to the high proportion of impoverished residents living in substandard housing infested by triatomines [2, 7, 51–57]. Large-scale screening of these states’ long-time residents would help elucidate the underlying disease burden attributable to T. cruzi infection. While it is necessary to understand prevalence of infection, it is also important to identify incident cases of infection. Our current limitation of antibody-based diagnostic screening prohibits us from identifying new incident cases. Repeat screening of blood donors and other high-risk populations would help to distinguish the rate at which transmission to humans is occurring on an annual basis.


Historical Perspectives on the Epidemiology of Human Chagas Disease in Texas and Recommendations for Enhanced Understanding of Clinical Chagas Disease in the Southern United States.

Garcia MN, Woc-Colburn L, Aguilar D, Hotez PJ, Murray KO - PLoS Negl Trop Dis (2015)

Texas counties of confirmed and/or suspected Chagas infection: publications from 1935–2015.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4634991&req=5

pntd.0003981.g001: Texas counties of confirmed and/or suspected Chagas infection: publications from 1935–2015.
Mentions: T. cruzi exposure from infected vectors to Texas residents dates back to 1935. The scientific literature supports the probability of frequent autochthonous infection in humans, as evidenced by compounding studies demonstrating established transmission cycles that have been occurring for more than half a century (Fig 1) (Table 1). It is imperative that we continue to identify which populations are at highest risk for infection. Texas is just one of 23 states with T. cruzi-infected vectors [2]. Multiple publications have highlighted the southern US as an area where autochthonous infection occurs, especially due to the high proportion of impoverished residents living in substandard housing infested by triatomines [2, 7, 51–57]. Large-scale screening of these states’ long-time residents would help elucidate the underlying disease burden attributable to T. cruzi infection. While it is necessary to understand prevalence of infection, it is also important to identify incident cases of infection. Our current limitation of antibody-based diagnostic screening prohibits us from identifying new incident cases. Repeat screening of blood donors and other high-risk populations would help to distinguish the rate at which transmission to humans is occurring on an annual basis.

Bottom Line: Human reports of triatomine bites and disease exposure were found to be prevalent in Texas.Both imported cases and autochthonous transmission contribute to the historical disease burden in Texas.We end by discussing the current knowledge gaps, and recommend priorities for advancing further epidemiologic studies and their policy implications.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, National School of Tropical Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, United States of America.

ABSTRACT
Chagas disease (Trypanosoma cruzi infection) has recently been identified as an important neglected tropical disease in the United States. Anecdotally referred to as a "silent killer," it leads to the development of potentially fatal cardiac disease in approximately 30% of those infected. In an attempt to better understand the potential of Chagas disease as a significant underlying cause of morbidity in Texas, we performed a historical literature review to assess disease burden. Human reports of triatomine bites and disease exposure were found to be prevalent in Texas. Despite current beliefs that Chagas disease is a recently emerging disease, we report historical references dating as far back as 1935. Both imported cases and autochthonous transmission contribute to the historical disease burden in Texas. We end by discussing the current knowledge gaps, and recommend priorities for advancing further epidemiologic studies and their policy implications.

No MeSH data available.


Related in: MedlinePlus