America has a hidden health epidemic in its poorest cities. Chagas disease caused by a parasitic infection of Trypanosoma cruzi is most commonly spread through blood feeding triatomine bugs, pregnancy, blood transfusion and contaminated food and drink. Up to 30% of infections result in debilitating and life-threatening heart disease and severe intestinal and liver complications and Chagas disease kills many of those infected after they reach 40 years of age. Infection estimates suggest that 40,000 pregnant North American women may be infected with T. cruzi at any given time, resulting in 2,000 congenital cases through mother-to-child transmission.
“We have already identified critical steps to save lives and make breakthroughs in Chagas disease control in North America,” said Dr. Peter Hotez, the editorial’s lead author, director of the Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development and dean of the National School of Tropical Medicine at Baylor College of Medicine. “This is an achievable public health goal that will also reduce the disease’s detrimental economic burden. Greater medical awareness, scientific cooperation between key countries, and public-private partnerships will help us beat this scourge.”
Mexico ranks third and the United States seventh, in terms of the number of infections detected in the Western Hemisphere, where 99 % of the infections occur. Poverty stricken communities are most vulnerable due to poor-quality housing and inadequate access to health care, education and vector control.
“The research community is pushing science as hard as possible to ensure we get new treatments to people living with Chagas disease, but we need to ensure that governments prioritize the disease,” said Dr. Bernard Pecoul, a co-author of the editorial and Executive Director of the Drugs for Neglected Diseases initiative (DNDi). “It is urgent to diagnose and treat patients with what we have available today, until research and development efforts deliver true breakthroughs for the millions in need.” DNDi has produced a pediatric dosage form of benznidazole for children with Chagas disease, and is currently developing new drug candidates for a truly novel, safe, effective and affordable treatment for all patients.
An added dimension to Chagas is that the parasite invades its host embryo cells and spreads its mitochondrial DNA (kDNA) minicircles into the host’s genome.
A study at the University of Brasilia, Brazil, demonstrated that kDNA-mutated chickens undergo genotype alterations, developing an inflammatory heart condition similar to Chagas disease in humans.
Antonio R. L. Teixeira, Clever Gomes, Nadjar Nitz, Alessandro O. Sousa, Rozeneide M. Alves, Maria C. Guimaro, Ciro Cordeiro, Francisco M. Bernal, Ana C. Rosa, Jiri Hejnar, Eduardo Leonardecz, Mariana M. Hecht. Trypanosoma cruzi in the Chicken Model: Chagas-Like Heart Disease in the Absence of Parasitism. PLoS Neglected Tropical Diseases, 2011; 5 (3): e1000 DOI: 10.1371/journal.pntd.0001000
Peter J. Hotez, Eric Dumonteil, Miguel Betancourt Cravioto, Maria Elena Bottazzi, Roberto Tapia-Conyer, Sheba Meymandi, Unni Karunakara, Isabela Ribeiro, Rachel M. Cohen, Bernard Pecoul. An Unfolding Tragedy of Chagas Disease in North America. PLoS Neglected Tropical Diseases, 2013; 7 (10): e2300 DOI: 10.1371/journal.pntd.0002300