Acute Chagas disease in the state of Pará, Amazon Region: is it increasing?

Acute Chagas disease (ACD) has a distinct epidemiological profile in the Amazon Region, with cases and outbreaks of Trypanosoma cruzi infection being possibly related to the ingestion of contaminated food. Data on ACD in the state of Pará retrieved from 2000 to 2016 from the Brazilian Notifiable Diseases Information System (SINAN) were evaluated. During this period, 2,030 of the 16,807 reported cases were confirmed, with a higher incidence between the months of August and December, thus characterising a seasonal pattern of acute infection, and coinciding with the higher production of “açaí”, one fruit likely involved in the oral transmission of the disease. Evaluation of the absolute numbers of confirmed ACD cases secondary to oral infection suggests that infection through this route increased during the 2010-2016 period, differing from what was recorded in terms of vectorial or other infection routes. These findings point to the need of intensifying strategies to prevent or substantially reduce oral transmission.

急性恰加斯病（Acute Chagas disease, ACD）在亚马逊地区具有独特的流行病学特征，其病例及克氏锥虫（Trypanosoma cruzi）感染暴发事件可能与受污染食物的食入行为相关。本研究对2000年至2016年间从巴西法定传染病信息系统（Brazilian Notifiable Diseases Information System, SINAN）调取的帕拉州急性恰加斯病相关数据展开评估。在此研究周期内，16807例报告病例中共有2030例得到确诊，8月至12月的发病率更高，呈现出急性感染的季节性流行模式，且该时段与阿萨伊果（açaí）的高产期相重合——该水果被认为可能参与了本病的经口传播。对经口感染继发的确诊急性恰加斯病病例绝对数的评估显示，2010至2016年期间，经此传播途径的感染病例数呈上升趋势，这与经媒介传播或其他传播途径的既往记录情况存在差异。上述研究结果提示，亟需强化相关防控策略以预防或大幅减少本病的经口传播。