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Published Date: 12-17-
17
Subject: PRO/EDR> Trypanosomiasis (Chagas disease) - Canada:
congenital
Archive Number: 20171217.5509223
TRYPANOSOMIASIS (CHAGAS DISEASE) - CANADA: CONGENITAL
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Sun 17 Dec 2017
Source: Canadian Medical Association Journal [edited]
http://www.cmaj.ca/content/189/48/E1489.long
Plourde PJ, Kadkhoda K Ndao M. Congenitally transmitted Chagas
disease in Canada: a family cluster. CMAJ 2017 December
4;189:E1489-92. doi: 10.1503/cmaj.170648
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Highlights
Congenitally acquired Chagas disease has rarely been reported in
Canada (1,2). Although it is difficult to confirm, we hypothesized
that these 3 adults with polymerase chain reaction-positive,
indeterminate Chagas disease acquired their infection congenitally,
as they were born in Canada, spent small periods of time in an
endemic area (fewer than 3 months cumulatively) and were born to a
mother who was parasitemic and never treated for Chagas disease.
Since Canadian Blood Services and Héma-Québec began screening for
Chagas disease less than a decade ago, an increasing number of
people with newly diagnosed Chagas disease have been identified
(1,2). Given the substantial numbers of Latin American immigrants
from endemic countries, there are likely thousands of undiagnosed,
chronically infected persons with Chagas disease in Canada (3), with
only a small minority discovered via blood donation. With large
numbers of undiagnosed, foreign born Canadians and the risk of
congenital transmission through multiple generations, a high index
of suspicion is needed for screening of Chagas disease in
asymptomatic immigrants from Chagas disease-endemic countries,
including screening offspring born of women who have received a
diagnosis of Chagas disease.
References
1. Fearon MA, Scalia V, Huang M, et al. A case of vertical
transmission of Chagas disease contracted via blood transfusion in
Canada. Can J Infect Dis Med Microbiol 2013;24:32-4.
2. Mongeau-Martin G, Ndao M, Libman M, et al. A family cluster of
Chagas disease detected through selective screening of blood: a case
report and brief review. Can J Infect Dis Med Microbiol
2015;26:157-61.
3. Schmunis GA, Yadon ZE. Chagas disease: A Latin American health
problem becoming a world health problem. Acta Trop 2010;115:14-21.
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Communicated by:
ProMED-mail
<promed@promedmail.org>
[ProMED received a comment from the 1st author Dr Pierr J. Plourde:
"The key message is that persons who have immigrated to Canada from
endemic Central and South American countries should be screened for
Chagas disease to make sure that they are not infected, especially
women of childbearing age before they get pregnant, to prevent
congenital transmission in Canada.
Based on immigration patterns to Canada from Central/South America
since 2006 and seroprevalence of Chagas disease per country, there
are an estimated 6000-10 000 persons in Canada with undiagnosed
Chagas disease."
ProMED thanks Dr Plourde for his comment highlighting the key
messages in the study. - Mod.EP
HealthMap/ProMED-mail map:
Canada: http://healthmap.org/promed/p/12]
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