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Latino Illegals Spreading Chagas Disease In Canada

From Patricia Doyle


Published Date: 12-17- 17
Subject: PRO/EDR> Trypanosomiasis (Chagas disease) - Canada: congenital
Archive Number: 20171217.5509223

A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Sun 17 Dec 2017
Source: Canadian Medical Association Journal [edited]

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

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.

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.

Communicated by:

[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

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