Chagas outbreak of possible oral transmission and occupational exposure, Maní — Casanare, 2019
DOI:
https://doi.org/10.33610/01229907.2020v2n2a3Keywords:
Chagas disease, Trypanosoma cruzI, Outbreak, Oral transmissionAbstract
Introduction: the department of Casanare is endemic for Chagas disease, where chronic cases predominate. In recent years acute cases have increased due to presumed oral transmission. In March 2019, the first outbreak was configured in the municipality of Maní - Casanare.
Objective: Describe the outbreak and determine the possible transmission route to establish prevention and control strategies.
Materials and methods: outbreak investigation through institutional and community search, laboratory tests, entomological and sanitary evaluation. A survey was designed in Epicollet 5 application and analyzed using Epi-Info 7.2.2™.
Results: 22 cases of acute Chagas were identified (18 confirmed by laboratory and 5 linked). Attack rate 55 % (22/40), 100 % received treatment. 95,5 % of cases occurred in men; the main symptoms were fever 100 %, dyspnea 72,7 % and chest pain 31,8 %. 72,7 % of the cases required hospitalization and one case required management in a third-level hospital due to acute cardiomyopathy. 81,8 % (18/22) belonged to the contributory health regime; 40,9 % (9/22) were the first beneficiary and 50,1 % by the outsourcing of services. 59,1% (13/22) of the cases had terminated their employment relationship before the outbreak was identified. The average incubation period was 17 days (3 - 21 days). Rhodnius prolixus, Eratyrus mucronatus and Panstrongylus geniculatus were found in the intra and peridomicile with a natural infection of 75 %. The outbreak of oral transmission and occupational exposure with zero lethality was confirmed.
Conclusion: an outbreak of Chagas disease was configured with possible oral transmission and occupational exposure due to the presumed ingestion of food contaminated with T. cruzi.
References
Molina I, Salvador F. Actualización en enfermedad de Chagas. Enferm Infecc Microbiol Clin [Internet]. 2016;34(2):132 –8. Disponible en: http://dx.doi.org/10.1016/j.eimc.2015.12.008
Caryn B. Chagas’ Disease. N Engl J Med [Internet]. 2015;373(3):456–66. Disponible en: https://www.ncbi.nlm.nih.gov/ pubmed/26222561
Andrade D V., Gollob KJ, Dutra WO. Acute Chagas Disease: New Global Challenges for an Old Neglected Disease. PLoS Negl Trop Dis. 2014;8(7):1–10.
World Health Organization. Chagas disease in Latin America: an epidemiological update based on 2010 estimates. Cha- gas Dis Lat Am an Epidemiol Updat based 2010 Estim = Mal Chagas en Amérique Lat le point épidémiologique basé sur les Estim 2010. 2015;90(6):33–43.
Zuleta-Dueñas LP, López-Quiroga ÁJ, Torres-Torres F, Castañeda-Porras O, Castañeda-Porras O. Posible transmisión oral de la enfermedad de Chagas en trabajadores del sector de los hidrocarburos en Casanare, Colombia, 2014. Biomédica [Internet]. 2017;37(2):218–32. Disponible en: http://www.revistabiomedica.org/index.php/biomedica/article/view/3153
Soto H, Tibaduiza T, Montilla M, Triana O, Suárez DC, Torres MT, et al. Investigación de vectores y reservorios en brote de Chagas agudo por posible transmisión oral en Aguachica, Cesar, Colombia. Cad Saude Publica. 2014;30(4):746–56.
Nicholls RS, Cucunubá Pérez ZM, Knudson A, Flórez AC, Montilla M, Puerta Bula CJ, et al. Enfermedad de Chagas aguda en Colombia, una entidad poco sospechada. Informe de 10 casos presentados en el periodo 2002 a 2005. Biomédica, Rev del Inst Nac Salud [Internet]. 2007;27(supl. 1):8–17. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/18154241
Ríos JF, Arboleda M, Montoya AN, Alarcón EP, Parra-Henao GJ. Probable brote de transmisión oral de enfermedad de Chagas en Turbo, Antioquia. Biomédica. 2014;31(2):185.
Hernández LM, Ramirez Cano AN, Cucunubá Pérez ZM, Zambrano P. Brote de Chagas Agudo en Lebrija, Santander 2008. Rev del Obs Salud Pública Santander [Internet]. 2009;1:28–36. Disponible en: http://www.observatorio.saludsantander.gov. co/index.php/publicaciones/revosps/ano-ivnumero-01-2009/5-05-brote-de-chagas-agudo-en-lebrija-santander-2008/file
Congreso de Colombia. Ley 1652 de 2012. 1994. p. 1–22.
República Colombiana. Decreto 1477 de 2014 [Internet]. 2014. Disponible en: http://www.mintrabajo.gov.co/documents/20147/36482/decreto_1477_del_5_de_agosto_de_2014.pdf/b526be63-28ee-8a0d-9014- 8b5d7b299500
Noya BA De, Díaz-bello Z, Colmenares C, Zavala-jaspe R. Transmisión urbana de la enfermedad de Chagas en Caracas , Venezuela : aspectos epidemiológicos, clínicos y de laboratorio. Medicina (B Aires). 2009;20(3):158–64.
Parra GJ, Florez M, Ángulo VM. Vigilancia de Triatominae (Hemiptera: Reduviridae) en Colombia. 2015.
Guhl F, Aguilera G, Pinto N, Vergara D. Actualización de la distribución geográfica y ecoepidemiología de la fauna de tria- tominos (Reduviidae : Triatominae) en Colombia. Biomédica. 2007;27:143–62.
Cordovez JM, Guhl F. The impact of landscape transformation on the reinfestation rates of Rhodnius prolixus in the Ori- noco Region, Colombia. Acta Trop [Internet]. 2015;151(1):73–9. Disponible en: http://dx.doi.org/10.1016/j.actatropi- ca.2015.07.030
[1] La definición de cada situación – fuente de afectación, tiene enfoque de gestión del riesgo.
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