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Oral Transmission of Trypanosoma cruzi, Brazilian Amazon

Rosa Amélia G Santana et al. Emerg Infect Dis. 2019 Jan.

Abstract

In the Brazilian Amazon, the suspected source of infection in an outbreak of acute Chagas disease involving 10 patients was Euterpe oleracea (açaí berry) juice. Patient blood and juice samples contained Trypanosoma cruzi TcIV, indicating oral transmission of the Chagas disease agent.

Keywords: Brazil; Brazilian Amazon; Chagas disease; Euterpe oleracea; Triatominae; Trypanosoma cruzi; açaí juice; disease outbreak; food safety; oral transmission; parasites.

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Figures

Figure 1
Figure 1
Zçaí berry juice sample from Brazilian Amazon. A) A 50 mL-tube after centrifugation shows 3 layers: 1, pulp, 2, intermediate fat (box); and 3: supernatant. B) Top view of layer 2 (arrow). C) Fresh preparation of layer 2 showing Trypanosoma cruzi flagellated form (arrow).
Figure 2
Figure 2
Comparison of Trypanosoma cruzi açaí juice samples and Chagas disease patient blood samples, Brazilian Amazon. A) Alignment of GPI sequences from açaí juice samples and patient blood samples. B–C) Phylogenetic position of T. cruzi responsible for the 2017 Chagas disease outbreak in the Brazilian Amazon, based on the cytochrome oxidase subunit II gene sequences (best-fit model: Hasegawa-Kishino-Yano) and on the GPI gene sequences (best-fit model: Kimura 2-parameter). The following standard strains obtained from GenBank (discrete typing units [strain name, access no. for COII–GPY]) were used: TcI (SilvioX10 cl4, EU302222.1–Silvio10cl1–AY540730.1), TcII (Esmeraldo cl3, AF359035.1–AY540728.1), TcIII (M6241 cl6, AF359032.1– AY484478.1), TcIV (CANIII cl1–AF359030.1), TcV (Mn cl2, DQ343718.1–AY484480.1), and TcVI (CL Brener, DQ343645.1–XM_815802.1). B, blood; C, culture; GPI, glucose-phosphate isomerase; P0, patient number; X, xenodiagnosis; (i) repetition number. Scale bars indicate number of mutations per site.
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