Trypanosoma cruzi: Time for international recognition as a foodborne parasite.

Chagas disease is one of the “neglected tropical diseases” (NTDs) listed by the World Health Organization (WHO). Depending on the study, the global prevalence has been estimated to be between 9 and 10 million people, with a disease burden from 300,000 to over 800,000 disability adjusted life years (DALYs). At least 10,000 people die from Chagas disease annually. Chagas disease accounts for over 11% of heart failure in Brazil, and over 7% of deaths due to heart failure during 2006 were due to Chagas disease. The global costs of Chagas disease have been estimated at US$7.19 billion per year.

Transmission of Trypanosoma cruzi, the protozoan etiological agent of Chagas disease, was traditionally considered almost exclusively vectorborne, transmitted by bugs (Hemiptera) in the family Reduviidae, sub-family Triatominae. However, other transmission routes exist, including intrauterine, by blood transfusions and organ transplantation, laboratory accidents, and foodborne transmission. In foodborne infections, food is, or more commonly, drinks are, contaminated with metacyclic trypomastigotes, which are then ingested by susceptible humans. These contaminant metacyclic trypomastigotes may be derived from either the feces of triatomines or from the whole insect. This indicates that although such transmission is not classical vector-borne transmission, the vector is still essential in this foodborne modality.