Académie royale de Médecine de Belgique

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Résumé de Emmanuel Bottieau (IMT Anvers), invité et Yves Carlier (ULB), membre titulaire

CHAGAS DISEASE, A NEGLECTED DISEASE ALSO IN EUROPE

par Emmanuel BOTTIEAU (Institut de Médecine tropicale, Anvers), invité, et le Pr Yves CARLIER (ULB), membre titulaire.                

American trypanosomiasis, also called Chagas disease from the name of the Brazilian doctor who discovered the pathogen in 1907, is an infection caused by the protozoa Trypanosoma cruzi with acute and chronic manifestations. This disease is endemic in Latin America from Mexico to Argentina, where transmission is mainly vector-borne (via bugs called triatomes). Other routes of transmission in the endemic areas may occur via oral contamination, blood transfusion, organ transplantation and vertical (mother-to-child) infection. Thank to major control efforts since 30 years, the number of cases has decreased to about 5 million nowadays (against > 15 million in 1980).

If undiagnosed and left untreated, Chagas disease may cause an acute systemic illness (rather infrequent), but also severe chronic cardiac and digestive complications in up to 30% of the infected individuals, sometimes after decades of asymptomatic latency.

Europe, like other non-endemic areas, has been increasingly confronted with the disease, following the waves of Latin American immigration. It is estimated that about 100,000 T. cruzi-infected Latin American migrants currently live in Europe (about 300,000 in USA). Only a very tiny minority comes to medical attention, because a large part of this immigration is undocumented, and up to 95% of individuals are unaware of their infection.

In this presentation, the current epidemiological situation of Chagas disease in Europe will be reviewed. In addition, we will elaborate on the efforts undertaken in several countries (including Belgium) to increase awareness in the medical and migrant communities as well as the interventions aimed at improving case detection and management in the at-risk population.