MMWR Morb Mortal Wkly Rep. 2012 Jul 6;61(26):477-9.
Chagas disease, caused by infection with the parasite Trypanosoma cruzi, affects 8-11 million persons globally. In the endemic areas of Mexico, Central America, and South America, most infections are transmitted by triatomine insect (kissing bug) vectors. However, infection also can be acquired congenitally or through blood transfusion, organ transplantation, consumption of triatomine-contaminated food or drink, or laboratory accident. Early detection and treatment are highly effective; however, acute infection often is subclinical, and most persons are unaware of their infection. If left untreated, the infection is lifelong. The majority of persons with chronic infection remain without signs or symptoms, but 20%-30% eventually develop disease manifestations, most commonly, cardiomyopathy. Migration from endemic areas has led to an estimated 300,000 persons in the United States with chronic Chagas disease, including women of reproductive age who risk transmitting the infection to their children. This report describes the first case of congenital Chagas disease in the United States confirmed by CDC and highlights the importance of raising awareness of Chagas disease among health-care providers.
恰加斯病由寄生虫克氏锥虫感染引起,影响全球 800 万至 1100 万人。在墨西哥、中美洲和南美洲的流行地区,大多数感染是由三锥虫(接吻虫)媒介传播的。然而,感染也可通过母婴垂直传播、输血、器官移植、食用受三锥虫污染的食物或饮料、或实验室事故获得。早期发现和治疗非常有效;然而,急性感染通常是无症状的,大多数人并不知道自己被感染了。如果不治疗,感染将终身存在。大多数慢性感染的人没有症状或体征,但 20%-30%的人最终会出现疾病表现,最常见的是心肌病。从流行地区移民导致美国约有 30 万人患有慢性恰加斯病,其中包括育龄妇女,她们有将感染传染给子女的风险。本报告描述了美国首例经疾控中心确认的先天性恰加斯病病例,并强调了提高卫生保健提供者对恰加斯病认识的重要性。