Zuleta-Dueñas Liliana Patricia, López-Quiroga Ángela Johana, Torres-Torres Fernando, Castañeda-Porras Oneida
Grupo de Vigilancia en Salud Pública, Secretaría de Salud de Casanare, Yopal, Colombia.
Biomedica. 2017 Jun 1;37(2):218-232. doi: 10.7705/biomedica.v37i3.3153.
Trypanosoma cruzi, the etiological agent for Chagas disease, can be transmitted by oral intake of contaminated food or drinks. During epidemiological week 14 of 2014, two cases of acute Chagas disease were notified among hydrocarbons sector workers in Paz de Ariporo, Casanare.
To characterize the affected population, to establish control and prevention measures and to confirm the outbreak.
We conducted an outbreak investigation that included the following components: a) Search for symptomatic people compatible with Chagas disease according to the case definition for their referral to medical services; b) entomological survey (192/197 houses); c) sanitary inspection and microbiological analysis of food samples; and d) study of reservoirs. Data management and analysis were done with Epi-Info 7.1.5 using descriptive statistics. We also calculated intradomicile and peridomicile triatomine infestation indexes.
We detected 552 exposed people; 40 had the disease (7.2%), of whom seven were women (17,5%) and 33, men (82.5%), i.e., a male-female ratio of 5:1. The mean age was 39.1 ± 10.8 years; the attack rate was 7.2% and lethality, 5% (2/40). Symptoms included fever (100% of cases), headache (80%), myalgia and arthralgia (65%), facial edema (55%), and abdominal pain (37.5%). The mean incubation time was 17 days (range: 3-21). Rhodnius prolixus domiciliary infestation index was 3.3 % and 2.2% in the peridomicile. In the five restaurants inspected sanitary conditions were deficient and food samples were microbiologically non-conforming. We found a dog and two opossums positive for IgG antibodies by ELISA.
Environmental, sanitary and epidemiological conditions at the place confirmed an outbreak of Chagas diseases related to occupational exposure, possibly by oral transmission, which may be the largest to date in Colombia.
克氏锥虫是恰加斯病的病原体，可通过摄入受污染的食物或饮料传播。在2014年第14个流行病学周期间，卡萨纳雷省帕兹德阿里波罗的碳氢化合物部门工人中报告了两例急性恰加斯病病例。
对受影响人群进行特征描述，制定控制和预防措施，并确认疫情。
我们开展了一次疫情调查，包括以下内容：a）根据病例定义寻找符合恰加斯病症状的人员，以便将其转诊至医疗服务机构；b）昆虫学调查（197户中的192户）；c）对食品样本进行卫生检查和微生物分析；d）宿主研究。使用Epi-Info 7.1.5进行数据管理和分析，采用描述性统计方法。我们还计算了室内和室外的锥蝽感染指数。
我们检测到552名暴露者；40人患病（7.2%），其中7名女性（17.5%），33名男性（82.5%），男女比例为5:1。平均年龄为39.1±10.8岁；发病率为7.2%，致死率为5%（2/40）。症状包括发热（100%的病例）、头痛（80%）、肌痛和关节痛（65%）、面部水肿（55%）以及腹痛（37.5%）。平均潜伏期为17天（范围：3 - 21天）。室内罗得西亚锥蝽感染指数为3.3%，室外为2.2%。在检查的五家餐馆中，卫生条件较差，食品样本微生物检测不合格。通过酶联免疫吸附测定法，我们发现一只狗和两只负鼠的IgG抗体呈阳性。
该地的环境、卫生和流行病学状况证实了一起与职业暴露相关的恰加斯病疫情，可能通过口腔传播，这可能是哥伦比亚迄今为止最大的一次疫情。
