MMWR Morb Mortal Wkly Rep. 2018 Jul 6;67(26):738-741. doi: 10.15585/mmwr.mm6726a2.
Chagas disease, a potentially life-threatening disease caused by the protozoan parasite Trypanosoma cruzi, has become a concern in the United States as a result of human emigration from Latin America where Chagas disease is endemic (1). It is estimated that as many as 8 million people living in Mexico, and Central and South America have Chagas disease.* Most cases of Chagas disease in the United States are chronic infections; however, rare cases of acute congenital infections and autochthonous vectorborne transmission have been reported (2). To understand how data are collected and used, a review of state-level public health surveillance for Chagas disease was conducted through semistructured interviews with health officials in six states (Arizona, Arkansas, Louisiana, Mississippi Tennessee, and Texas) where Chagas disease is reportable and one (Massachusetts) where it was previously reportable. States implemented surveillance in response to blood donor screening for Chagas disease and to identify the route of disease transmission. Many states reported primarily chronic cases and had limited ability to respond to local transmission because acute cases were infrequently reported. Surveillance remains important in states with large populations of immigrants or frequent travelers from countries with endemic disease and for states with a risk for local transmission. Surveillance efforts can also help increase awareness among providers and assist in linking patients with Chagas disease to treatment to help prevent cardiac and gastrointestinal complications.
恰加斯病是一种由原生动物寄生虫克氏锥虫引起的潜在危及生命的疾病,由于拉丁美洲移民到美国,这种疾病在美国成为一个关注点,而拉丁美洲恰加斯病流行。据估计,多达 800 万人生活在墨西哥、中美洲和南美洲患有恰加斯病。美国的大多数恰加斯病病例都是慢性感染;然而,也有罕见的急性先天性感染和本地媒介传播的病例报告。为了了解数据是如何收集和使用的,对六个报告恰加斯病的州(亚利桑那州、阿肯色州、路易斯安那州、密西西比州、田纳西州和得克萨斯州)和一个以前报告恰加斯病的州(马萨诸塞州)的州级公共卫生监测进行了半结构化访谈。这些州实施监测是为了对恰加斯病献血者进行筛查,并确定疾病传播途径。许多州报告的主要是慢性病例,由于急性病例很少报告,因此应对本地传播的能力有限。在移民人口众多或经常有来自流行地区旅行者的州,以及有本地传播风险的州,监测仍然很重要。监测工作还可以帮助提高提供者的意识,并协助将恰加斯病患者与治疗联系起来,以帮助预防心脏和胃肠道并发症。