부산대학교 도서관

Chagas disease (ChD), caused by infection with the flagellated protozoan, Trypanosoma cruzi, has a complicated transmission cycle with many infection routes. These include vector-borne (via the triatomine (reduviid bug) vector defecating into a skin abrasion, usually following a blood meal), transplacental transmission, blood transfusion, organ transplant, laboratory accident, and foodborne transmission. Foodborne transmission may occur due to ingestion of meat or blood from infected animals or from ingestion of other foods (often fruit juice) contaminated by infected vectors or secretions from reservoir hosts. Despite the high disease burden associated with ChD, it was omitted from the original World Health Organization estimates of foodborne disease burden that were published in 2015. As these estimates are currently being updated, this review presents arguments for including ChD in new estimates of the global burden of foodborne disease. Preliminary calculations suggest a burden of at least 137,000 Disability Adjusted Life Years, but this does not take into account the greater symptom severity associated with foodborne transmission. Thus, we also provide information regarding the greater health burden in endemic areas associated with foodborne infection compared with vector-borne infection, with higher mortality and more severe symptoms. We therefore suggest that it is insufficient to use source attribution alone to determine the foodborne proportion of current burden estimates, as this may underestimate the higher disability and mortality associated with the foodborne infection route. Author summary: The World Health Organization is working to update previous estimates of the global health burden associated with different foodborne diseases. Previous estimates, published in 2015, did not include Chagas Disease (ChD). This disease, which occurs predominantly in Latin America, is caused by a parasite, Trypanosoma cruzi. The disease can be transmitted to people by a variety of routes. Although the conventionally accepted pathway is via an insect vector, foodborne transmission seems to be very important. This can be via contaminated food, particularly fruit juice or by eating undercooked meat from infected animals. Here, we argue why this parasitic infection should be included in the new estimates of the health burden of foodborne diseases. Growing evidence indicates that foodborne transmission of T. cruzi occurs as commonly as vector-borne infection. Moreover, foodborne infection results in considerably more severe disease than vector-borne infection, with higher mortality and greater symptom severity, particular in the acute phase. [ABSTRACT FROM AUTHOR]