N Engl J Med July 30, 2015 V.373 P.456-466
From Global Health Sciences, Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine, San Francisco.
Address reprint requests to Dr. Bern at the Department of Epidemiology and Biostatistics, UCSF, 550 16th St., San Francisco, CA 94158, or at firstname.lastname@example.org
Chagas’ disease is caused by the protozoan parasite Trypanosoma cruzi, which is transmitted when the infected feces of the triatomine vector are inoculated through a bite site or through an intact mucous membrane of the mammalian host .
Vectorborne transmission is limited to areas of North America, Central America, and South America. Both in endemic and in nonendemic areas, other infection routes include transfusion, organ and bone marrow transplantation, and congenital transmission.
Outbreaks attributed to contaminated food or drink have been reported in northern South America, where transmission cycles involving wild vector populations and mammalian reservoir hosts are prominent. Infection is lifelong in the absence of effective treatment.
The most important consequence of T. cruzi infection is cardiomyopathy, which occurs in 20 to 30% of infected persons……