New outbreak of acute Chagas disease in non-endemic department: Chocó - Colombia, 2018

Abstract

Background: Chocó, a non-endemic department for Chagas disease, reported the first acute-phase case from Rio Iró. In this region historically endemic for malaria, the identification of the first case of Chagas disease was a challenge for public health surveillance. The objective of the study was to describe the outbreak of Chagas disease, identify the route of transmission and recommend prevention and control actions.

Materials y methods: outbreak research by: searching for symptomatic persons, taking serological samples; application of entomological survey, sanitary inspection. Data analysis by means of descriptive statistics with the Epi-Info 7.2.2™ program.

Results: the acute case corresponded to a 12-yearold girl with clinical symptoms of 8 days of evolution consisting of fever, asthenia, adynamia, general malaise, vomiting and chills and diagnosed through a positive thick blood smear for Trypanosoma sp. The investigation identified the first chronic case in a 10- year-old child who was a close contact of de index case. Twenty-four samples were taken with negative results for T. cruzi. The patients received etiologic treatment with final live condition. No intra-household infestation of triatomines was found; community search identified Pastrongylus geniculatus in the peridomicile of the homes of the affected children. Poor sanitary conditions, dwellings with wooden walls, dirt floors, storage of firewood indoors and a history of occasional sighting and consumption of opossums.

Conclusions: the first two cases of Chagas disease were identified in the municipality of Rio Iró, one acute and one chronic case in children aged 12 and 10 years, respectively. Vector-borne or oral transmission is being questioned. These cases represent a focus of Chagas disease in this community and open the door to future interventions and research on the subjecta.