Ten Year Evaluation of the Epidemiology of Oral Transmission of Acute Chagas Disease in Brazil

Document Type

Conference Proceeding

Publication Date

1-11-2026

Publication Title

Open Forum Infect Dis

Keywords

adult, beverage, Brazil, Chagas disease, child, conference abstract, disease reservoir, epidemiology, fatality, female, health care system, human, male, oral transmission, rain forest, retrospective study, risk factor

Abstract

Background: Acute Chagas (AC) disease poses a considerable health challenge in Brazil, and many cases are believed to stem from oral transmission (OT). We seek to outline the epidemiology, demographics, and modes of transmission over a ten year period in Brazil, while also examining the pathophysiology of oral transmission. Brazil's five geopolitical regions Methods: This retrospective study used data from SINAN, Brazil's Notifiable Disease Information System, which collects information from the national healthcare system. We analyzed demographic and epidemiological data from Brazil's five regions between 2014 and 2023 (Figure 1). Results: We identified a total of 3,408 cases of AC (table 1). Of these, 3,246 were from the Northern region, with most cases (84.1%) occurring in the state of Para. The Southern region reported the fewest cases. The majority of patients were 10 to 19 years of age (1917 cases, 56%). However, nearly half of the cases in the Southeast region involved children under the age of 9 (42%). The primary mode of transmission was presumed to be oral in 2,869 cases (84.1%) (table 2). Notably, for 7 of 19 patients in the Southeast region, the transmission was reported as vertical. Laboratory diagnosis was confirmed for 3,238 patients (95%). Unfortunately, 45 patients died due to complications from AC, with most of these fatalities occurring in the Northern region. Conclusion: This review highlights the frequency of oral route of transmission of Chagas disease in Brazil and its associated implications, with large impact on the communities within the Amazon rainforest. The pathophysiology of OT occurs when people consume food or beverages contaminated with the feces of triatomines or secretions from parasite reservoirs. In Northern Brazil, a common beverage associated with outbreaks is 'açai' (see figure 3). We suspect this food source has large contribution to OT cases. It is difficult however to confirm oral route, as triatomines can infest areas where food and drinks are contaminated, leading to potential exposure through both oral ingestion and vector-borne transmission. With this review, we hope to highlight the importance of considering oral exposure as a risk factor for AC.

Volume

13

First Page

S252

Last Page

S253

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