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2. A guide for the generation of repositories of clinical samples for research on Chagas disease.

Author

Nieves Martínez-Peinado, Juan Carlos Gabaldón-Figueira, Roberto Rodrigues Ferreira, María Carmen Thomas, Manuel Carlos López, Tania Cremonini Araújo-Jorge, Belkisyolé Alarcón de Noya, Soledad Berón, Janine Ramsey, Irene Losada Galván, Alejandro Gabriel Schijman, Adriana González Martínez, Andrés Mariano Ruiz, Gimena Rojas, Roberto Magalhães Saraiva, Oscar Noya-González, Andrea Gómez, Rosa A Maldonado, Jimmy Pinto, Faustino Torrico, Ivan Scandale, Fernán Agüero, María-Jesús Pinazo, Joaquim Gascón, Alejandro Marcel Hasslocher-Moreno, Julio Alonso-Padilla, and NHEPACHA Network (New Tools for the Diagnosis and Evaluation of Chagas Disease)

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

Chagas disease, caused by the parasite Trypanosoma cruzi, affects over 6 million people, mainly in Latin America. Two different clinical phases, acute and chronic, are recognised. Currently, 2 anti-parasitic drugs are available to treat the disease (nifurtimox and benznidazole), but diagnostic methods require of a relatively complex infrastructure and trained personnel, limiting its widespread use in endemic areas, and the access of patients to treatment. New diagnostic methods, such as rapid tests (RDTs) to diagnose chronic Chagas disease, or loop-mediated isothermal amplification (LAMP), to detect acute infections, represent valuable alternatives, but the parasite's remarkable genetic diversity might make its implementation difficult. Furthermore, determining the efficacy of Chagas disease treatment is complicated, given the slow reversion of serological anti-T. cruzi antibody reactivity, which may even take decades to occur. New biomarkers to evaluate early therapeutic efficacy, as well as diagnostic tests able to detect the wide variety of circulating genotypes, are therefore, urgently required. To carry out studies that address these needs, high-quality and traceable samples from T. cruzi-infected individuals with different geographical backgrounds, along with associated clinical and epidemiological data, are necessary. This work describes the framework for the creation of such repositories, following standardised and uniform protocols, and considering the ethical, technical, and logistic aspects of the process. The manual can be adapted according to the resources of each laboratory, to guarantee that samples are obtained in a reproducible way, favouring the exchange of data among different work groups, and their generalizable evaluation and analysis. The main objective of this is to accelerate the development of new diagnostic methods and the identification of biomarkers for Chagas disease.

Published
2024
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3. A standardized clinical database for research in Chagas disease: The NHEPACHA network.

Author

Adriana González Martínez, Irene Losada-Galván, Juan Carlos Gabaldón-Figueira, Nieves Martínez-Peinado, Roberto Magalhães Saraiva, Marisa Liliana Fernández, Janine M Ramsey, Oscar Noya-González, Belkisyole Alarcón de Noya, Alejandro Gabriel Schijman, Soledad Berón, Marcelo Abril, Joaquim Gascón, Sergio Sosa-Estani, María Jesús Pinazo, Julio Alonso-Padilla, Alejandro Marcel Hasslocher-Moreno, and NHEPACHA network (Nuevas Herramientas para el diagnóstico y la evaluación del paciente con enfermedad de Chagas)

Subjects
Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

The NHEPACHA Iberoamerican Network, founded on the initiative of a group of researchers from Latin American countries and Spain, aims to establish a research framework for Chagas disease that encompasses diagnosis and treatment. For this purpose, the network has created a questionnaire to gather relevant data on epidemiological, clinical, diagnostic, and therapeutic aspects of the disease. This questionnaire was developed based on a consensus of expert members of the network, with the intention of collecting high-quality standardized data, which can be used interchangeably by the different research centers that make up the NHEPACHA network. Furthermore, the network intends to offer a clinical protocol that can be embraced by other researchers, facilitating comparability among published studies, as well as the development of therapeutic response and progression markers.

Published
2024
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4. Dipylidiasis in children, a generally misdiagnosed cestodiasis. First case reported in Venezuela

Author

Luisa Carolina González-Ramírez, María Alejandra Blanco de García, Florimar Gil-Gómez, José Javier Díaz-Mora, Oscar Noya-González, José Gregorio Prato-Moreno, and Màrius Vicent Fuentes

Subjects
dipylidium caninum, infecciones por cestodos, parásito, zoonosis, niños, venezuela, Arctic medicine. Tropical medicine, RC955-962, Public aspects of medicine, RA1-1270
Abstract

The first case report of human dipylidiasis in Venezuela is presented, including the diagnosis and treatment of a two-year-old child’s infection. The diagnosis was parasitologically confirmed, the child was treated with praziquantel and the animal reservoir and its fleas were identified

Published
2019
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6. Venezuela's humanitarian crisis, resurgence of vector-borne diseases, and implications for spillover in the region

Author

Maikell Segovia, Philipp Schwabl, Santiago Mas-Coma, Maria G Basañez, Gustavo Benaim, Maria F. Vincenti-Gonzalez, J Glen Morris, Jan E. Conn, Harry Acquattela, Hernán J. Carrasco, José Luis Ramírez, Daniel T. Haydon, Leopoldo Villegas, Daniel G. Streicker, Juan D Moreno, Adriana Tami, Juan V Hernández-Villena, Clara Martínez, Juan D Plaza-Morr, Adriana C Mogollon-Mendoza, Peter J. Hotez, Maria E. Grillet, Raul Espinoza, John A. Lednicky, Jaime A. Costales, Luis A Colmenares, Mary C Graterol-Gil, Carlos E. Hernandez-Pereira, Juan Carlos Navarro, Gabriella Blohm, Michael A. Miles, Alberto Paniz-Mondolfi, Mario J. Grijalva, Juan David Ramírez, James Lee Crainey, Alvaro Acosta-Serrano, Sérgio Luiz Bessa Luz, Marilianna Marquez, Marlenes Rodríguez, Heather M. Ferguson, Oscar Noya González, Julio A. Urbina, Luis E. Hernandez-Castro, Poppy H. L. Lamberton, Martin S. Llewellyn, Hirotomo Kato, Belkisyolé Alarcón de Noya, and Héctor Freilij

Subjects
Chagas disease, Disease transmission, Seroprevalence, Review, medicine.disease_cause, Communicable Diseases, Emerging, BOLIVAR STATE, Zika virus, CHIKUNGUNYA, Dengue, 0302 clinical medicine, Infection prevention, INFECTION, SIFONTES, 030212 general & internal medicine, Chikungunya, Geography, Medical, MAYARO, Child, Socioeconomics, Leishmaniasis, Priority journal, Arbovirus, biology, Transmission (medicine), Incidence (epidemiology), Incidence, Politics, Oil, Parasite incidence, Infectious Diseases, Geography, VIRUS, Infection, geographic locations, Human, Adult, medicine.medical_specialty, animal structures, Adolescent, CHAGAS-DISEASE, Trypanosoma cruzi, 030231 tropical medicine, Humanitarian crisis, Epidemic, Vector Borne Diseases, Disease elimination, 03 medical and health sciences, MALARIA, HUMANITARIAN CRISIS, EPIDEMIC, parasitic diseases, medicine, Animals, Humans, Epidemics, Aged, MUNICIPALITY, Public health, Disease re-emergence, Nonhuman, medicine.disease, biology.organism_classification, Venezuela, Malaria, Economic aspect, Disease carrier, Communicable Disease Control
Abstract

In the past 5–10 years, Venezuela has faced a severe economic crisis, precipitated by political instability and declining oil revenue. Public health provision has been affected particularly. In this Review, we assess the impact of Venezuela's health-care crisis on vector-borne diseases, and the spillover into neighbouring countries. Between 2000 and 2015, Venezuela witnessed a 359% increase in malaria cases, followed by a 71% increase in 2017 (411 586 cases) compared with 2016 (240 613). Neighbouring countries, such as Brazil, have reported an escalating trend of imported malaria cases from Venezuela, from 1538 in 2014 to 3129 in 2017. In Venezuela, active Chagas disease transmission has been reported, with seroprevalence in children ( less than 10 years), estimated to be as high as 12·5% in one community tested (n=64). Dengue incidence increased by more than four times between 1990 and 2016. The estimated incidence of chikungunya during its epidemic peak is 6975 cases per 100 000 people and that of Zika virus is 2057 cases per 100 000 people. The re-emergence of many vector-borne diseases represents a public health crisis in Venezuela and has the possibility of severely undermining regional disease elimination efforts. National, regional, and global authorities must take action to address these worsening epidemics and prevent their expansion beyond Venezuelan borders. © 2019 Elsevier Ltd

Published
2019

7. Identification and validation of clinical phenotypes with prognostic implications in patients admitted to hospital with COVID-19: a multicentre cohort study

Author

Jaime Fernández-Bujarrabal Villoslada, Beatriz Dietl Gómez-Luengo, Daniel Ortiz-Sánchez, José Ramón Blanco Ramos, Bartolomé Gómez-Arroyo, Martín Sebastián Ruiz Grinspan, Ester Sáez de Adana Arróniz, Daniel Daniel López, Judit Villar-García, Begoña De Dios García, Josefina García García, Nuria Rabella García, Ana Rodríguez-Revillas, Lydia Martín González, Mercedes San Franco, Elena Martinez Robles, Teresa González Alegre, Elena Morcillo Rodríguez, Oriol Gasch Blasi, Laura Prieto Pérez, Isabel Jiménez Martínez, Elena Isaba Ares, Ricardo Deza-Palacios, Helena Mendez del Sol, Melchor Riera Jaume, Mercedes Rodriguez-Gutiérrez, Daniel Podzamczer, Mikel Urroz, Luis Ramos Ruperto, María Paniagua, Sergio Alcolea-Batres, Mar Masiá Canuto, Rubén Soriano-Arroyo, Paloma Merino Amador, Berta Antón-Huguet, Gabriela Alcaraz, Pablo Ryan, Carlos Franco, Leyre Díez-Porres, Juan Carlos Figueiras, Sara Lidia Kamal, Mónica Hernández, Lorena Barrera-López, Germán Ramírez-Olivencia, Kapil Laxman Nanwani Nanwani, Alberto Oreja, Montserrat Laguno, José Javier Castrodeza Sanz, Belén Loeches Yagüe, Maria Vargas, Luis Eduardo López-Cortés, Isabel Gutiérrez, Sara Vela Berna, P. Martín, Miguel Pedromingo Kus, Jesús Sanz Sanz, Mº Antonia Sepúlveda Berrocal, Carmen Yera Bergua, Juan Cuadros González, Julen Cadiñanos Loidi, Josefa Serralta Buades, María Concepción Prados Sánchez, Francesca Gioia, Iris Pedrola Gorrea, Francisco Arnaiz de las Revillas, Xabier Kortajarena Urkola, Laia Lorenzo-Esteller, Ruth Bravo-Lizcano, Angel Iniesta, Sofía González-García, Belén Martínez López, Agustín Rojas-Vieyra, Concepción García García, Raquel Cavallé-Pulla, Lucía Gómez García, Alicia Herrero, Carlos Jesús Dueñas Gutiérrez, Loreto Vidaur Tello, Carmen Fernández-Capitán, Victoria Lo-Iacono García, Cecilia Gómez-Domínguez, Adalgisa Falcone, María José Ruiz Rodríguez, Arancha Castellano, Miquel Hortos Alsina, María Concepción Nuñez, María Luisa Fernández Vidal, Jésica Abadia Otero, Natalia Moya-González, Albert Sabater Gil, Pedro de la Oliva, Ylenia María Conde-Alonso, Laura Castelo Corral, José Mº García de Lomas Guerrero, Verónica Pérez-Blanco, Isabel San Juan, Martina Archinà, Júlia Sellarés, Juan Carlos Ramos, Cintia María Martínez Mateu, Belén Fernández-Puntero, Andrea Torrecillas-Mainez, Luis Falgueras López, Carlos Carpio-Segura, María Gandullo-Moro, Francisco Abellán Martínez, Cristina Díez, Pilar Martín Dávila, Silvia Gómez-Zorrilla, María Pilar García García, Renzo Tejada-Sorados, María Dolores del Toro, E. Álvarez-Rojas, Gema Muñiz, Lucía Cajuela, María Novella Mena, Estel Pons Viñas, Andrea Pérez Rodríguez, Benito Almirante, Mónica Gozalo, Patricia Girón De Velasco-Sada, Camilo Sanz Zamudio, Ángeles García Flores, Joaquín López-Contreras González, Blanca Fabre-Estremera, Pelayo Fernández Cidón, María Martínez-Redondo, Paula Alejandra Hernández-Liebo, Juan Herrero, Marta Duque-Alcorta, María Teresa García Morales, Concepción Amador Prous, Alex Soriano, Raquel Hernando Nieto, Raquel Álvarez Franco, Alfonso Cabello Úbeda, Luis Force Sanmartín, Laura Mao Martín, Daniel Prieto-Arribas, Mario Pérez-Butragueño, Pere Domingo Pedrol, Henar Serrano-Martín, Mónica Zubimendi, M. Rodríguez-Rubio, David Pujol-Pocull, Manuel García-Gutiérrez, Carlos Manrique de Lara, Lucy Abella Vázquez, Marta Navarro Vilasaró, Carlota Cascajares-Sanz, Berta Torres, Daniel Ceniza-Pena, Isidro Moreno Gómez-Limón, María Rodríguez Mahía, Alí Martakoush, Antonio Buño-Soto, Patricia Serrano de la Fuente, Claudia González Rico, Teresa Pedraz, Conchita Pérez-Jorge Peremarch, Elena Trigo Esteban, Rosana Rouco Esteves Marques, Juan Mora Delgado, Inés Pérez Zapata, Sandra Pérez-Recio, María Ángeles Domínguez, Manuel Cervantes García, Francisco Reinoso-Lozano, M. Martí De Gracia, Carmina Oltra, Beatriz Pérez-Monte Mínguez, Guillermina Bejarano-Redondo, Sara Heili Frades, María Paz García Butenegro, Miguel Torralba González de Suso, Elena Álvaro-Alonso, Víctor J Moreno Cuerda, Gonzalo Garzón, Marcelo Daltro-Lage, Alberto Serrano Martínez, José María Aguado, Mar Mosquera, Ruth Figueroa Cerón, Juan Carlos Martin Gutiérrez, Javier Oliver Ortega, Esteban Martínez, Cristina Gómez-Ayerbe, Nerea Carrasco Antón, María Carmen Fariñas Álvarez, José Antonio Ruiz, Justo Menéndez, Lucía Díaz, José L. Casado, Pilar Vizcarra, Javier Veganzones, Miguel Ángel Moran Rodríguez, Mercedes López-Martinez, Emilio Letang, Paloma Romero Gallego-Acho, Julia Vasquez-Manau, Alexander Rombauts, Marta Robledo del Prado, Luis Puente, Beatriz Alvarez, Juan Emilio Losa García, José Tomas Algado Rabasa, Rafael Torres Perea, Angélica Rivera-Núñez, Esther Expósito Palomo, Antonio J. Carcas, Lucía Platero-Dueñas, Irene Martín Rubio, Miguel Salavert Lletí, Claudia García-Vaz, Antonio Martínez-Verdasco, Jorge Díaz-Garzón, Javier Nieto Arana, Fernando Cadenas-Gota, Richard Rojas, Abelardo García de Lorenzo, Juan Carlos López, Pedro Luis Martinez Hernández, Manuela de Pablos-Gómez, Pablo Alonso, Enrique Seco, María García-López, Lorena López-Corcuer, Celia Blasco-Andres, Delia Romera-Cano, José M. Azcona Gutiérrez, Almudena Gutiérrez-Arroyo, Paula Mendoza Roy, Ignacio De los Santos Gil, Miguel Angel Sánchez-Castellano, Sara Medrano Pardo, Mikel del Álamo Martínez de Lagos, Rocío Martínez Avilés, Elisabet Martínez-Cerón, José Manuel Vázquez Comendador, Marta Virgós-Varela, Alejandra Álvarez Brandt, Carmen Herrero Rodríguez, Jorge Martínez Jordán, Antonio Rezusta López, Marta Vizcaíno Callejón, Manuela Simon-Velasco, Jorge Ignacio Alonso-Eiras, Elisa García Vázquez, Mercè Gurguí Ferrer, Mónica González Bardanca, Nataly Cancelliere-Fernández, José Luis Díaz de Tuesta del Arco, María Larrosa, Alejandro García García, Carmen Román-Hernández, Elena Calvin-García, José Sanz Moreno, Miguel Silvestre-Niño, Nieves Valcarce Pardeiro, Maria Teresa Corcuera-Pindado, Enrique Monteoliva, Aina Gabarrell Pascuet, Elena María Aranda Rife, Aina Gomila Grange, Alba Alastrué Violeta, Daniel Roger Zapata, Jaime Montserrat, Eduardo Malmierca Corral, Marco Palma, Blanca Martínez Cifre, Gema Domínguez de Pablos, Emilio Cuesta, Eva Perales, Silvia Hernáez Crespo, Juan Torres-Macho, Adrián Sánchez Montalvá, Rocío Montejano Sánchez, Eva Van den Eynde Otero, Silvia Castañeda Espinosa, Virginia Pérez Doñate, Adriana Hernández Belmonte, Laura Iglesias Llorente, María Sanz de Pedro, Juan Espinosa Pereiro, Lubna Dani Ben-Abdellah, Raquel Barrós González, Iván Piñero, Araceli López-Tofiño, Ana Such-Diaz, Karim Mohamed Ramírez, Pilar Toledano Sierra, Rebeca Izquierdo, Guillermo Cuevas, Andrés Felipe Cardona Arias, Ileana Gabriela-Tomoiu, David Vinuesa García, Ander González Sarria, Stephan Stuart, José María Fernández, Javier Torres-Cortés, Elisabet Delgado Sánchez, María Varela-Cerdeira, Gemma Bassani, Berta Román Bernal, Isabel García, Paula Betancort de la Torre, Yolanda Martínez-Abad, Beatriz Arizcun, Juan José Cabanillas-Martín, Guillermo Estrada Fernández, Oscar del Río Pérez, Inmaculada Martín Pérez, Andony García, Luis Gómez-Carrera, Alexander Agrifoglio, Alberto M. Borobia, Jordi Niubó, Vanessa Alende Castro, Lara Montes Andújar, Alexandra De la Vega, Efrén Sánchez Vidal, Isabel A. Pérez Hernández, Laura Frade-Pardo, Ana Josefa Tebar-Martinez, Silvia Álvarez Kaelis, Sara De la Fuente Moral, Luz Martin Carbonero, Juan Cantón De Seoane, María Dolores Montero-Vega, Juan Carlos Gainzarain Arana, Sergio España Cueto, Rocío Nuñez-Cabetas, María Sánchez-Martín, Constanza Muñoz Hornero, Ana Gómez-Zamora, Javier Díaz Luperena, Patricia González-Donapetry, José Miguel Cisneros, Lucía Hernández-Rivas, Patricia González Ruano, Andrea Espigares Correa, Rocío González-León, Nicolás García-Arenzana, Omar Cervera, Andrés Canut Blasco, Ana Isabel Cañabate, Mercedes Villarreal García-Lomas, Melania Íñigo Pestaña, Maria Álvarez de Castro, Ana Correa Ruiz, Belén Civantos, Lydia Pascual-García, Paula Villares Fernández, Mikel Rico-Briñas, María José Alcaide-Martín, Adoración Valiente, Victoria Arnalich-Montiel, Pilar Retamar, Jesús Mingorance, Eva María Romay Lema, Pablo Galindo-Ballesteros, M. Teresa Pérez-Rodríguez, Rosario Maria Torres Santos-Olmo, Inmaculada Pinilla, Elie Dahdouh, Beatriz Tejero-Soriano, Cristina Pizarro-Sanchez, Félix Gutiérrez Rodero, Luis Jara-Palomares, María Hernández-Gancedo, Cristina Chico Chumillas, Sergio Gilaberte Reyzábal, Manuel González-Viñolis, Ana Martínez Sapiña, Francisco Parras, Teresa Rubio Obanos, Iker Falces-Romero, Adriana Sánchez Serrano, Teresa Álvarez de Espejo Montiel, Jorge Valencia, Miquel Pujol, José Luis Velasco Garrido, Belén Calderón-Llopis, Álvaro Varela Plaza, Abel Caro, Juan José González-Garcia, Miguel Sampedro Núñez, María Fernández-Velilla, Emilio Cendejas-Bueno, María Cecilia Cánepa, José Luis Santiago Blanco, Alicia Rico-Nieto, Mónica Liébana Gómez, Sarah Caro Bragado, Susana Sánchez-Rico, José María Marimón Ortiz de Zárate, Paloma Dorao, Cristina Plaza-Moreno, Isabel Valbuena, Natividad Benito Hernández, Ginger Giorgiana Cabrera Tejada, Jordi Carratalà, Sara Fernández Rodríguez, Vicente Ferrer Díaz De Brito Fernández, Pilar Catalán, Pablo Mariscal-Aguilar, Germán Daroca-Bengoa, Rafael Fernandez, Raquel Casitas-Mateo, Ester Zamarrón de Lucas, Úrsula Quesada, Julio Yagüe, María Isabel Quijano Contreras, Trinidad Baselga-Puente, Lourdes Herrera Pacheco, Carlota Gudiol, Alazne Lartategi Iraurgi, Estefanía Martinez-Chavez, Silvia Valero Rovira, Alba Bergas, Zaida Ruiz de Azua, Teresa Prim, Cristina García-Quero, Pilar Hernández Machín, Rubén Gomez-Rioja, María Pavón-Masa, María de las Mercedes Valentín-Pastrana Aguilar, Ilduara Pintos Pascual, Lucía Brieba-Plata, María Jesús Domínguez Santalla, Francisco Javier Membrillo de Novales, Raúl Galera-Martínez, Ana Lérida Urteaga, Miguel Cervero, Alberto Mangas-Moro, José Hernández Quero, Teresa Sancho Bueso, María Angustias Quesada Simón, Luz Parra-Gordo, Sofía Díaz-Carrasco, Juan Carlos Abad Almendro, Andrés Javier Ruiz Fernández, Estíbaliz Molina Iturritza, Aurea Díez-Tascón, Yale Tung-Chen, Marta Rava, Carlos Villasante, Gabriel Gaspar Alonso-Vega, Clara Cabré-Verdiell Surribas, Esther Fraile Villarejo, Aida Gutiérrez García, Ana Robustillo-Rodela, Rafael Padrós Selma, Jesús Rodríguez-Baño, Frank Perdomo-García, Lydia de la Fuente Regaño, María del Mar Arenas-Miras, Cristina Rodríguez Roca, Blanca Montero-San Martín, Gema Crespo-Sánchez, Miguel Ramírez-Verdyguer, Alberto Diaz de Santiago, Marta Díaz Menéndez, María de la Luz Padilla Salazar, Silvia Arribas-Terradillos, Sadaf Zafar Iqubal-Mirza, Isabel Rábago Lorite, Belén Estébanez, Maite Ganchegui Aguirre, André Barbosa Ventura, Estefanía Fernandez-Cerezo, Maria Eulalia Valencia, Zaira R. Palacios-Baena, Beatriz Diaz Pollan, Lidia Martín, Sara Fabra-Cadenas, José Miguel Cantero-Escribano, Carmen Busca Arenzana, Emilia Guasch-Arévalo, Virginia Fernández Espinilla, Ainhoa Urrutia Losada, Oscar Noya González, Raquel Aranega, Alejandro Rodríguez Saenz de Urturi, María Jesús Jaras Hernandez, Charbel Maroun Eid, Marta Mora Rillo, Antonio Ramos Martínez, Meritxell Ortega Montoliu, Jose María Mostaza, Sonia García Calvo, Cristina Verdú, Celia Salamanca, Cristina Cervera Acedo, Mónica Martínez, Miren Urrestarazu Larrañag, Carmen Barroso Castro, Ivo Vives-Beltrán, Lorea Arteche Eguizabal, Ana Montero, Javier Balsa Vázquez, Amparo Perez-Garcia Morillón, Alejandra Pérez García, Isabel Pérez-Tamayo, Rafael Cantón Moreno, Antonio Marín-García, Inmaculada Jarrín, Núria Trullen, Ines Fernandez-Jimenez, Guillermo Ruiz-Carrascosa, Almudena Villa Martí, Jamil Cedeño, Marcos Díez Martínez, Carlos Lahoz, Lorena De la Mora, Javier Sánchez-Lora, Ana María Martínez-Virto, Irene Sanjosé Muñiz, Adrian Peña-Hidalgo, Cristina López Mestanza, Carola Gutiérrez, Ana Laila Qasem-Moreno, Irene Salvo García, Lucía Fernández de Orueta, Jorge Parra Ruiz, Sergio Pérez Pinto, Carlos García-Mochales Fortún, Esteban García de las Heras, Patricia González Muñiz, Mario Fernández-Ruiz, Anna Ferrer Santolaria, Olga Sánchez Pernaute, Julieta Latorre, Jesús Manzanares, Miguel Angel Martinez Gallego, Helena Notario, Ángel Rodríguez-Villodres, Eva Fernández-Bretón, Encarnación Moral Escudero, Mónica Sánchez-Santiuste, Carmen Martínez Cilleros, Ricardo Fernández Roblas, María Yllescas, Eva Soria-Alcaide, Marta Arsuaga Vicente, Marta Gómez-López, Regina Cabrera-Gamero, Natalia Carrasco Fons, Diana Piñar Cabezos, Begoña Sánchez-Sánchez, Francisca Garcia-Iglesias, Raquel Marín-Baselga, Alberto Arranz Caso, Virginia Guedez-López, Lucia Boix Palop, Íñigo Gredilla Zubiría, María Hidalgo-Sánchez, Laura López-Tappero Irazábal, José Ignacio Bernardino de la Serna, Javier Queiruga, Natalia Guadalupe Barrera-López, María López-Jodar, Jorge Calderón Parra, Diego Rodríguez-Álvarez, José Molina, María Luisa Montes, Beatriz Rodríguez-Alonso, Daniel Useros Brañas, Maria Gracia Liras-Hernández, Lucía Romero-Imaz, Nieves Jaén Sánchez, Marta Segovia-Amaro, Marta Vara, Maribel Zamora Cintas, Montaña Jiménez Álvaro, Alberto Moreno Fernandez, Asunción Díaz, Jordi Mancebo Cortés, Francisco Javier De Castro Vega, Álvaro Navarro Batet, Francisco Javier Sagra, Alexandre Pérez González, Luis Castro, Isabel Barrio López, Marta Ruiz-Alguero, Silvia Ossaba-Vélez, Alberto Martín-Vega, Maria Jesus Bustinduy Odriozola, Sivia Pastor-Yvorra, Nuria Espinosa, Elena Múñez Rubio, María E García-Leoni, Sandra Rosillo, Cristina Carbonell, Iván Navas Clemente, Paula Arriola Martínez, Marta Peña, Lucía Martínez de Soto, Roberto Mora-Corcovado, Alberto Iglesias-Sigüenza, Rocío Ruíz-Hueso, Elena Alvar, Pedro Camacho, Jesús Sojo-Dorado, Remedios Alemán Valls, Ines Ponz, Esmeralda Palmier Peláez, María Arcos Rueda, Guillermo Maestro de la Calle, Ramón Pérez Tanoira, Ana Martínez Vidal, Cristina Amodeo, Marina Pacheco Martínez-Atienza, Clara Muñoz Aguirre, Felipe Villar Álvarez, Giorgina Salgueiro, Xavier Sanz Salvador, César Pérez-Romero, Beatriz Álvarez Zapatero, Nelsa González-Aguado, Robert Torres Sánchez del Arco, Enrique Míguez Rey, Merce Sirisi, Xavier Bonfill Cosp, Marta Yagüe-Barrado, Elena Pérez-Costa, Sandra Casares, Eva Estirado, Jorge Alvarez Troncoso, Cristina Martín-Carrasco, Diana Sande Llovo, Melchor Álvarez de Mon Soto, Arantzazu Mera Fidalgo, Francisco Marqués-González, Agustín Valido-Morales, Luis Alberto Nieto Fernández del Campo, Helem Haydee Vilchez, María Rivas-Carmenado, Francisco Moreno, Ignacio Fernández-Fernández, Henar Calvo Sánchez, Ana González-Cordón, Isabel Fernández-Navarro, María Simón Sacristán, Eva Jiménez-González de Buitrago, M. Muñoz, María Laplaza-González, Rosa de Miguel Buckley, Marta Redondo-Gutierrez, Paula Santibáñez Sáenz, Raquel Martínez Goñi, Marta Rico Rodríguez, Carlos Toro-Rueda, Francisco Arnalich, Ana Santiago-Recuerda, Clara Soto Abanedes, María Dolores Herrero Mendoza, Aquilino Sanchez Purificación, Diego Franch Llasat, María Velasco Arribas, Alejandro Martín-Quirós, Jorge Alba Fernández, Elena Ramírez, Amparo López-Bernus, Marta Alvarado, María Rexach Fumaña, Martín Pilares-Barco, Carmen Liébana Martos, Yolanda Martínez Martínez, Nicolas Merchante Gutiérrez, Maria José Asensio, Ianire Virto Peña, Lucía Mejuto-Illade, María Angeles Martinez-López, Pilar López-Pirez, Alejandro Suárez, Cristóbal Manuel Rodríguez Leal, Sara Garcia-Bellido Ruiz, Jorge Guisández Martín, Lucia Cachafeiro, Pedro Gil Divasson, Almudena Quintás-Viqueira, Laura Currás-Sánchez, Alverio Seiz-Martinez, Mario Ruiz-Bastián, Juan José Menéndez, Jorge Orihuela Martín, María Dolores Nieto Martín, Cristina Arévalo, Rebeca Marinas, Susana Casas Rodríguez, Zuriñe Ortiz de Zárate Ibarra, Yolanda Posada Franco, Joan Gómez-Junyent, Ana María Garijo Saiz, Marina Alguacil-Guillén, Ana Alguacil, Esther Aznar Muñoz, Sara Bañón Escandell, Juan Salillas Hernando, Chiara Fanciulli, Rosa Gómez-Gil, Francisco García-Río, Moncef Belhassen-García, Belén Gutierrez Sancerni, Sonia Vega Molpeceres, Inés Suárez-García, Leire Pérez-Latorre, Elena Chamarro Martí, Carmen Rosario Herrero Gil, Belén Gutiérrez-Gutiérrez, Tatiana Mata Forte, Francesca Sánchez Martínez, Lucía Ramos Merino, Santiago Yus, Mº Ángeles Marcos, Susana Martínez-Álvarez, Alexy Inciarte, Manuel Quintana-Díaz, Lucía Serrá, Belén Alejos, Guillem Policarpo Torres, José Román Muñoz del Rey, Irene Blanco-Bartolomé, Alberto Bahamonde Carrasco, Victoria Hernando, Jhon Rojas, David Roa, María Ángeles Garcinuño, Aránzazu Villasante de la Puente, Patricia Pérez-Palacios, Jesús Ruiz Aragón, Valvanera Ibarra Cucalón, Lucía Ortega Enciso, Ismail Zakariya-Yousef Breval, Jorge Navarro López, Gema Barbeito Castiñeiras, Clara Sala Jofre, Nora Molina Torres, Manuel Poyato, Inmaculada Poquet Catala, Virginia Pomar Solchaga, María Pilar Romero-Gómez, Clara Hernández, Helena Mozas Moriñigo, Mercedes Guillamón Sánchez, Zineb Karroud, Arianna Catino, Violeta Ramos Sesma, Santos del Campo, Pilar Fernández-Calle, Ana Fernández Cruz, Fernando Salvador, Rosa Mayayo-Alvira, Pilar Barco Núñez, Ana Isabel Peláez Ballesta, Silvia Suárez Diaz, Beatriz María Sanjuan, Nora Izko Gartzia, Teresa Aldámiz-Echevarría, Cecilia Tortajada Alamilla, Pau Bosch-Nicolau, María del Mar Alonso Socas, Sonia Calzado Isbert, Jose R. Arribas, Juan Fernández-Lahera, Elizabet Petkova Saiz, Eva Jiménez, Gabriela Abelenda-Alonso, Alba Ribera Puig, Pascual Sanabria-Carretero, Sara Rodrigo González, Irene Díaz de la Torre, Tamara Manso Gómez, Carmen Sáez Barberá, Roi Suárez Gil, Paloma García-Clemente, Héctor Meijide Míguez, Elsa Izquierdo-García, Josune Goikoetxea Agirre, Olalla Martínez Macia, Jesús Santos González, Guillermo Jiménez Álvarez, Cristina Marcelo-Calvo, Javier Coy Coy, Isabel Arenas-Berenguer, Julio García Rodríguez, Natalia Yustas-Benitez, Sarai Quirós-Fernández, Marina Noguerol-Gutiérrez, María Adalid Moll, Iván Bloise-Sánchez, Mario José Rodriguez Dominguez, Elena Salamanca, Francisco Mora Gómez, Lucio García-Fraile, Pablo Millán, C Gutiérrez, Montserrat Rodríguez, José Antonio Oteo Revuelta, Joseba Portu Zapirain, Cristina Moreno, Irene Carrillo Acosta, Jorge Calvo, Ana Mariño Callejo, David Romero-Ribate, Blanca Alonso, Elena Muñoz del Val, Elena Resino Foz, Olaia Rodriguez-Fraga, Miguel Villamarín, Irene Amores-Hernández, Laura Muñoz López, Esther García Almodóvar, Ismael Casares Guerrero, Angélica Villanueva-Freije, Nuria Parra Arribas, Montserrat Sanmarti Vilamala, Macarena Lerín-Baratas, Mercedes Castro-Martínez, Melissa Carreres Candela, Lucia Suárez Pérez, Jose Manuel Iturzaeta-Sánchez, Thamires Silva-Freire, José Antonio Peregrina, María Luisa Machado Sicilia, Sergio Zurita, Daniel Molina Morant, Olga González-Peña, Fernando Lázaro-Perona, Paloma Oliver-Saez, Beatriz Mestre-Gómez, Luis Díaz Díez Picazo, Silvia García-Bujalance, Francisco Rodríguez Gómez, Pere Comas Casanova, Carlos Ruiz Martínez, Alberto Delgado-Iribarren, Berta Alonso-González, Isabel Moreno-Parra, Teresa Gómez-Ballesteros, Araceli Menéndez, Jose Manuel Añón, Ruth Jorge García, Jonathan Cámara Fernández, Miguel Górgolas Hernández-Mora, Itziar Diego Yagüe, Miriam Latorre-Millán, Covadonga Morcate Fernández, M. Río-García, Elisabet Lerma-Chippirraz, Carmen Yllera Gutiérrez, Francesc Albertí, Eva Flores, Carmen R. Uña Orejón, Patricio González-Pizarro, Neila Rodriguez-Roca, Miguel Fernández-Huerta, Inés Ferrer Ortiz, María José Blanco Vidal, Juan Pablo Avilés, Alicia Lorenzo Hernández, Mireia Puig Campmany, José Bravo-Ferrer, Gonzalo Martínez-Alés, Pablo Marguenda Contreras, M. Sánchez, Antonio García Pardo, Yolanda Meije, Francisco Tejerina, Carolina Hernández Carballo, Victoria Moreno, Daniel Laorden-Escudero, Ana Barrios Blandino, Alexia Costanza Espiño Álvarez, Ana Milagro Beamonte, Jerónimo Pachón, S San José-Villar, Marta Morando, María del Carmen Navarro Sáez, Rodolfo Álvarez-Sala Walther, Jon Ugalde Espiñeira, Fernando De la Calle Prieto, Nuria Fernández, Iván Pelegrín Senent, Alba Rueda López, Cristina Schüffelmann, Marcelino Hayek Peraza, Laura Labajo-Montero, Angel Robles Marhuenda, Pilar Durán, Ana Esteban-Romero, María Rosa Oltra Sempere, Ana Cosmen Sánchez, Alex Smithson Amat, Margarita Ramírez-Schacke, Marco Antonio Sempere Alcocer, Paloma Carrera-Vázquez, M Miarons, Teresa García Delange, Amelia Rodriguez-Mariblanca, Eva Talavera García, Roberto Vates Gómez, Óscar Sanz Peláez, José María Muñoz-Ramón, José Luis García Fogeda, Isabel Arroyo-Rico, Verónica Cano Llorente, Fernando González-Romo, Alberto Alonso-Babarro, Fátima Brañas, Fabricio Iannuccelli, Pilar Álvarez Padín, Luis Metola Sacristán, Vicente Boix, Víctor Hontañón, Juan Berenguer, José Luís Del Pozo León, Patricia Sorní Moreno, Maria Isabel Torres, Rafael Mican Rivera, Amparo Blasco Claramunt, Carmen Ardanuy, Aychel Elena Roura Piloto, María Ángeles Molina, Isabel Asschert Agüero, Julía Alvárez del Vayo, Consuelo García-Sánchez, Begoña Reche-Martínez, Guillermo Cuervo, Carlos Iniesta, María Antonia Gómez-Mendieta, Ana María Noblejas Mozo, Andres Bartrina-Tarrio, Carmen De la Higuera Arranz, Yeray Untoria Tabares, Andrés Enrique Suárez-Plaza, Jesús Frías, Paloma López-Arévalo, Irene María Llorente-Cortijo, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación (España), and Fundación SEIMC-GESIDA

Subjects
Male, Prognostic variable, medicine.medical_specialty, Databases, Factual, Coronavirus disease 2019 (COVID-19), 030204 cardiovascular system & hematology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Humans, Medicine, 030212 general & internal medicine, Aged, Retrospective Studies, Models, Statistical, SARS-CoV-2, business.industry, Mortality rate, COVID-19, Retrospective cohort study, Articles, Middle Aged, Prognosis, medicine.disease, Phenotype, Hospitals, Hospitalization, Logistic Models, Infectious Diseases, Spain, Cohort, Female, Lymphocytopenia, business, Cohort study
Abstract

REIPI-SEIMC COVID-19 group and COVID@HULP group., [Background] The clinical presentation of COVID-19 in patients admitted to hospital is heterogeneous. We aimed to determine whether clinical phenotypes of patients with COVID-19 can be derived from clinical data, to assess the reproducibility of these phenotypes and correlation with prognosis, and to derive and validate a simplified probabilistic model for phenotype assignment. Phenotype identification was not primarily intended as a predictive tool for mortality., [Methods] In this study, we used data from two cohorts: the COVID-19@Spain cohort, a retrospective cohort including 4035 consecutive adult patients admitted to 127 hospitals in Spain with COVID-19 between Feb 2 and March 17, 2020, and the COVID-19@HULP cohort, including 2226 consecutive adult patients admitted to a teaching hospital in Madrid between Feb 25 and April 19, 2020. The COVID-19@Spain cohort was divided into a derivation cohort, comprising 2667 randomly selected patients, and an internal validation cohort, comprising the remaining 1368 patients. The COVID-19@HULP cohort was used as an external validation cohort. A probabilistic model for phenotype assignment was derived in the derivation cohort using multinomial logistic regression and validated in the internal validation cohort. The model was also applied to the external validation cohort. 30-day mortality and other prognostic variables were assessed in the derived phenotypes and in the phenotypes assigned by the probabilistic model., [Findings] Three distinct phenotypes were derived in the derivation cohort (n=2667)—phenotype A (516 [19%] patients), phenotype B (1955 [73%]) and phenotype C (196 [7%])—and reproduced in the internal validation cohort (n=1368)—phenotype A (233 [17%] patients), phenotype B (1019 [74%]), and phenotype C (116 [8%]). Patients with phenotype A were younger, were less frequently male, had mild viral symptoms, and had normal inflammatory parameters. Patients with phenotype B included more patients with obesity, lymphocytopenia, and moderately elevated inflammatory parameters. Patients with phenotype C included older patients with more comorbidities and even higher inflammatory parameters than phenotype B. We developed a simplified probabilistic model (validated in the internal validation cohort) for phenotype assignment, including 16 variables. In the derivation cohort, 30-day mortality rates were 2·5% (95% CI 1·4–4·3) for patients with phenotype A, 30·5% (28·5–32·6) for patients with phenotype B, and 60·7% (53·7–67·2) for patients with phenotype C (log-rank test p, [Interpretation] Patients admitted to hospital with COVID-19 can be classified into three phenotypes that correlate with mortality. We developed and validated a simplified tool for the probabilistic assignment of patients into phenotypes. These results might help to better classify patients for clinical management, but the pathophysiological mechanisms of the phenotypes must be investigated., [Funding] Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, and Fundación SEIMC/GeSIDA., Funding: Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, and Fundación SEIMC/GeSIDA.

Published
2021

8. Malaria in Venezuela: Gabaldón's legacy scattered to the winds

Author

Oscar Noya González, Leonor Pocaterra, Alberto Paniz-Mondolfi, Juan C. Gabaldon-Figueira, Mariapí Bevilacqua, Leopoldo Villegas, Javier Lezaun, Maria Eugenia Grillet, and Carlos Chaccour

Subjects
Insecticides, Geography, medicine, Humans, General Medicine, medicine.disease, Venezuela, Cartography, Malaria, Health Services Accessibility
Published
2020

9. Orally Transmitted Chagas Disease: Biology, Epidemiology, and Clinical Aspects of a Foodborne Infection

Author

Oscar Noya González and Belkisyolé Alarcón de Noya

Subjects
Chagas disease, medicine.medical_specialty, education.field_of_study, biology, Population, Outbreak, medicine.disease, biology.organism_classification, Therapeutic approach, Immune system, parasitic diseases, Epidemiology, medicine, Trypanosoma, Trypanosoma cruzi, Intensive care medicine, education
Abstract

Chagas disease has been one of the great neglected infectious pathologies, affecting not only developing countries but also the most vulnerable sectors of the population with greater intensity. In the spectrum of its mechanisms of infection, the most forgotten, unknown, and underestimated is the oral infection. Despite being the usual form of infection among mammals and the increasing frequency of oral Trypanosoma cruzi-transmitted outbreaks since 1967, many aspects about the physiopathology, the histotropism, clinical evolution, evasion mechanisms of Trypanosoma cruzi, the consequent host immune response, and the therapeutic efficacy are still unknown. However, nowadays we already know, and are discussed in this chapter, the risk factors, the clinical aspects, the incriminated vectors, the ideal diagnostic methods, and the therapeutic approach primarily applicable to the acute phase.

Published
2019

10. An ecological overview on the factors that drives to Trypanosoma cruzi oral transmission

Author

Oscar Noya González and Belkisyolé Alarcón de Noya

Subjects
Chagas disease, Male, Veterinary (miscellaneous), Trypanosoma cruzi, Biodiversity, Animals, Wild, Food Contamination, Disease Outbreaks, Feces, Zoonoses, parasitic diseases, medicine, Animals, Humans, Chagas Disease, Triatoma, biology, Ecology, Transmission (medicine), Zoonosis, Outbreak, South America, biology.organism_classification, medicine.disease, Fruit and Vegetable Juices, Infectious Diseases, Insect Science, Animals, Domestic, Parasitology, Female, Food contaminant
Abstract

American trypanosomiasis is one of the few native parasites of this continent. As a zoonosis, Trypanosoma cruzi infects about 180 species out of 25 families of mammals. Its regular transmission is through triatomines, which can easily transmit parasites either by the skin route (contamination of mammals skin with their feces) or by oral route (ingestion of food contaminated with complete triatomines or their feces) and additionally through haematogenous via (congenital and transfusional) and by tissues (transplants). The oral route, which seems to be the ancestral form of transmission to wild and domestic mammals, has recently become more important after the success achieved in the control of domicile vectors using residual pesticides. From its initial diagnosis in 1967, tens of oral outbreaks have been diagnosed mostly in the Brazilian Amazon and subsequently in other four countries in South America. Environmental imbalance caused by man through the invasion and deforestation of woodlands, results in reduction of biodiversity of mammals as food source for triatomines, affecting the "dilution effect" of T. cruzi in the nature increasing the risk of human infection. On the other hand, triatomines invade houses looking for new blood sources. One of the consequences of domiciliated triatomines is the food contamination spread, especially in home-made juices, which has been the source of infection of most oral outbreaks. Other biotic and abiotic factors help to explain the recent increase of oral transmission outbreaks of Chagas disease, distributed in nine eco-regions of America.

Published
2015

11. Clinical Aspects in Foodborne Chagas Disease

Author

Oscar Noya González and Belkisyolé Alarcón de Noya

Subjects
Chagas disease, medicine.medical_specialty, education.field_of_study, business.industry, Transmission (medicine), Public health, Population, Outbreak, medicine.disease, Asymptomatic, Health personnel, medicine, Identification (biology), medicine.symptom, business, Intensive care medicine, education
Abstract

Mode of transmission may affect clinical aspects of infection for many diseases that have different potential transmission routes, and this is also the case for Chagas disease, for which oral transmission has particular aspects of interest. In this chapter we not only consider the clinical aspects associated with oral transmission of Trypanosoma cruzi, but also particular aspects associated with diagnosis and treatment. One aspect that is also of importance is that in an outbreak of foodborne Chagas disease, when there is the potential for many hundreds of people developing symptoms almost simultaneously, then different strategies for diagnosis and treatment, and preventing further infections occurring, must be implemented. Identification of asymptomatic cases is also important. This may put particular strains on health personnel and public health officials, who also need to disseminate information to a concerned population. Regardless of transmission route, development and implementation of more appropriate diagnostic tools and more effective treatment options are important goals.

Published
2015

12. Prophylactic Measures and Implementation of Control Measures in Foodborne Chagas Disease

Author

Oscar Noya González and Lucy J. Robertson

Subjects
Chagas disease, Artificial light, Microbial risk, Critical control point, Environmental health, Control (management), Immunology, medicine, Outbreak, Foodborne transmission, Legislation, Business, medicine.disease
Abstract

In order to minimize the likelihood of foodborne infection with Chagas disease the whole food-chain, from production to consumption, needs to be considered using a Hazard Analysis and Critical Control Point (HACCP) approach in order to identify where control measures can be most usefully implemented that will have the greatest effect at reducing risk. Legislation regarding food control in general is in place, and application of the steps of microbial risk assessment is also possible, but, nevertheless, it is clear that foodborne outbreaks of Chagas disease continue to occur in endemic regions. Although the international perspective on outbreaks of orally transmitted Chagas disease is, and unfortunately continues to be, that this is a local and limited problem and without any global impact, it is nevertheless clear that acai, sugarcane, and fruit juices are ideal food matrices for foodborne transmission; vital risk factors include the crops for these drinks often being grown, harvested, and pressed locally, (with the pressing often occurring at night-time under artificial light), in rural or periurban areas where sylvatic triatomines may be abundant. In this chapter we discuss not only the legislation and tools available to reduce the likelihood of foodborne transmission, but also practical measures that could be implemented at all stages along the food-chain, not forgetting educational measures for the vendors and consumers of the final products.

Published
2015

13. Documented Outbreaks of Foodborne Chagas Disease

Author

Raiza Ruiz-Guevara, Belkisyolé Alarcón de Noya, and Oscar Noya González

Subjects
Chagas disease, medicine.medical_specialty, Ecoregion, Ecology, Host (biology), Urbanization, Ecology (disciplines), Epidemiology, Foodborne outbreak, medicine, Outbreak, Biology, medicine.disease
Abstract

In this chapter we provide an overview of documented outbreaks of foodborne Chagas disease. Although the presence of parasites are seldom, if ever, demonstrated in the suspected vehicle of infection, there are particular characteristics that implicate a foodborne, rather than vectorborne, route of infection: simultaneous onset of symptoms, usually in groups of individuals with a common history of consumption of particular items of food or drink obtained from the same source, and without showing any cutaneous signs of exposure to triatomines. We have divided the outbreaks by ecoregion, and divided again by country, and this demonstrates clearly that particular ecoregions are more prone to foodborne transmission. It is notable that the Northern Andean Montane Forests, the Coastal Venezuela Montane Forests, and, especially, the Southwestern Amazonian Moist Forests are ecoregions from which a preponderance foodborne outbreaks of Chagas disease have been reported. This probably reflects the vegetation in these areas being of importance in the diversity and density of triatomines, and thus the parasite. Furthermore, other epidemiological aspects, such as aspects of the ecology, host behavior, and “urbanization” of wild reservoir hosts, may be of relevance. The overview provided in this chapter may be of use in further determination of relevant factors for contamination of food vehicles by trypomastigotes of T. cruzi, and the subsequent ingestion by susceptible humans.

Published
2015

14. Future Challenges and Final Remarks

Author

Belkisyolé Alarcón de Noya, Lucy J. Robertson, and Oscar Noya González

Subjects
Transmission (mechanics), Latin Americans, law, Political science, Development economics, Foodborne transmission, Speculation, Investment (macroeconomics), law.invention
Abstract

In this final section we try to pull together some of the key points made in previous sections and emphasise that whilst we may be coming to grips with vectorborne transmission of Chagas disease, epidemiological changes are likely to exacerbate the rising threat of foodborne transmission. In addition, the threat of exporting this disease beyond the confines of Latin America should be considered—globalization of people and insects, and the adaptation of the versatile Trypanosoma cruzi to potential new vectors, reservoirs and transmission routes mean that this is not just idle speculation. Investment in prevention, detection, treatment, and education is fundamental for meeting these challenges.

Published
2015

15. Mechanisms of Infection in Chagas Disease

Author

Oscar Noya González, Belkisyolé Alarcón de Noya, and Cecilia Colmenares

Subjects
Chagas disease, medicine.medical_specialty, Transmission (medicine), Mechanism (biology), business.industry, Parasitemia, Disease, medicine.disease, Organ transplantation, medicine, Effective treatment, Infective Agent, business, Intensive care medicine
Abstract

Although regarded primarily as a vectorborne disease, American trypanosomiasis can be transmitted by various mechanisms. These include: cutaneous vector transmission, transfusions, congenital transfer, organ transplantation, laboratory accidents, and oral transmission. In this chapter, we focus particularly on the latter mode of infection. We consider both the mechanism of oral transmission, addressing the question of how the infective agent gains access to the mouth of the human host with food, and also describe and summarize our knowledge on the characteristics of host-parasite interactions in cases of oral transmission. In particular, we consider the extent of parasitemia associated with oral transmission, the results of histological studies in experimental animals, and also more recent molecular and immuno-pathological studies. Understanding these fundamental biological interactions is important in the development of effective treatment strategies, or even the development of prophylactic vaccines.

Published
2015

16. Epidemiological Factors Related to Foodborne Transmission of Chagas Disease

Author

Belkisyolé Alarcón de Noya, Lucy J. Robertson, and Oscar Noya González

Subjects
Chagas disease, education.field_of_study, Epidemiological Factors, Transmission (medicine), Human migration, business.industry, Population, Outbreak, Biology, medicine.disease, biology.organism_classification, Environmental health, Triatoma infestans, medicine, Trypanosoma cruzi, business, education
Abstract

The increasing number of cases, clusters and outbreaks of foodborne Chagas disease are likely to be due to a number of factors that have resulted in conditions for oral transmission becoming more favourable. This is, in part, emphasised by vector-control initiatives reducing the spread of vectorborne transmission. In this chapter we explore a range of epidemiological factors that have facilitated the foodborne transmission of Chagas disease. These factors include human migration and urban development, both of which have, in their turn, impacted upon important facets in the lifecycle of T. cruzi, such as the invasion and domiciliation of triatomine species, and alterations in the population dynamics of triatomines and wild animal reservoirs. It should be remembered that although transmission routes may be understood, they seldom remain static and different factors may alter and tweak different aspects. For the future, factors such as climate change (resulting in wider distribution of some vectors), the emergence of new vectors, the migration of individuals infected with T. cruzi to non-endemic areas, and globalization of the food-chain may be suggested as such as factors that may ensure that oral transmission of T. cruzi continues and expands, both in endemic areas, but also in other regions beyond the traditionally endemic areas.

Published
2015

17. Trypanosoma cruzi: Time for International Recognition as a Foodborne Parasite

Author

Oscar Noya González, Brecht Devleesschauwer, Lucy J. Robertson, Belkisyolé Alarcón de Noya, Paul R. Torgerson, University of Zurich, and Robertson, Lucy J

Subjects
0301 basic medicine, Life Cycles, Internationality, Epidemiology, Protozoology, Disease Vectors, TRIATOMINAE, Global Health, HEMIPTERA, Foodborne Diseases, Infection biology, 0302 clinical medicine, Food Parasitology, Medicine and Health Sciences, Public and Occupational Health, Cooking, Protozoans, CHALLENGES, lcsh:Public aspects of medicine, Neglected Diseases, Viewpoints, Cold Temperature, VENEZUELA, MUCOSAL, Infectious Diseases, Protozoan Life Cycles, OUTBREAKS, Acute Chagas' disease, Neglected Tropical Diseases, Trypanosoma, lcsh:Arctic medicine. Tropical medicine, Infectious Disease Control, lcsh:RC955-962, Trypanosoma cruzi, 030231 tropical medicine, Library science, 610 Medicine & health, Biology, Microbiology, 03 medical and health sciences, Parasitic Diseases, Humans, INFECTIVITY, Chagas Disease, ORAL-TRANSMISSION, 10599 Chair in Veterinary Epidemiology, Protozoan Infections, REDUVIIDAE, Organisms, Public Health, Environmental and Occupational Health, Biology and Life Sciences, lcsh:RA1-1270, 2739 Public Health, Environmental and Occupational Health, 2725 Infectious Diseases, ACUTE CHAGAS-DISEASE, Trypomastigotes, Tropical Diseases, Virology, Parasitic Protozoans, Vector-Borne Diseases, 030104 developmental biology, Food Storage, Parasitology, 570 Life sciences, biology, Developmental Biology
Abstract

1 Parasitology Lab, Section for Microbiology, Immunology, and Parasitology, Department of Food Safety and Infection Biology, Norwegian University of Life Sciences, Adamstuen-Campus, Oslo, Norway, 2 Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium, 3 Emerging Pathogens Institute and Department of Animal Sciences, University of Florida, Gainesville, Florida, United States of America, 4 Immunology Section, Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela, 5 Biohelmintiasis Section, Instituto de Medicina Tropical, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela, 6 Centro para Estudios Sobre Malaria, Instituto de Altos Estudios “Dr. Arnoldo Gabaldon”, Instituto Nacional de Higiene, MPPS, Caracas, Venezuela, 7 Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland

Published
2016

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