[Prevention concerning the different alternative routes for transmission of Trypanosoma cruzi in Brazil]

Vectorial, transfusion and congenital are considered the main transmission mechanisms in human Chagas disease. Alternative mechanisms are accidental, oral and by organ transplantation. Other hypothetic mechanisms could be by other vectors, sexual, criminal and by means of marsupial anal secretions. The present accorded strategies for prevention are: CONGENITAL: early case detection and immediate treatment. If possible, start during the pre natal period, throughout mothers serology, performing parasitological tests in the new born from positive women. For positive cases, immediate treatment; for those negative babies, conventional serology at the 8th month, treating specifically those with positive results. ACCIDENTAL TRANSMISSION: Rigorous training and utilization of protection equipments. IF accident occurs, immediate disinfection, conventional serology and beginning of specific treatment by ten days. Revision of the serology after 30 days: if positive, extend the treatment until the total dose (60 days or more). ORGAN TRANSPLANTATION: previous serology for donor and receptor. When the former is infected and the last negative, cancel the surgery or install the specific treatment by ten days before the surgery for the donor, followed by the receptor during ten days after the transplantation. ORAL TRANSMISSION: Specific measures are not available, food hygiene is recommended, including the cooking of meats delivered from possible reservoirs. Nowadays, the detection and immediate treatment of the case is recommended, followed by active research of new cases around the detected one.