[Chagas disease (American trypanosomiasis) in France]

Chagas disease is an anthropozoonotic infection caused by Trypanosoma cruzi, transmitted by a hematophagous triatomine insect vector belonging to the Reduviidae family, while taking a blood meal. There is a large reservoir of wild and domestic mammals. Human contamination may come via vectorial, transplacental, and digestive routes, blood transfusion, organ or tissue transplantation, and by accident. The disease has two phases. The acute phase, oligosymptomatic, is frequently undiagnosed. It is followed by a chronic phase. Most of the infected patients remain asymptomatic all life-long. But 10 or 25 years later, one third of infected patients present with cardiac or digestive complications. Chagas disease is endemic in Latin America, from Mexico to Argentina. In French Guyana, the prevalence of the infection was estimated at 0.25% and 0.5% (from 500 to 1000 infected patients) on blood samples collected from 1992 to 1998. In 2000 and 2009, 192 cases were diagnosed. In this district, there is no established domestic vector and the transmission risk is low. The vector is very easily found in forest habitats and even in the peridomestic persistent forest, with an infection rate of 46 to 86%. Vectorial eradication is impossible. Fighting against Chagas disease in French Guyana relies more on individual protection, control of blood transfusion, prevention of mother-to-child transmission, diagnosis, and treatment of infected patients than on vectorial control.