An Unfolding Tragedy of Chagas Disease in North America

In North America, Chagas disease (American trypanosomiasis caused by Trypanosoma cruzi) was first reported in Mexico in 1940 [1] and in the United States in Texas in 1955 [2]. However, based on ancient mummified remains discovered in the Rio Grande Valley, human T. cruzi infection has been present in North America since prehistoric times [3].

T. cruzi is a protozoan hemoflagellate that is most commonly transmitted to humans by blood-feeding triatomine bugs followed by autoinoculation [2]. Chagas disease can also be transmitted to man by non-vectorial mechanisms, namely mother-to-child-transmission [4], blood transfusion, and orally through food-borne transmission. When untreated in the acute stage, the disease becomes chronic and up to 30% or more of infected individuals will progress to Chagasic cardiomyopathy or megavisceral disease associated with debilitating morbidity or death. Today, Chagas disease is a leading cause of heart disease among people living in extreme poverty in the Western Hemisphere, especially in Latin America, where it is a major parasitic killer [2].

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Neglected Infections of Poverty among the Indigenous Peoples of the Arctic

The neglected tropical diseases are not always exclusively tropical as defined by their endemicity between the Tropic of Cancer in the northern hemisphere and in the Tropic of Capricorn in the southern hemisphere. Indeed, in previous articles, it has been pointed out that neglected infections occur wherever extreme poverty occurs [1], even in pockets of poverty in North America and Europe [2]–[4]. One of the more dramatic illustrations of poverty as the single most important determinant of neglected infections among human populations is the observation that these conditions occur among the poorest people living in the Arctic region.

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