Acute Chagas disease outbreak of possible oral transmission in Merida, Venezuela

An acute Chagas disease outbreak associated with oral transmission, detected in a rural village of Merida-Venezuela, is reported. The massive transmission due to ingestion of food contaminated with Trypanosoma cruzi generated, in 5 members of the same family, severe clinical features causing acute myocarditis in two of them (40%) including a fatal case. Parasitological, serological and molecular (PCR) examination of samples from the 5 patients involved in the outbreak, revealed T. cruzi blood circulating tripomastigotes, anti-T. cruzi specific antibodies (IgM; IgG) and the presence of T. cruzi respectively. The recorded clinical pattern detected a total of 17 signs or symptoms with an average +/- SD 12 +/- 3 per patients (range = 9-16) showing simultaneity in 8 symptoms and a 20% mortality. A remarkable characteristic detected during the study was the presence of internal facial swollen with paresthesia in tongue in absence of the typical Romana's sign or chagoma commonly found in Chagas disease-infection caused by vector transmission. The possible oral transmission and the potential of the findings from the epidemiological viewpoint are discussed.