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Chagas Disease in Europe September 2011

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Chagas Disease in Europe September 2011 Listed for Impact Factor Europe’s journal on infectious disease epidemiology, prevention and control Special edition: Chagas disease in Europe September 2011 This special edition of Eurosurveillance reviews diverse aspects of Chagas disease that bear relevance to Europe. It covers the current epidemiological situation in a number of European countries, and takes up topics such as blood donations, the absence of comprehensive surveillance, detection and treatment of congenital cases, and difficulties of including undocumented migrants in the national health systems. Several papers from Spain describe examples of local intervention activities. www.eurosurveillance.org Editorial team Editorial board Based at the European Centre for Austria: Reinhild Strauss, Vienna Disease Prevention and Control (ECDC), Belgium: Koen De Schrijver, Antwerp 171 83 Stockholm, Sweden Belgium: Sophie Quoilin, Brussels Telephone number Bulgaria: Mira Kojouharova, Sofia +46 (0)8 58 60 11 38 or +46 (0)8 58 60 11 36 Croatia: Borislav Aleraj, Zagreb Fax number Cyprus: Chrystalla Hadjianastassiou, Nicosia +46 (0)8 58 60 12 94 Czech Republic: Bohumir Križ, Prague Denmark: Peter Henrik Andersen, Copenhagen E-mail England and Wales: Neil Hough, London [email protected] Estonia: Kuulo Kutsar, Tallinn Editor-in-Chief Finland: Hanna Nohynek, Helsinki Ines Steffens France: Judith Benrekassa, Paris Germany: Jamela Seedat, Berlin Scientific Editors Greece: Rengina Vorou, Athens Kathrin Hagmaier Hungary: Ágnes Csohán, Budapest Williamina Wilson Iceland: Haraldur Briem, Reykjavik Karen Wilson Ireland: Lelia Thornton, Dublin Assistant Editors Italy: Paola De Castro, Rome Alina Buzdugan Latvia: Jurijs Perevoščikovs, Riga Ingela Söderlund Lithuania: Milda Zygutiene, Vilnius Associate Editors Luxembourg: Robert Hemmer, Luxembourg Andrea Ammon, Stockholm, Sweden FYR of Macedonia: Elisaveta Stikova, Skopje Tommi Asikainen, Frankfurt, Germany Malta: Tanya Melillo Fenech, Valletta Mike Catchpole, London, United Kingdom Netherlands: Paul Bijkerk, Bilthoven Denis Coulombier, Stockholm, Sweden Norway: Hilde Klovstad, Oslo Christian Drosten, Bonn, Germany Poland: Malgorzata Sadkowska-Todys, Warsaw Johan Giesecke, Stockholm, Sweden Portugal: Judite Catarino, Lisbon Herman Goossens, Antwerp, Belgium Romania: Daniela Pitigoi, Bucharest David Heymann, London, United Kingdom Scotland: Norman Macdonald, Glasgow Irena Klavs, Ljubljana, Slovenia Slovakia: Lukáš Murajda, Martin Karl Kristinsson, Reykjavik, Iceland Slovenia: Alenka Kraigher, Ljubljana Daniel Lévy-Bruhl, Paris, France Spain: Elena Rodríguez Valín, Madrid Richard Pebody, London, United Kingdom Sweden: Aase Sten, Stockholm Panayotis T. Tassios, Athens, Greece Turkey: Aysegul Gozalan, Istanbul Hélène Therre, Paris, France European Commission: Paolo Guglielmetti, Luxembourg Henriette de Valk, Paris, France World Health Organization Regional Office for Europe: Nedret Emiroglu, Copenhagen Sylvie van der Werf, Paris, France Design / Layout Fabrice Donguy / Oudomphone Bounyavong www.eurosurveillance.org © Eurosurveillance, 2011 Contents Special edition: Chagas disease in Europe EuroTravNet: imported Chagas disease in nine European countries, 2008 to 2009 52 by JA Perez-Molina, A Perez-Ayala, P Parola, Y Jackson, Editorials S Odolini, R Lopez-Velez, for the EuroTravNet Network The hidden Chagas disease burden in Europe 2 Chagas disease at the crossroad of international by P Albajar-Viñas, J Jannin migration and public health policies: why a national screening might not be enough 57 A note from the editors: Chagas disease – neglected by C Di Girolamo, C Bodini, BL Marta, A Ciannameo, in Europe? 5 F Cacciatore by Eurosurveillance editorial team Surveillance and outbreak reports Chagas disease in Italy: breaking an epidemiological silence 6 by A Angheben, M Anselmi, F Gobbi, S Marocco, G Monteiro, D Buonfrate, S Tais, M Talamo, G Zavarise, M Strohmeyer, F Bartalesi, A Mantella, M Di Tommaso, KH Aiello, G Veneruso, G Graziani, MM Ferrari, I Spreafico, E Bonifacio, G Gaiera, M Lanzafame, M Mascarello, G Cancrini, P Albajar- Viñas, Z Bisoffi, A Bartoloni Chagas disease in Switzerland: history and challenges 14 by Y Jackson, F Chappuis Chagas disease in European countries: the challenge of a surveillance system 18 by L Basile, JM Jansà, Y Carlier, DD Salamanca, A Angheben, A Bartoloni, J Seixas, T Van Gool, C Cañavate, M Flores- Chávez, Y Jackson, PL Chiodini, P Albajar-Viñas, Working Group on Chagas Disease Surveillance of Chagas disease in pregnant women in Madrid, Spain, from 2008 to 2010 28 by MD Flores-Chavez, FJ Merino, S García-Bujalance, P Martin-Rabadán, P Merino, I García-Bermejo, A Delgado, J Cuadros, Working Group on Chagas Disease of Autonomous Community of Madrid Research articles Clinical, electrocardiographic and echocardiographic abnormalities in Latin American migrants with newly diagnosed Chagas disease 2005-2009, Barcelona, Spain 35 by L Valerio, S Roure, M Sabrià, X Balanzó, X Vallès, L Serés Perspectives Targeted screening and health education for Chagas disease tailored to at-risk migrants in Spain, 2007 to 2010 41 by M Navarro, A Perez-Ayala, A Guionnet, JA Perez-Molina, B Navaza, L Estévez, F Norman, M Flores-Chávez, R Lopez-Velez The current screening programme for congenital transmission of Chagas disease in Catalonia, Spain 46 by L Basile, I Oliveira, P Ciruela, A Plasencia, working group for developing the Catalonian Screening Programme for congenital transmission of Chagas disease This is a micrograph of Trypanosoma cruzi in a blood smear using Giemsa staining technique. This protozoan parasite, T. cruzi, is the causative agent for Chagas disease, also known as “American trypanosomiasis”. It is estimated that 16 - 18 million people are infected with Chagas disease, and of those infected, 50,000 will die each year. © CDC/Dr. Mae Melvin www.eurosurveillance.org 1 Editorials The hidden Chagas disease burden in Europe P Albajar-Viñas ([email protected])1, J Jannin1 1. World Health Organization (WHO), Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland Citation style for this article: Albajar-Viñas P, Jannin J. The hidden Chagas disease burden in Europe. Euro Surveill. 2011;16(38):pii=19975. Available online: http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19975 Article published on 22 September 2011 Chagas disease in non-endemic countries - that is, in was young, with high rates of labour force participation countries outside Latin America with exceptional or no and relatively high rates of educational attainment, vectorial transmission such as in Europe - has come with great capacity to integrate into European socie- to light since the beginning of 2000. The emergence ties. Additionally, they represented a prime example of of the disease in those countries was mainly linked to the current worldwide trend towards the feminisation population mobility, notably migration. During the last of migration, which is relevant in the context of Chagas century, Chagas disease cases were detected in non- disease because of the possibility of congenital trans- endemic countries in North America (Canada and the mission from infected mothers. Finally, there was also United States) and the Western Pacific Region (mainly a significant number of undocumented migrants, and Australia and Japan), and only more recently in Europe that irregular migration posed a significant challenge [1,2]. to governments [7]. The history of Chagas disease in Europe can be divided The year 2007 marked the beginning of a third period in three significant periods. The initial period, started in the history of Chagas disease in Europe, character- at the beginning of the 1980s, when the first Chagas ised by various initiatives launched at different levels. disease case in Europe was published [3], 72 years In July 2007, the World Health Organization (WHO) and after Carlos Ribeiro Justiniano Chagas discovered the the Pan American Health Organization (PAHO) con- disease in Brazil [4]. Since then, successive sporadic vened a meeting entitled Revisiting Chagas disease: publications have started to draw attention to the exist- from a Latin American health perspective to a glo- ence of Chagas disease cases in different European bal health perspective, with participants of 28 Latin countries and the existence of the responsible para- American and non-Latin American countries where the site Trypanosoma cruzi. These publications describe disease was present. A major outcome of the meeting infection transmission in Europe through different was to highlight the presence of T. cruzi infection out- non-vectorial routes such as transfusional, congenital side Latin America in the so-called non-endemic coun- and laboratory-accident transmission, as well as spo- tries and an initiative to deal with Chagas disease in radically through the arrival of infected travellers such non-endemic countries, supplementing the existing as tourists, people visiting friends and relatives and intergovernmental initiatives for the control of Chagas adopted children [5]. disease in Latin America [8]. The year 2000 marked the beginning of a second With the main objectives of assessing the burden of period, characterised by an increase in the number Chagas disease as a public health problem in non- of cases reported in the scientific literature in many endemic countries and formulating an appropriate European countries [6]. According to the International response, the WHO organised a series of meetings Organization for Migration
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