Globalization of Chagas disease (American trypanosomiasis): the situation in Europe and Belgium.

Trypanosoma cruzi, the protozoan agent of Chagas disease infects ten million people in Latin America where it is the main cause of cardiac failure. It is transmitted by insect vectors in endemic areas, and also congenitally, by transfusion of infected blood, transplantation of infected organs and oral route in both endemic and non-endemic areas. Since the 1990s, a constant decrease of incidence of infection is observed in Latin America, where vector control programmes and improvement of blood banks have been implemented. However, the important migration flows in the last decades for economic reasons have brought considerable numbers of Latin American subjects infected with T. cruzi, in US, Europe, Japan and Australia. Such globalization of T. cruzi infection/Chagas disease has been confirmed in an WHO historical meeting in 2007, emphasizing the importance of a wise management of such patients and the need of implementing control measures in blood banks, transplantation centres and maternities of involved countries in non-endemic areas. This paper considers these elements and the present situation of Chagas disease in Europe and Belgium.