There are two forms of trypanosomiasis, American and African. American trypanosomiasis occurs in Mexico, south and Central America.
American trypanosomiasis is transmitted through the skin by infected reduviid bugs (also known as 'kissing bugs'). These bugs inhabit the thatched roofs and cracks in the walls of mud huts in extensive areas of southern and central America. The bugs come out at night, transmitting infection by rubbing the organism, which is passed in their excreta, into the bite wound as they feed.
In recent years, oral transmission of infection via contaminated fruit juice has been the cause of outbreaks in Brazil (2005) and Venezuela (2007). Research indicates that foodborne transmission of infection may occur more frequently than currently recognised.
Infection may also be acquired congenitally and by blood transfusion.
The majority of infections will show no symptoms. Children who become infected may have fever, swollen lymph glands, enlarged liver and feel generally unwell. Conjunctivitis may be present if the infection enters via the eye. The site of infection (the bite) may become inflamed and a sore will develop that can persist for around 8 weeks.
Some of those infected will progress to a chronic illness that is lifelong and may cause heart disease and problems with the gastrointestinal system.
Travellers suspected of having this illness should be referred to a specialist in infectious diseases or tropical medicine for treatment. There are medicines available for treatment of the early stage of the illness but they are of little benefit in the chronic stage.
Recommendations for travellers
- No vaccine is available to prevent trypanosomiasis.
- Prevention is by avoidance of reduviid bug bites.
- If possible avoid living in mud huts in risk areas.
- Treat bedding and clothing with insecticide.
- Sleep under an impregnated mosquito net.
- Report any bites promptly on return from risk area.
- Do not consume locally produced fruit juice from markets and street vendors.
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