Intended for healthcare professionals


Chagas disease in non-endemic settings

BMJ 2021; 373 doi: (Published 09 April 2021) Cite this as: BMJ 2021;373:n901
  1. Natalie Elkheir, visiting research fellow1,
  2. Jessica Carter, academic GP2,
  3. Ana García-Mingo, infectious disease registrar3,
  4. Peter Chiodini, consultant parasitologist1 4
  1. 1London School of Hygiene and Tropical Medicine, London, UK
  2. 2St George’s University, London, UK
  3. 3Whittington Health NHS Trust, London, UK
  4. 4Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to: N Elkheir Natalie.Elkheir{at}

End UK’s neglect of this serious disease

Neglected tropical diseases are no longer confined to the tropics. Chagas disease, one of 20 such diseases, is increasingly recognised as a public health problem in Europe and the US because of population migration.12 If we are to meet the World Health Organization’s goals to prevent, control, eliminate, and eradicate neglected tropical diseases by 2030,3 we must pay attention to how migration and non-endemic settings have moved the goalposts.

Chagas disease affects people from Latin America and can cause fatal cardiac and gastrointestinal complications if left untreated. Such complications include conduction defects, dysrhythmias (a cause of sudden cardiac death), dilated cardiomyopathy, gastrointestinal tract dilatation, and motor disorders.4 Reactivation in immunosuppression (particularly HIV) and congenital infection both confer high morbidity and mortality.5 The causative parasite of Chagas disease, Trypanosoma cruzi, is transmitted by blood feeding triatomine bugs in endemic settings (South America, Central America, and Mexico) but also through mother-to-child transmission, blood transfusion, and organ transplantation. These non-vectoral routes of transmission …

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