02416nas a2200253   4500000000100000008004100001260003700042653002400079653005700103653002700160100001700187700001600204700001300220700002200233700001200255700001700267700001600284245010400300856009900404300000900503490000700512520162900519022001402148       2024                            d  bPublic Library of Science (PLoS)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health10afoodborne transmission1 aRobertson LJ1 aHavelaar AH1 aKeddy KH1 aDevleesschauwer B1 aSripa B1 aTorgerson PR1 aBuonfrate D00aThe importance of estimating the burden of disease from foodborne transmission of Trypanosoma cruzi  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011898&type=printable  a1-160 v183 a<p>Chagas disease (ChD), caused by infection with the flagellated protozoan, Trypanosoma cruzi, has a complicated transmission cycle with many infection routes. These include vector-borne (via the triatomine (reduviid bug) vector defecating into a skin abrasion, usually following a blood meal), transplacental transmission, blood transfusion, organ transplant, laboratory accident, and foodborne transmission. Foodborne transmission may occur due to ingestion of meat or blood from infected animals or from ingestion of other foods (often fruit juice) contaminated by infected vectors or secretions from reservoir hosts. Despite the high disease burden associated with ChD, it was omitted from the original World Health Organization estimates of foodborne disease burden that were published in 2015. As these estimates are currently being updated, this review presents arguments for including ChD in new estimates of the global burden of foodborne disease. Preliminary calculations suggest a burden of at least 137,000 Disability Adjusted Life Years, but this does not take into account the greater symptom severity associated with foodborne transmission. Thus, we also provide information regarding the greater health burden in endemic areas associated with foodborne infection compared with vector-borne infection, with higher mortality and more severe symptoms. We therefore suggest that it is insufficient to use source attribution alone to determine the foodborne proportion of current burden estimates, as this may underestimate the higher disability and mortality associated with the foodborne infection route.</p>
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