Prevention of oral transmission

Over the last few years, research centers have emerged in the Amazonian region and elsewhere, which has led to an increase in the knowledge of vectors, reservoirs and the symptomatology of acute cases found in the areas where few sporadic cases or chronic cases have been reported. The transmission of T. cruzi through contaminated food and beverages was evaluated in a technical consultation of PAHO/WHO.¹³⁷ It was concluded that oral transmission of T. cruzi was an important consideration that warranted inclusion in the National Programs of Prevention and Control of Chagas disease.

Risk factors involved in oral transmission are directly bound to the consumption of food or beverages contaminated by the parasite. These food and beverages are either naturally contaminated or contaminated during their preparation.

In 2007, Brazil’s Ministry of Health, with the departments of surveillance and prevention, in conjunction with the Evandro Chagas Institute, FUNASA, ANVISA, the Ministry of Agriculture and Fishing, and other institutions, proposed several measures to prevent and survey the preparation and production of food and beverages likely to be contaminated with T. cruzi, including acai” juice, which is very important to the economy of northern Brazil. At the industrial level, it was recommended that acai juice should be pasteurized. For small producers (on the family scale), recommendations were proposed to improve hygiene and minimize the risk of juice contamination during fruit collection, transportation, and handling. While kissing bugs are primarily responsible for the contamination of food and beverages, it is obvious that to prevent oral transmission, vector control with insecticides and/ or improvements to homes do not apply. The only alternative is education for the communities exposed to the risk of oral transmission and improving hygiene when preparing homemade food and beverages.¹³²