Epidemiological Factors Related to Foodborne Transmission of Chagas Disease

The increasing number of cases, clusters and outbreaks of foodborne Chagas disease are likely to be due to a number of factors that have resulted in conditions for oral transmission becoming more favourable. This is, in part, emphasised by vector-control initiatives reducing the spread of vectorborne transmission. In this chapter we explore a range of epidemiological factors that have facilitated the foodborne transmission of Chagas disease. These factors include human migration and urban development, both of which have, in their turn, impacted upon important facets in the lifecycle of T. cruzi, such as the invasion and domiciliation of triatomine species, and alterations in the population dynamics of triatomines and wild animal reservoirs. It should be remembered that although transmission routes may be understood, they seldom remain static and different factors may alter and tweak different aspects. For the future, factors such as climate change (resulting in wider distribution of some vectors), the emergence of new vectors, the migration of individuals infected with T. cruzi to non-endemic areas, and globalization of the food-chain may be suggested as such as factors that may ensure that oral transmission of T. cruzi continues and expands, both in endemic areas, but also in other regions beyond the traditionally endemic areas.