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Mother-to-Child Transmission of Congenital Chagas Disease, Japan - Volume 20, Number 1—January 2014 - Emerging Infectious Disease journal - CDC

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Mother-to-Child Transmission of Congenital Chagas Disease, Japan - Volume 20, Number 1—January 2014 - Emerging Infectious Disease journal - CDC

link to Volume 20, Number 1—January 2014

Volume 20, Number 1—January 2014


Mother-to-Child Transmission of Congenital Chagas Disease, Japan

Kazuo Imai, Takuya MaedaComments to Author , Yusuke Sayama, Kei Mikita, Yuji Fujikura, Kazuhisa Misawa, Morichika Nagumo, Osamu Iwata, Takeshi Ono, Ichiro Kurane, Yasushi Miyahira, Akihiko Kawana, and Sachio Miura
Author affiliations: National Defense Medical College, Saitama, Japan (K. Imai, T. Maeda, K. Mikita, Y. Fujikura, K. Misawa, M. Nagumo, T. Ono, Y. Miyahira, A. Kawana)Japanese Red Cross Society, Tokyo, Japan (Y. Sayama, S. Miura)Tokai University Oiso Hospital, Kanagawa, Japan (O. Iwata)National Institute of Infectious Diseases, Tokyo (I. Kurane)


We report a patient with congenital Chagas disease in Japan. This report reemphasizes the role of neglected and emerging tropical diseases in the era of globalization. It also indicates the need for increased vigilance for detecting Chagas disease in non–disease-endemic countries.
Chagas disease, which is caused by the pathogenic protozoa Trypanosoma cruzi, was previously endemic only to Central and South America but is now estimated to affect up to 10 million persons worldwide (1). Recent unprecedented trends in globalization have been accompanied by the migration of ≈14 million persons from disease-endemic regions to North America, Europe, Japan, and Australia. Consequently, and as predicted, sporadic reports of patients with chronic Chagas disease have emerged, and documented cases have presumably been caused by chronically infected persons who migrated from disease-endemic countries (2). Despite the wide geographic spread of patients with Chagas disease, cases of congenital transmission in non–disease-endemic countries have been documented (Table 1) (3)
It is estimated that ≈300,000 immigrants from Latin America, to which Chagas disease is endemic, are currently living in Japan and that ≈34,000 births from these immigrants have occurred in the past 10 years. However, vertical transmission of the disease in Japan has not been detected, probably because of the lack of screening programs for at-risk pregnant women and the disregard for the silent clinical manifestation of congenital Chagas disease.
The World Health Organization recommends that each country should strengthen its national and regional capacity to prevent and control congenital transmission of infectious pathogens while improving case management (4). We report a patient with congenital Chagas disease in Japan. We also highlight the need for increasing awareness of congenital transmission and urge establishment of an appropriate diagnostic and treatment system for Chagas disease in nonendemic countries.


This study was partly supported by a grant for Research on Regulatory Science of Pharmaceuticals and Medical Devices from the Ministry of Health, Labor and Welfare, Japan (H23-iyaku-ippan-003).


  1. Jannin JSalvatella R, editors. Quantitative estimates of Chagas disease in the Americas. Washington (DC): Pan American Health Organization; 2006.
  2. Schmunis GAEpidemiology of Chagas disease in non-endemic countries: the role of international migration. Mem Inst Oswaldo Cruz2007;102:7585DOIExternal Web Site IconPubMedExternal Web Site Icon
  3. Oliveira ITorrico FMuñoz JGascon JCongenital transmission of Chagas disease: a clinical approach. Expert Rev Anti Infect Ther2010;8:94556DOIExternal Web Site IconPubMedExternal Web Site Icon
  4. World Health Organization. Chagas disease: control and elimination. A62/17. 62nd World Health Assembly. Geneva, May 18–22, 2009 [cited 2013 Sep 17]. pdf_files/A62/A62_17-en.pdf Adobe PDF fileExternal Web Site Icon.
  5. Marcon GEAndrade PDde Albuquerque DMWanderley da Silva Jde Almeida EA,Guariento MEUse of a nested-polymerase chain reaction (N-PCR) to detectTrypanosoma cruzi in blood samples from chronic chagasic patients and patients with doubtful serologies. Diagn Microbiol Infect Dis2002;43:3943DOIExternal Web Site IconPubMedExternal Web Site Icon
  6. World Health OrganizationThe leishmaniases. Report of a WHO Expert Committee.World Health Organ Tech Rep Ser1984;701:1140 .PubMedExternal Web Site Icon
  7. Rassi ALuquetti AO. Specific treatment for Trypanosoma cruzi infection (Chagas disease). In: Tyler KM, Miles MM, editors. American trypanosomiasis. Boston: Kluwer Academic Publishers; 2013. p. 117–25.
  8. Schmunis GAYadon ZEChagas disease: a Latin American health problem becoming a world health problem. Acta Trop2010;115:1421DOIExternal Web Site IconPubMedExternal Web Site Icon
  9. Muñoz JGómez i Prat JGállego MGimeno FTreviño BLópez-Chejade PClinical profile of Trypanosoma cruzi infection in a non-endemic setting: immigration and Chagas disease in Barcelona (Spain). Acta Trop2009;111:515DOIExternal Web Site IconPubMedExternal Web Site Icon
  10. Satoh FTachibana HHasegawa IOsawa MSudden death caused by chronic Chagas disease in a non-endemic country: autopsy report. Pathol Int2010;60:23540 . DOIExternal Web Site IconPubMedExternal Web Site Icon
  11. Torrico FAlonso-Vega CSuarez ERodriguez PTorrico MCDramaix MMaternalTrypanosoma cruzi infection, pregnancy outcome, morbidity, and mortality of congenitally infected and non-infected newborns in Bolivia. Am J Trop Med Hyg2004;70:2019 .PubMedExternal Web Site Icon
  12. Navarro MPerez-Ayala AGuionnet APerez-Molina JANavaza BEstevez LTargeted screening and health education for Chagas disease tailored to at-risk migrants in Spain, 2007 to 2010. Euro Surveill2011;16:19973 .PubMedExternal Web Site Icon
  13. Altcheh JBiancardi MLapeña ABallering GFreilij HCongenital Chagas disease: experience in the Hospital de Niños, Ricardo Gutiérrez, Buenos Aires, Argentina. Rev Soc Bras Med Trop2005;38:415 .PubMedExternal Web Site Icon



Suggested citation for this article: Imai K, Maeda T, Sayama Y, Mikita K, Fujikura Y, Misawa K, et al. Mother-to-child transmission of congenital Chagas disease, Japan. Emerg Infect Dis [Internet]. 2014 Jan [date cited]. Web Site Icon
DOI: 10.3201/eid2001.131071

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