Chagas Testing Icky things that can drop on you from your thatched roof! Abc 7-04 Chagas Disease
- Icky things that can drop on you from your thatched roof!
- ABC 7-04
- Acute: Uncommon- Chagoma(primary inflammatory skin swelling), lymphadenopathy, facial, eye swelling, encephalitis
- Chronic- (often asymptomatic for >20 years)
- Cardiac: Rhythm defects (RBBB), CHF
- GI: Esophageal and Colonic dysmotility- megaesophagus and megacolon
- Hager: NEJM (1991) 325:763
- Prentation: Symptomatic AV block, CHF, anginal chest pain, sudden death, sustained ventricular tachycardia
- EKG frequently suggested coronary artery disease. Majority had some EKG abnormality.
- LV aneurysm 14/25, segmental akinesia 5/25 and diffuse hypkinesia 3/25.
- Angiography required to rule out coronary disease
- Limited geographic or ethnic origin screening proposed….but
- 2/7 transfusion transmissions occurred in Western Canada..donors were Mennonite Missionaries who had spent time in S. America
- Most recent transfusion transmission occurred in Rhode Island, following implementation of a diversity effort to increase donations among Hispanics.
- Fastest growing minorities in Minnesota, US are Hispanics (Note: in much of Florida and California, they aren’t the minority!)
- Many blood centers implementing collection programs targeting Hispanic donations (translating/preparing Spanish language materials & donor history)
Chagas Screening in Central and South America
Challenges to new testing
Chagas confirmatory testing
- Various unlicensed assays available for confirmation including line immunoassay (LIA), Immunofluorescence, and radioactive immunoprecipitation assay (RIPA).
- RIPA currently considered “gold standard” but only available @ ARC-Holland lab- D. Leiby and Dr. Kirchoff- University of Iowa
Chagas and the press
- ARC very active in promoting need for Chagas testing.
- Many recent lay press articles on potential for Chagas testing.
- Several US Manufacturer’s currently working on EIA assay development and clinical trials planned. (Keep tuned….)
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