Molecular epidemiology of human oral Chagas disease outbreaks in Colombia
File(s)
Author(s)
Type
Journal Article
Abstract
Background
Trypanosoma cruzi, the causative agent of Chagas disease, displays significant genetic variability revealed by six Discrete Typing Units (TcI-TcVI). In this pathology, oral transmission represents an emerging epidemiological scenario where different outbreaks associated to food/beverages consumption have been reported in Argentina, Bolivia, Brazil, Ecuador and Venezuela. In Colombia, six human oral outbreaks have been reported corroborating the importance of this transmission route. Molecular epidemiology of oral outbreaks is barely known observing the incrimination of TcI, TcII, TcIV and TcV genotypes.
Methodology and Principal Findings
High-throughput molecular characterization was conducted performing MLMT (Multilocus Microsatellite Typing) and mtMLST (mitochondrial Multilocus Sequence Typing) strategies on 50 clones from ten isolates. Results allowed observing the occurrence of TcI, TcIV and mixed infection of distinct TcI genotypes. Thus, a majority of specific mitochondrial haplotypes and allelic multilocus genotypes associated to the sylvatic cycle of transmission were detected in the dataset with the foreseen presence of mitochondrial haplotypes and allelic multilocus genotypes associated to the domestic cycle of transmission.
Conclusions
These findings suggest the incrimination of sylvatic genotypes in the oral outbreaks occurred in Colombia. We observed patterns of super-infection and/or co-infection with a tailored association with the severe forms of myocarditis in the acute phase of the disease. The transmission dynamics of this infection route based on molecular epidemiology evidence was unraveled and the clinical and biological implications are discussed.
Author Summary
Chagas disease represents a serious health problem affecting more than 10 million people in the Americas. The oral transmission route has emerged as a new epidemiological scenario that needs to be considered in prevention and control strategies. Herein was developed a high-resolution molecular characterization using mtMLST and MLMT tools in order to unravel the molecular epidemiology and transmission dynamics drivers in six well-characterized human oral outbreaks in Colombia. We observed the majority of clones typed as TcI and one clone as TcIV. The analysis of mitochondrial haplotypes allowed us to observe a high frequency of sylvatic haplotypes and a low proportion of domestic haplotypes. Likewise, a tailored allelic profile by each outbreak was observed. Our results suggest that sylvatic populations of T. cruzi are the causative agents of Chagas disease oral outbreaks and these findings should help to pursue new initiatives of control and prevention in those areas where domiciliated vectorial transmission has been interrupted.
Trypanosoma cruzi, the causative agent of Chagas disease, displays significant genetic variability revealed by six Discrete Typing Units (TcI-TcVI). In this pathology, oral transmission represents an emerging epidemiological scenario where different outbreaks associated to food/beverages consumption have been reported in Argentina, Bolivia, Brazil, Ecuador and Venezuela. In Colombia, six human oral outbreaks have been reported corroborating the importance of this transmission route. Molecular epidemiology of oral outbreaks is barely known observing the incrimination of TcI, TcII, TcIV and TcV genotypes.
Methodology and Principal Findings
High-throughput molecular characterization was conducted performing MLMT (Multilocus Microsatellite Typing) and mtMLST (mitochondrial Multilocus Sequence Typing) strategies on 50 clones from ten isolates. Results allowed observing the occurrence of TcI, TcIV and mixed infection of distinct TcI genotypes. Thus, a majority of specific mitochondrial haplotypes and allelic multilocus genotypes associated to the sylvatic cycle of transmission were detected in the dataset with the foreseen presence of mitochondrial haplotypes and allelic multilocus genotypes associated to the domestic cycle of transmission.
Conclusions
These findings suggest the incrimination of sylvatic genotypes in the oral outbreaks occurred in Colombia. We observed patterns of super-infection and/or co-infection with a tailored association with the severe forms of myocarditis in the acute phase of the disease. The transmission dynamics of this infection route based on molecular epidemiology evidence was unraveled and the clinical and biological implications are discussed.
Author Summary
Chagas disease represents a serious health problem affecting more than 10 million people in the Americas. The oral transmission route has emerged as a new epidemiological scenario that needs to be considered in prevention and control strategies. Herein was developed a high-resolution molecular characterization using mtMLST and MLMT tools in order to unravel the molecular epidemiology and transmission dynamics drivers in six well-characterized human oral outbreaks in Colombia. We observed the majority of clones typed as TcI and one clone as TcIV. The analysis of mitochondrial haplotypes allowed us to observe a high frequency of sylvatic haplotypes and a low proportion of domestic haplotypes. Likewise, a tailored allelic profile by each outbreak was observed. Our results suggest that sylvatic populations of T. cruzi are the causative agents of Chagas disease oral outbreaks and these findings should help to pursue new initiatives of control and prevention in those areas where domiciliated vectorial transmission has been interrupted.
Date Issued
2013-02-01
Date Acceptance
2012-12-14
Citation
PLoS Neglected Tropical Diseases, 2013, 7 (2), pp.1-7
ISSN
1935-2727
Publisher
Public Library of Science
Start Page
1
End Page
7
Journal / Book Title
PLoS Neglected Tropical Diseases
Volume
7
Issue
2
Copyright Statement
© 2013 Ramírez et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000315644900010&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Parasitology
Tropical Medicine
TRYPANOSOMA-CRUZI-I
TRANSMISSION
IDENTIFICATION
GENOTYPES
VARIABILITY
RELEVANCE
CONSENSUS
SEQUENCE
STRAINS
REGIONS
Publication Status
Published
Article Number
ARTN e2041
Date Publish Online
2013-02-21