寄生虫和矢量:原始叛徒

Triatomine bugs and their trypanosomes are popping up in New Orleans, a beloved mecca of food, arts, and music- reminding us that parasites and their vectors don’t play by our rules.

TheWorld Health Organization疾病控制中心最近宣布SARS-COV2是通过气溶胶液滴传输的。一年多来,我们已经知道了这个关键的小花絮,但是该声明终于使它成为现实吗?

In many respects, the answer is yes. When something is OFFICIALLY ANNOUNCED, resources start flowing to address the OFFICIAL PROBLEM. Of course, less so with COVID-19, since it turned into a bonified pandemic. But for many other diseases, this is a real issue. Chagas disease, for example. Last month we celebrated a day designated by the World Health Organization to call attention to this wide-spread, parasitic disease afflicting millions of people in almost every country in the western hemisphere.

Despite millions of people suffering from Chagas disease, a life-long parasitic infection that can lead to heart failure, the disease is not well-known in the US because it is officially NOT TRANSMITTED HERE. Despite 112 years of research on the disease, there is no vaccine (and there certainly is no Operation Warp Speed for a disease that is NOT HERE). The parasite that causes Chagas disease,Trypanosoma cruzi, transmits in a number of ways, including through contact with the feces of triatomine bugs. Like HIV, measles, and likely COVID-19, Chagas disease is a zoonotic disease, meaning we share it with animals.

人畜共患病可以从动物跳到人和后退。它们是行星和人类健康的交织性质的象征,也是不断破坏非人类栖息地的症状。查加斯病特别复杂,因为它是由寄生虫引起的,由虫子传播,并由包括我们在内的哺乳动物托管。结果,该疾病在许多不同的景观 - 森林,村庄以及两者之间的一切之间传播。

There are a lot of assumptions surrounding whereT. Cruzitransmission happens, and by what. Most of these assumptions are based on an absence of evidence, starting with Chagas disease being a rural disease of poverty. While, yes, Chagas disease is transmitted in rural areas, the disease is also found in urban areas.T. Cruzi- 在拉丁美洲的城市中发现了受感染的接吻虫子 -Sao Paulo,Rio de Janeiro,Cochabamba,arequipa,加拉加斯- 清单继续增长。

第二个假设是接吻虫子是“边界南部”问题。在美国,对三角胺的研究正在上升,这并不是因为尽管有些新闻媒体可能会告诉您,但这些虫子与中美洲移民一起搭便车。这些虫子已经在这里已经数百万年了。事实是,只有现在人们才开始感兴趣,这带来了第三个Chagas Tenet,尽管这通常是正确的 - 如果您寻找三眼粒,您会发现它们。在2009年,美国的亲吻虫子开始受到很多关注部署到伊拉克的炸弹杀死狗开始出现由于T. Cruzi收紧。由于Chagas病严格在美洲传播,因此注意力转移到了受过训练的地方 - 得克萨斯州圣安东尼奥。自然,美国政府为这个问题投入了很多钱。一系列后续调查显示,生活在德克萨斯州的军事狗狗窝及其周围的四种亲吻虫子,以及感染的狗T. Cruzi在德克萨斯州发现。A slew of new kissing bug studies followed, which are still happening. Just this year, astudy of 476 government working dogs in 40 US states found aT. Cruzi血清阳性为12.2%(58/476)。这些研究继续揭示,在德克萨斯州和大美国的人类主导地区(即,不仅是“自然区域”)中,接吻虫子到处都是。具有讽刺意味的是,2009年是100Thanniversary of the discovery ofT. Cruzi卡洛斯·恰加斯在分钟as Gerais, Brazil. I can’t help but wonder what all the money thrown at Chagas in military pups could have done for the millions of people suffering from Chagas disease throughout Latin America and the Caribbean.

啮齿动物的地图和流行率Trypanosoma cruzi在新奥尔良地区。Ghersi及其同事的数字研究

但是,我们不是在这里谈论美国军事支出,我们也不在这里谈论德克萨斯州。我们在这里谈论N'awlins,Jumblaya市,爵士乐和……亲吻虫子?在一个游客涌向吸收其独一无二的美食,艺术和文化场景的城市中,最近的研究表明,显然是亲吻虫子和T. Cruzi-infected mammals want to be there too. In their work recently published in Parasites and Vectors,Ghersi等。发现11%的啮齿动物是阳性的T. Cruzi,包括从法国区等旅游热点采样的人。而且仅几周前Dumonteil et al. reported 25% of shelter cats sampled in southern Louisiana to be positive forT. CruziIn另一项研究, 45 bugs collected from human homes and animal shelters were analyzed molecularly to determine the hosts on which the bugs were feeding, and they found the bugs to be feeding opportunistically across a wide range of species, including birds, reptiles, amphibians, and mammals, both domestic and synanthropic. Finally,另一项研究从195个序列中发现Triatoma sanguisugacollected in and around human residences in Orleans Parish (i.e., county), human blood meals were found in 162 of them.

最重要的是,虫子的主要宿主物种是人类及其动物。这一发现使我认为另一个Chagas Dogma将会脑海T. Cruzi美国的传播严格是enzootic。我预测,更大的访问分子工具可以识别众多血液粉宿主物种,并与更多的人寻找虫子,将这些chagas传播教条转变为基于证据的接受T. Cruzi通过在包括城市地区在内的多个景观中亲吻美国的虫子,通过接吻人类传播给人类。不,这不是那么频繁,也不,没有必要吓坏了。但,as I have written about before, these dogmas and labels of, ‘this happens here but not here’ and, ‘to them but not us’ are not helpful. These labels serve as barriers to accessing resources and raising awareness for those who need to be aware (medical professionals, people living in areas with the bugs). We as a global health community need to stop slapping these labels on and filing them in the ‘forever’ category, and start accepting that transmission happens where it happens. Maybe then we will learn to be light on our toes and someday perhaps respond in time.

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