Neglected tropical diseases

Statement – Chagas disease in Europe

20 January 2010 | Geneva

© WHO/NTD Chagas in Europe 2009

Recommendations of an Informal Consultation meeting on Chagas Disease Control and Prevention in Europe, WHO headquarters, Geneva, Switzerland, 17–18 December 2009

Chagas disease (American trypanosomiasis) has emerged as an important public health challenge in Europe, where transmission to date has been non-vector-borne. Spread of the disease outside endemic countries in Latin America is mainly due to increased population mobility over the past few decades.

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Based on an evaluation of recently compiled epidemiological data by experts in many European countries, WHO convened an informal meeting of Chagas disease experts and European government health officials at which the following recommendations were made to European governments to adapt recent technical recommendations into public health decisions.

Cases of Chagas disease in Europe are known to occur from transfusion of contaminated blood, mother to child (congenital transmission) and during organ transplantation . It is estimated that the number of infected cases in Europe exceeds 80 000, with more than 3 900 laboratory-confirmed cases during the past 10 years in countries: Belgium, France, Italy, Spain, Switzerland and the United Kingdom.

Read an article from "PLOS Neglected Tropical Diseases": Prevalence, Clinical Staging and Risk for Blood-Borne Transmission of Chagas Disease among Latin American Migrants in Geneva, Switzerland
February 2010 | Volume 4 | Issue 2

"The majority of people infected by the parasite that causes Chagas disease and who are living in Europe do not know that they are affected by a disease …. it is an ethical duty to take care of these people …[and] carefully avoid to stigmatize people moving from one part of the world to the other…"

Dr. Jean Jannin, Coordinator, Intensified Disease Management, Department of Neglected Tropical Diseases, WHO, Geneva.

"… the main challenge that non-endemic countries have, at present, is to integrate the information that every country and every health institution has … and to share that information … "

Dr. Josep Mª Jansà Director, International Health and Tropical Medicine, University of Barcelona, Spain.

Sporadic cases are known to have occurred in other European countries including Austria, Croatia, Denmark, Germany, Luxembourg, the Netherlands, Norway, Portugal, Romania and Sweden.

Representatives of European governments and technical experts at the meeting strongly recommended:

  • setting up an integrated surveillance system to aggregate data and information about Chagas disease as provided by European national health authorities;
  • converting previous national technical recommendations into public health decisions;
  • implementing strict guidelines on control measures for blood banks and organ transplant systems to eliminate the risks of Chagas disease transmission;
  • testing of target groups such as women of childbearing age and patients with cardiac disorders at risk of having been infected earlier in endemic countries;
  • putting into practice early detection of cases and treatment of patients with congenital transmission;
  • providing greater access to diagnosis and medical care for anyone coming from countries/areas where Chagas disease is endemic;
  • enhancing the capacity of national health systems to correctly diagnose, manage and treat Chagas disease; and
  • harmonizing and validating diagnostic procedures through appropriate guidelines, with the support of appropriate public health institutions.

An increase in the number of cases in Europe led to the creation in 2007 of an informal network, the "Non Endemic Countries' Initiative" (NECI). This network comprises clinicians, biologists, public health specialists, academic experts, researchers and national health authorities working under the auspices of WHO.

At the meeting of the 6th European Congress of Tropical Medicine and International Health held between 6-10 September 2009 in Verona, Italy, the NECI reached broad consensus on the risks posed by the non-vector borne spread of Chagas disease in Europe and the need to implement measures to prevent its spread further.

Chagas disease was once almost entirely confined to Latin American countries. Patterns of population movement over the past decades show that the disease has spread at first to the United States and Canada and later to European countries.

Chagas disease has also been detected in Japan and Australia.