title: Molecular epidemiology of human oral Chagas disease outbreaks in Colombia.
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.
  
  
  RESULTS
  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.
authors: Centro de Investigaciones en Microbiología y Parasitología Tropical (CIMPAT), Universidad de Los Andes, Bogotá, Colombia.
authors: Juan David
authors: JD
authors: Ramírez
authors: Marleny
authors: M
authors: Montilla
authors: Zulma M
authors: ZM
authors: Cucunubá
authors: Astrid Carolina
authors: AC
authors: Floréz
authors: Pilar
authors: P
authors: Zambrano
authors: Felipe
authors: F
authors: Guhl
mesh_terms: D000328:Adult; D014355:Chagas Disease / Q000453:epidemiology* / Q000469:parasitology* / Q000635:transmission; D003105:Colombia / Q000453:epidemiology; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D008297:Male; D018895:Microsatellite Repeats; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D017422:Sequence Analysis, DNA; D014349:Trypanosoma cruzi / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D055815:Young Adult