Trypanosoma cruzi and Trypanosoma rangeli in Acre, Brazilian Amazonia: Coinfection and Notable Genetic Diversity in an Outbreak of Orally Acquired Acute Chagas Disease in a Forest Community, Wild Reservoirs, and Vectors

Acute Chagas disease (ACD) caused by Trypanosoma cruzi has emerged as a major food-borne in Brazilian Amazonia. For the first time, we characterized an outbreak of orally acquired ACD Acre, forest community Seringal Miraflores, affecting 13 individuals who shared pulp açai palm berries: 11 adults and two children (one newborn), all diagnosed thick-drop blood smears. The fluorescent fragment length barcoding method, which simultaneously identifies species/genotypes trypanosomes samples, uncovered unprecedented genetic diversity patients from single ACD: T. TcI patients, mostly concomitantly with non-pathogenic rangeli genotypes TrA or TrB, TcI, TcIV, TrB child. presented persistent fever, asthenia, myalgia, edema face lower limbs, hepatosplenomegaly and, rarely, cardiac arrhythmia. clinical symptoms were not correlated to gender, age, trypanosome species genotypes. inferred SSU rRNA phylogenetic analyses humans, triatomines sylvatic hosts included sequences humans southwestern (Acre Rondônia) Amazonia, TcI/TcIV Rhodnius spp. Acre. transmission cycles genetically different landscapes changed deforestation for human settlements increasing production is novel scenario favoring