The hidden Chagas disease burden in Europe

Chagas disease in non-endemic countries -that is, in countries outside Latin America with exceptional or no vectorial transmission such as in Europe -has come to light since the beginning of 2000.The emergence of the disease in those countries was mainly linked to population mobility, notably migration.During the last century, Chagas disease cases were detected in nonendemic countries in North America (Canada and the United States) and the Western Pacific Region (mainly Australia and Japan), and only more recently in Europe [1,2].The history of Chagas disease in Europe can be divided in three significant periods.The initial period, started at the beginning of the 1980s, when the first Chagas disease case in Europe was published [3], 72 years after Carlos Ribeiro Justiniano Chagas discovered the disease in Brazil [4].Since then, successive sporadic publications have started to draw attention to the existence of Chagas disease cases in different European countries and the existence of the responsible parasite Trypanosoma cruzi.These publications describe infection transmission in Europe through different non-vectorial routes such as transfusional, congenital and laboratory-accident transmission, as well as sporadically through the arrival of infected travellers such as tourists, people visiting friends and relatives and adopted children [5].