Chagas Disease: Europe's Unfinished Business

Chagas disease is a Latin American disease that was unknown in Europe until 1981, when the first case was reported on this continent. It was not until 2000, however, that the number of cases in Europe—and Spain in particular—started to rise at an alarming rate. Today, as we mark International Chagas Day, we take this opportunity to call attention to the major issue on the agenda that has still not been addressed three decades later: the lack of any clear, harmonised public health policy or regulation on the control and prevention of Chagas disease in Europe.

A recent study led by ISGlobal found that 4% of Latin Americans living in Europe have chronic Chagas disease. This figure is higher than previous estimates and highlights the urgent need for measures to prevent and control the disease. Although the insect vector that transmits Chagas is not found in Europe, the disease can be transmitted through blood transfusions and organ transplants, and also from a mother to her child.

It is precisely these non-vector modes of transmission of Chagas disease that the EU has failed to address. According to another ISGlobal study, while some European countries have implemented measures to screen for Chagas disease in organ donation programmes, there are no EU directives or national legislation regulating such screening. Only six European countries—Spain, Italy, France, Switzerland, the United Kingdom and Sweden—have included some level of screening for Chagas disease in their regulation of blood donations. And, despite the fact that most of the people with Chagas disease in Europe are women of childbearing age, no national laws or EU directives require that the at-risk population be screened to prevent mother-to-child transmission. In Spain, for example, screening and diagnostic protocols for pregnant women from high-incidence countries—a fundamental measure in the prevention of mother-to-child transmission—have been introduced by only four autonomous communities: Catalonia, Valencia, Galicia and, more recently, Andalusia.

"If we want to make progress in the fight against Chagas disease, non-endemic countries must address the problems this infection poses within their borders", commented Dr Joaquim Gascon, Head of the Tropical Medicine Department at Hospital Clínic and Director of the Chagas Initiative at ISGlobal. "The absence of clear legislation with specific provisions is one of the challenges that Europe must address in the coming months."

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