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Pediatric Chagas Disease in Europe: 45 Cases From Spain and Switzerland

Rodriguez-Guerineau, Luciana MD*†; Posfay-Barbe, Klara M. MD, MS*; Monsonis-Cabedo, Manuel; Juncosa-Morros, Teresa PhD; Diana, Alessandro MD*; Wyler-Lazarevic, Claire-Anne MD*; de Tejada, Begoña Martinez MD, PhD§; Chappuis, François MD, PhD; Fumadó-Pérez, Victoria MD, PhD; Jackson, Yves MD

The Pediatric Infectious Disease Journal: May 2014 - Volume 33 - Issue 5 - p 458–462
doi: 10.1097/INF.0000000000000139
Original Studies

Background: Chagas disease, a potentially fatal parasitic infection, is emerging in Europe in the context of international migration but there is little public health attention and frequent lack of clinicians’ awareness. To date, there is no published information about clinical characteristics in children.

Methods: We reviewed the medical files of all children (<18 years) with Chagas disease managed in 2 hospitals in Barcelona, Spain and Geneva, Switzerland between January 2004 and July 2012.

Results: Forty-five cases were identified. Two children (4.4%) were diagnosed during the acute phase and the remaining 43 (95.6%) were in the chronic phase of the infection. All but 1 were asymptomatic. Of the 41 treated children, 40 (97.6%) completed 60 days of treatment. Thirty-five (85.4%) received benznidazole, 5 (12.2%) nifurtimox and 1 (2.4%) both drugs consecutively. There were 2 (4.9%) treatment interruptions due to adverse events. The most frequent adverse events were rash (24.4%), anorexia or insufficient weight gain (14.6%) and anemia (2.4%). Twenty-nine (64.4%) children were followed up by serology after 2 years. Five (17.2%) were cured.

Conclusions: Pediatric Chagas disease is an emerging health issue in Europe that requires enhanced attention. Greater emphasis should be put on screening pregnant women at risk and their newborns in case of infection along with older children and relatives. Pediatricians have a central role to play in providing families with information and offering testing in situations of risk.

From the *Department of Pediatrics, University Hospitals of Geneva and University of Geneva, Switzerland; Department of Pediatrics; Laboratory of Microbiology, Sant Joan de Déu Hospital, University of Barcelona, Spain; §Department of Gynecology & Obstetrics; Division of International and Humanitarian Medicine, Department of Community Medicine, Primary Care and Emergency Medicine; and Division of Primary Care, Department of Community Medicine, Primary Care and Emergency Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland.

Accepted for publication October 15, 2013.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Luciana Rodriguez-Guerineau, MD, International Health Unit, Department of Pediatrics, Sant Joan de Déu Hospital, Passeig Sant Joan de Déu 2, 08950 Esplugues de Llobregat, Barcelona, Spain. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.