South American Trypanosomiasis - Revision history

Ellouise.Bishop@anthonynolan.org: /* Justification for guidance */

2026-04-28T14:16:01Z

Justification for guidance

Ellouise.Bishop@anthonynolan.org: /* Justification for guidance */

2026-04-28T14:12:23Z

Justification for guidance

Tania.Dexter@anthonynolan.org: /* Justification for guidance */

2025-10-30T11:22:00Z

Justification for guidance

Maram.Ghiti@anthonynolan.org: /* At CT/WORK-UP */

2025-02-13T13:44:52Z

At CT/WORK-UP

Maram.Ghiti@anthonynolan.org: /* Criteria related to travel history */

2025-02-04T13:58:42Z

Criteria related to travel history

Maram.Ghiti@anthonynolan.org: /* At CT/WORK-UP */

2025-02-04T13:57:43Z

At CT/WORK-UP

Maram.Ghiti@anthonynolan.org: /* At CT/WORK-UP */

2024-10-09T08:56:08Z

At CT/WORK-UP

Maram.Ghiti@anthonynolan.org: /* Criteria related to travel history */

2024-09-12T15:45:58Z

Criteria related to travel history

Maram.Ghiti@anthonynolan.org: /* Criteria related to travel history */

2024-09-12T15:45:32Z

Criteria related to travel history

Maram.Ghiti@anthonynolan.org: /* Criteria unrelated to travel history */

2024-09-12T15:44:39Z

Criteria unrelated to travel history

@@ Line 49: / Line 49: @@
 Chagas’ is endemic to mainland South and Central America. The people most at risk are those who spend early childhood in an endemic area in certain types of dwelling, those who receive blood transfusions in endemic areas, and children whose mothers grew up at risk of Chagas’ disease. Most of this risk can be captured by asking donors their country of birth and whether they have ever received a blood transfusion in a Chagas’-endemic country. The former can be definitively captured at recruitment, while the latter could occur at any time up to work-up.
 Risk of Trypanosoma cruzi infection to travellers is considered very low. In keeping with JPAC guidelines it is only recommended screening travellers who may have been exposed to the parasite with certain activity in at risk countries: namely those who have lived and/or worked in rural subsistence farming communities for a continuous period of four weeks or more. Camping or trekking in the jungle in South or Central America (including Mexico) is not considered of high enough risk to merit exclusion.
 The detection of antibodies to T. cruzi is an established strategy to prevent transmission of infection through blood transfusion. Where available, this strategy can be adapted to assess the risk of prospective HPC donors with identified risk factors for chronic, asymptomatic Chagas’ disease. Because the prevalence of Chagas’ disease varies widely within the populations of endemic areas, it is likely that most donors with identified risk factors – especially those residing in non-endemic countries – will test negative for T. cruzi antibodies.

@@ Line 49: / Line 49: @@
 Chagas’ is endemic to mainland South and Central America. The people most at risk are those who spend early childhood in an endemic area in certain types of dwelling, those who receive blood transfusions in endemic areas, and children whose mothers grew up at risk of Chagas’ disease. Most of this risk can be captured by asking donors their country of birth and whether they have ever received a blood transfusion in a Chagas’-endemic country. The former can be definitively captured at recruitment, while the latter could occur at any time up to work-up.
-Although the risk of Trypanosoma cruzi infection to travellers is considered very low, a possible case (likely false positive) in 2024 involving a donor who had recently returned from a short holiday to South America prompted a revision of guidelines. These updated guidelines recommend screening travellers who may have been exposed to the parasite, namely those who have stayed in rural areas AND in high-risk housing conditions (mud-lined huts, adobe housing, structures with thatched rooves).
+Risk of Trypanosoma cruzi infection to travellers is considered very low. In keeping with JPAC guidelines it is only recommended screening travellers who may have been exposed to the parasite with certain activity in at risk countries: namely those who have lived and/or worked in rural subsistence farming communities for a continuous period of four weeks or more. Camping or trekking in the jungle in South or Central America (including Mexico) is not considered of high enough risk to merit exclusion.
 The detection of antibodies to T. cruzi is an established strategy to prevent transmission of infection through blood transfusion. Where available, this strategy can be adapted to assess the risk of prospective HPC donors with identified risk factors for chronic, asymptomatic Chagas’ disease. Because the prevalence of Chagas’ disease varies widely within the populations of endemic areas, it is likely that most donors with identified risk factors – especially those residing in non-endemic countries – will test negative for T. cruzi antibodies.

@@ Line 49: / Line 49: @@
 Chagas’ is endemic to mainland South and Central America. The people most at risk are those who spend early childhood in an endemic area in certain types of dwelling, those who receive blood transfusions in endemic areas, and children whose mothers grew up at risk of Chagas’ disease. Most of this risk can be captured by asking donors their country of birth and whether they have ever received a blood transfusion in a Chagas’-endemic country. The former can be definitively captured at recruitment, while the latter could occur at any time up to work-up.
-Although the risk of Trypanosoma cruzi infection to travellers is considered very low, a confirmed case in 2024 involving a donor who had recently returned from a short holiday to South America has prompted a revision of guidelines. These updated guidelines recommend screening travellers who may have been exposed to the parasite, namely those who have stayed in rural areas or in high-risk housing conditions (mud-lined huts, adobe housing, structures with thatched rooves).
+Although the risk of Trypanosoma cruzi infection to travellers is considered very low, a possible case (likely false positive) in 2024 involving a donor who had recently returned from a short holiday to South America prompted a revision of guidelines. These updated guidelines recommend screening travellers who may have been exposed to the parasite, namely those who have stayed in rural areas AND in high-risk housing conditions (mud-lined huts, adobe housing, structures with thatched rooves).
 The detection of antibodies to T. cruzi is an established strategy to prevent transmission of infection through blood transfusion. Where available, this strategy can be adapted to assess the risk of prospective HPC donors with identified risk factors for chronic, asymptomatic Chagas’ disease. Because the prevalence of Chagas’ disease varies widely within the populations of endemic areas, it is likely that most donors with identified risk factors – especially those residing in non-endemic countries – will test negative for T. cruzi antibodies.

@@ Line 35: / Line 35: @@
 A comprehensive lifetime travel history should be assessed, with particular attention to any travel to Chagas-endemic regions in South and Central America:
-A history of sleeping in mud-lined huts, adobe housing, or dwellings with thatched roofs in a rural area should trigger serological testing to quantify risk.
+A history of sleeping in dwellings with mud-lined walls, adobe housing, or dwellings with thatched roofs in a rural area should trigger serological testing to quantify risk.
 === T. cruzi antibody testing ===

@@ Line 35: / Line 35: @@
 A comprehensive lifetime travel history should be assessed, with particular attention to any travel to Chagas-endemic regions in South and Central America:
-*  A history of sleeping in mud-lined huts, adobe housing, or dwellings with thatched roofs in a rural area should trigger serological testing to quantify risk.
+A history of sleeping in mud-lined huts, adobe housing, or dwellings with thatched roofs in a rural area should trigger serological testing to quantify risk.
 === T. cruzi antibody testing ===

@@ Line 35: / Line 35: @@
 A comprehensive lifetime travel history should be assessed, with particular attention to any travel to Chagas-endemic regions in South and Central America:
-*  A history of travel to rural areas in South and Central America America, regardless of duration, should trigger serological testing to quantify risk.
+*  A history of travel to rural areas in South and Central America, regardless of duration, should trigger serological testing to quantify risk.
 *  A history of sleeping in mud-lined huts, adobe housing, or dwellings with thatched roofs for any amount of time should also trigger serological testing to quantify risk.

@@ Line 33: / Line 33: @@
 === Criteria related to travel history ===
-A comprehensive lifetime travel history should be assessed, with particular attention to any travel to Chagas-endemic regions in South and Central America.
+A comprehensive lifetime travel history should be assessed, with particular attention to any travel to Chagas-endemic regions in South and Central America:
-A history of travel to rural areas in South and Central America America, regardless of duration, trigger serological testing to quantify risk.
+*  A history of travel to rural areas in South and Central America America, regardless of duration, trigger serological testing to quantify risk.
-A history of sleeping in mud-lined huts, adobe housing, or dwellings with thatched roofs for any amount of time should also trigger serological testing to quantify risk.
+*  A history of sleeping in mud-lined huts, adobe housing, or dwellings with thatched roofs for any amount of time should also trigger serological testing to quantify risk.
 === T. cruzi antibody testing ===

@@ Line 25: / Line 25: @@
 === Criteria unrelated to travel history ===
-A past history of Chagas’ disease should trigger permanent exclusion
+A past history of Chagas’ disease should trigger permanent exclusion.
 A history of being transfused in a Chagas endemic area should trigger serological testing to quantify risk.
 A history of being born or donor's mother being born in a Chagas endemic area should trigger serological testing to quantify risk.