A tropical disease in Switzerland: Call for coordinated action on Chagas disease

The Swiss Tropical and Public Health Institute (Swiss TPH), in collaboration with the World Health Organization and other partners, conducted a comprehensive review of Chagas disease in Switzerland. Although typically found in Latin America, Chagas disease affects between 2,000 and 4,000 people in Switzerland. The review, published in the Swiss Medical Weekly, underscores the need for improved screening and health care strategies to eliminate Chagas disease in Switzerland.

Chagas disease, caused by the parasite Trypanosoma cruzi, affects about 7 to 8 million people worldwide, mainly in Latin America. The parasite can be transmitted by triatomine bugs, via food, blood transfusions and organ donations, as well as from mother to child during pregnancy and birth.

Chagas disease has two phases: In the acute phase in the first 2 months, symptoms are mild or absent, though some may have fever, headache or swelling at the bite site. Decades later, in the chronic phase, up to a third of infected individuals develop cardiovascular, digestive and/or neurological problems. Advanced cases can lead to heart complications such as arrhythmias and sudden death. Chagas disease is categorized as a neglected tropical disease (NTD) by the World Health Organization (WHO).

2,000 to 4,000 people in Switzerland affected

The review sheds light on the prevalence, challenges and management of Chagas disease. The study found that an estimated 2,000 to 4,000 people are affected by this tropical disease. While most of the cases stem from migration, the study also shows that Chagas disease can be transmitted in Switzerland through mother-child transmission during pregnancy and childbirth. The vector—the triatomine bug—is not present in Europe.

“A major problem of Chagas disease is that it is often underdiagnosed, particularly in non-endemic regions,” said Pablo Martinez de Salazar, Senior Scientific Collaborator at Swiss TPH, and last author of the study. “Indeed, many cases remain undiagnosed or undetected for years, potentially resulting in severe cardiac or digestive complications if untreated.”

Factors such as limited awareness among health care professionals, absence of nationwide screening programs and barriers to health care access—especially for undocumented migrants—contribute to this underdiagnosis.

Establishment of the Swiss Chagas Network

To address these issues, the study team established the Swiss Chagas Network to eliminate Chagas disease as a public health problem through coordinated measures. The network aims to interrupt transmission and to provide adequate clinical management for people living with Chagas disease in Switzerland.

Key priorities include integrating screening into prenatal and pediatric care for early detection and preventing mother-to-child transmission during pregnancy and childbirth. In line with international guidelines, the Swiss Society for Gynecology and Obstetrics recently issued an expert letter on screening, prevention and treatment of congenital Chagas disease .

“Systematic screening in Latin American migrants, with a focus on women of reproductive age, pregnant women and children, will be critical,” said Mar Velarde, Scientific Collaborator at Swiss TPH and co-author of the paper. “If appropriate measures are put in place, Switzerland will be well positioned to achieve the targets of the WHO road map for neglected tropical diseases by 2030 and could become a blueprint for other countries.”

The road map sets out global targets to prevent, control, eliminate and eradicate different NTDs by 2030.

Provided by
Swiss Tropical and Public Health Institute