An outbreak of Chagas disease occurred in the city of Santa Isabel do Rio Negro, Brazil, after people ate Acai. Acai is a fruit from a palm tree. Eight adults and four children became ill. Fruit or palm juice have been implicated in previous outbreaks of orally transmitted Chagas disease (For example, Venezuela in 2007, Santa Catarina, Brazil in 2005 and Amazonas Province, Brazil in 2006). The fruit or juice was apparently contaminated with triatomid bug feces or entire triatomid bugs were crushed during the juice production process. The bugs can carry the flagellate protozoa, Trypanosoma cruzi. Trypanosoma cross through the mucosa of the digestive tract and enter the blood and then travel throughout the body. The early symptoms of Chagas disease include: fever, weakness, facial swelling, muscle ache, joint ache, and swelling of the extremities. The infection progresses if untreated. Treatment is most effective if given in the acute phase of the infection, however the treatments can be toxic. Heart and intestinal problems can develop later. If untreated, the disease is often fatal. For more information about Chagas disease, see the World Health Organization link provided below.