There are millions of people affected by Chagas disease, also known as American trypanosomiasis, in Latin America and the United States. When left untreated, Chagas disease can cause serious complications, including heart and digestive problems. Chagas disease is caused by a parasite called Trypanosoma cruzi, which is transmitted by blood-sucking bugs called triatomine bugs.
It is caused by the parasite Trypanosoma cruzi, which is transmitted by triatomine bugs that bite humans and animals. It bites people on the face, which is why it is called the kissing bug. After defecating near the bite wound, the parasite enters the body through the skin or mucous membranes. Other methods of parasite transmission include:
Congenital transmission: from mother to child during pregnancy or delivery.
Blood transfusion: from infected blood donors.
Organ transplant: from infected organ donors.
Contaminated food or drink: from ingestion of food or drink contaminated by the bug or its feces.
Accidental exposure: from contact with infected laboratory specimens or animals.
Acute Chagas disease lasts for a few weeks or months after the initial infection, with mild or no symptoms, whereas chronic Chagas disease may not show symptoms until years or decades after the initial infection.
The acute phase of Chagas disease may have the following symptoms:
Fever
Swelling at the bite site or around the eyes
Rash
Headache
Body aches
Fatigue
Nausea, vomiting, or diarrhea
Enlarged spleen or liver
The symptoms of the acute phase usually go away on their own, but the parasite remains in the body and can cause chronic infection.
The chronic phase of Chagas disease may have the following symptoms:
Irregular heartbeat
Heart failure
Cardiac arrest
Difficulty swallowing
Abdominal pain or constipation
Enlarged esophagus or colon
The symptoms of the chronic phase are caused by the damage that the parasite does to the heart, digestive, and nervous systems. The chronic phase can be life-threatening and requires medical attention.
Chagas disease can be diagnosed by various tests, such as:
Microscopic examination: to look for the parasite in a blood smear or tissue sample.
Blood test: to detect antibodies or antigens produced by the immune system against the parasite.
Echocardiogram: to check for abnormalities in the heart structure or function.
X-ray: to check for enlargement of organs, such as the heart, esophagus, or colon.
Electrocardiogram: to check for irregularities in the heart rhythm.
Endoscopy: to check for inflammation or obstruction in the esophagus or colon.
Treatment of Chagas disease depends on the phase and severity of the infection. The main goals of treatment are to kill the parasite, prevent or treat complications, and relieve symptoms.
The acute phase of Chagas disease can be treated with antiparasitic drugs, such as benznidazole or nifurtimox. They can kill the parasite and prevent chronic infection. However, they may cause skin rash, nausea, vomiting, or nerve damage, so they must be taken under medical supervision and closely monitored.
The chronic phase of Chagas disease cannot be cured with antiparasitic drugs, as the parasite is hidden in the tissues and organs. Therefore, the treatment focuses on managing the complications and symptoms. Some of the treatment options are:
Medications: to control heart rate, blood pressure, or heart failure.
Surgery: to repair or replace damaged heart valves, or to remove enlarged or obstructed organs.
Pacemaker or defibrillator: to regulate heart rhythm or prevent cardiac arrest.
Diet and lifestyle changes: to avoid alcohol, tobacco, caffeine, or spicy foods that may worsen the symptoms.
Prevention of Chagas disease is based on avoiding exposure to the parasite and its vectors. Some of the prevention measures are:
Insect control: to eliminate or reduce the presence of triatomine bugs in the home or workplace, by using insecticides, screens, or nets.
Blood screening: to ensure that blood donors are not infected with the parasite, and that blood products are safe for transfusion.
Organ screening: to ensure that organ donors are not infected with the parasite, and that organ transplants are safe for recipients.
Food safety: to wash fruits and vegetables, cook meat thoroughly, and boil or filter water before consumption, to avoid contamination by the bug or its feces.
Personal protection: to wear long sleeves, pants, and shoes, and to apply insect repellent, when traveling or staying in areas where Chagas disease is endemic.
Anyone exposed to the parasite or its vectors may contract Chagas disease, a serious and potentially fatal illness. It is, however, possible to improve the quality of life of people living with Chagas disease by early diagnosis, proper treatment, and effective prevention. Your doctor or health care provider can answer any questions you may have about Chagas disease.
