Chagas Disease

By:    Published: June 3, 2012

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Chagas disease, a tropical illness that is caused by the Trypanosoma cruzi parasite, is one of the largest health issues plaguing South America. Recently, Chagas disease has made headlines here in America and is being compared to HIV/AIDS. This comparison is based on the way the disease affects the immune system of infected individuals.

Spread by insects that transmit the parasite to humans, Chagas disease has infected an estimated 10 million people around the globe, according to the World Health Organization (WHO). Although the majority of infected individuals live in Latin and Central America, some 300,000 people living in the United States have Chagas disease, according to the Centers of Disease Control and Prevention (CDC).

Definition

Chagas disease, also known as American trypanosomiasis, is an infectious disease that causes inflammation throughout the body and when left untreated, can cause the heart and other organs to swell. This eventually leads to serious heart and digestive issues. The disease is very common in parts of Mexico, Central America and South America.

Although much less common in America, some cases have been reported in the southern parts of the United States. Although individuals of any age can be infected, Chagas disease is most commonly diagnosed in children.

Symptoms

Symptoms for Chagas disease vary among individuals and can range from mild to severe. Depending on the phase of the illness, symptoms can be non-existent or debilitating.

During the acute phase, many individuals experience mild symptoms, if any. The acute phase can last for several weeks to months. These symptoms will eventually disappear even without treatment. Without treatment, the disease will progress to the chronic phase, at which point more serious symptoms may or may not occur. It can take up to 20 years for symptoms of the chronic phase to develop.

Symptoms of Chagas disease in the acute phase can include:

  • Swelling at the site of the insect bite
  • Fever
  • Body aches
  • Fatigue
  • Rash
  • Swollen glands
  • Headache
  • Loss of appetite
  • Nausea and/or vomiting
  • Diarrhea
  • Liver or spleen enlargement

Symptoms of Chagas disease in the chronic phase can include:

  • Enlarged heart
  • Irregular heart beat
  • Congestive heart failure
  • Sudden cardiac arrest
  • Difficulty swallowing
  • Abdominal pain
  • Constipation

Causes

Chagas disease is caused by a parasite known as Trypanosoma cruzi. This parasite is found in the feces of the triatomine bug. When one of these bugs ingests the blood of an animal that is infected by the parasite, the bug becomes infected.

Humans become infected with the disease when bitten by the insect. During the bite, which generally occurs while a person is asleep; the bug transmits the parasite onto the skin. The parasite is then able to enter the body through the eyes, mouth or an opening in the skin such as a scratch or cut. Many times, the parasite gains entry into the body when an individual wakes up and scratches the bug bite, creating a tiny opening in the skin. Once the parasite gains entry into the body, it can multiply and may spread to other areas.

Triatomine bugs are commonly found in Mexico, Central America and South America. The bugs live in mud and thatch huts, where they hide during the day and come out at night to feed on people while they sleep.

Although less common, there are other modes of transmission for Chagas disease. Other ways in which Individuals can become infected include:

  • Eating uncooked food that is contaminated with feces from an infected bug.
  • Receiving a blood transfusion from an infected individual.
  • Receiving an organ transplant from an infected individual.
  • Being born from an infected woman.
  • Accidentally being exposed to the infection in a laboratory.
  • Being exposed to infected wildlife in a forest.
  • Having a pet that is infected.

Risk Factors

Chagas disease is rare in the United States. The majority of individuals who travel to high-risk areas have a very low risk of becoming infected with the illness. There are some risk factors that can increase the chance of developing Chagas disease, including:

  • Living in poverty-stricken areas of Mexico, Central America and South America.
  • Living in mud or thatch huts.
  • Living in any dwelling that is infested with triatomine bugs.
  • Receiving a blood transfusion or organ transplant from an infected person.

Diagnostic Tests

If you have any of the risk factors for Chagas disease or if you have any reason to believe you may be infected, it is important to contact your health care provider immediately. During your appointment, your doctor will inquire about your risk factors and any symptoms you are experiencing.

A physical examination will also be performed. Your doctor will order blood tests to check for the presence of the parasite and to look for specific parasitic antibodies. If an infection is confirmed, additional tests will be ordered to determine what phase the disease is in and uncover any possible complications it may have caused. Additional tests may include:

  • Electrocardiogram
  • Abdominal X-ray
  • Upper endoscopy

Treatment

The main focus of treatment for Chagas disease is to kill the parasite during the acute stage of the infection and managing symptoms during the chronic phase.

If the infection is diagnosed during the acute phase, treatment with prescription medications will be started. The two drugs that are used to treat Chagas disease, benznidazole and nifurtimox, are readily available in high risk areas of the world. In the United States, these drugs can only be obtained from the CDC.

If Chagas disease advances to the chronic phase without treatment, prescription medications are not effective. Treatment under these circumstances is focused on the specific symptoms caused by the disease.

For heart-related symptoms, medications may be prescribed to regulate heart rhythm. A pacemaker, open heart surgery or a heart transplant may be required. Symptoms that target the digestive system may be treated with diet modification, medications and surgery.

Prevention

People who live in or travel to high risk areas can take simple precautions to protect themselves from contracting Chagas disease. When in a high risk area, do not sleep in mud, thatch or adobe huts. If you do have to sleep in these types of dwellings, be sure to place netting soaked with insecticide over your bed. Use insecticides throughout your dwelling if you are in a high risk area.

Considerations

Chagas disease that is not diagnosed and treated during the acute stage can progress to the chronic stage. When this happens, serious heart complications or digestive issues may occur. If you live in or have traveled to a high risk area and develop symptoms of acute Chagas disease, it is important that you contact your doctor immediately.

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