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Chagas Disease
Introduction
Chagas disease is an inflammatory, infectious condition caused by a parasite and which is transmitted to humans through the feces of the infected reduvid bug.
Chagas disease is common in South America, Central America and Mexico, the primary home of the reduvid bug. Chagas disease has also spread to the southern United States in recent years.
Chagas disease, also called American trypanosomiasis, has two phases. During the acute phase, signs and symptoms are often mild. Left untreated, Chagas disease may become chronic, possibly resulting in serious heart and digestive problems.
Treatment focuses on killing the parasite and managing signs and symptoms. You can take steps to prevent the infection.
Signs and symptoms
Chagas disease occurs in two phases: the acute phase and the chronic phase. Symptoms in either phase can range from mild to severe. Many people don't experience symptoms until the chronic stage.
Acute phase
The acute phase of Chagas disease may be symptom-free. When signs and symptoms do occur, they are usually mild and may include:
- Redness and swelling at the site of infection, especially around your eye and eyelid.
- Fever.
- Fatigue.
- Body aches.
- Headache.
- Loss of appetite.
- Nausea, diarrhea or vomiting.
- Swollen glands.
- Enlargement of your liver or spleen.
The chronic phase of Chagas disease may occur 10 to 30 years after initial infection. In severe cases, Chagas disease symptoms may include:
- Irregular heartbeat.
- Inflamed, enlarged heart (cardiomyopathy).
- Congestive heart failure.
- Difficulty swallowing due to enlarged esophagus.
- Abdominal pain or constipation due to enlarged colon.
The cause of Chagas disease is the parasite Trypanosoma cruzi.
T. cruzi is transmitted to humans by various species of bloodsucking insects called "kissing bugs," such as the reduvid bug. These insects become infected by T. cruzi when they ingest blood from an animal already infected with the parasite.
Reduvid bugs live primarily in mud, thatch or adobe huts in South America and Central America. They hide in cracks or crevices in the walls or roof during the day, then come out at night — often feeding on sleeping humans.
When infected reduvid bugs bite humans, they defecate — passing the T. cruzi parasites in their feces. The parasites can then enter your body through your eyes, mouth, a cut or scratch, or the wound from the reduvid bug's bite. The parasites can be helped into these openings if you scratch or rub at the bite site.
You may also become infected from:
- Eating uncooked food contaminated with feces from infected reduvid bugs.
- Being born to a woman infected with T. cruzi.
- A blood transfusion containing infected blood.
- An organ transplant containing infected blood.
- Accidental transmission in a laboratory.
Treatment for Chagas disease focuses on killing the parasite and managing signs and symptoms.
During the acute phase of Chagas disease, the prescription medications benznidazole and nifurtimox may be of benefit. Both drugs are available in the regions most affected by Chagas disease. In the United States, however, benznidazole is not available and nifurtimox is currently undergoing clinical trials. Nifurtimox is available from the Centers for Disease Control and Prevention when necessary.
Once Chagas disease is in the chronic phase, medications aren't effective for curing the disease. Instead, treatment depends on the specific signs and symptoms:
- Heart-related complications. Treatment may include medications, a pacemaker or other devices to regulate your heart rhythm, surgery, or even heart transplant.
- Digestive-related complications. Treatment may include diet modification, medications, corticosteroids or, in severe cases, surgery.
If you live in an area that increases your risk of Chagas disease, these steps can help you prevent infection:
- Avoid sleeping in a mud, thatch or adobe house, if possible. These types of residences are more likely to harbor reduvid bugs.
- Use netting over your bed when sleeping in thatch, mud or adobe houses.
- Use insecticides to remove insects from your residence.
If you need a blood transfusion, make sure the blood you get is tested for chagas disease. In Central America and South America, blood donors are routinely screened for exposure to T. cruzi. In the United States, this is less common. However, due to the recent introduction of chagas disease to the United States, the Food and Drug Administration has approved a test to screen blood donors for T. cruzi.
Information obtained from National Institute of Health