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CHAGAS DISEASE

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CHAGAS DISEASE

Chagas disease is an inflammatory infectious disease caused by the parasite protist Trypanosoma cruzi found in the feces of the triatomine bug (kissing bug).

  • Chagas disease is common in Central America, South America and Mexico (mainly in rural areas where poverty is widespread).
  • According to estimates, about 8 million people in Central America, South America, and Mexico have the disease, most of whom do not know they are infected.
  • In 2015, Chagas disease was estimated to result in 8,000 deaths.
  • The disease may be acute, causing a brief sudden illness, or chronic, lasting for a long time
  • The Chagas disease also called America trypanosomiasis can affect anyone and can later cause chronic heart and digestive problems if left untreated.
  • Large-scale population movements mostly from rural to urban areas of the world have increased the geographic distribution of Chagas disease.
  • Rare cases have been found in the southern United States as well.

CAUSES

Chagas disease is caused by the parasite trypanosome cruzi, which is transmitted from the triatomine bug. These blood-sucking bugs get infected when they ingest blood from an animal already infected with the trypanosome cruzi parasite.

Triatomine bugs can be found in houses made from mud, straw and palm thatch. In the day, they hide in crevices in the walls or roof, then come out at night to feed on sleeping inhabitants, passing the parasite through their feces.

Infected bugs defecate after biting and feeding, leaving behind the parasite on the skin. The parasite can then enter the body through the nose, mouth, eyes, a cut, or the bite wound if it is accidentally scratched or rubbed.

Other modes of infections include:

  • Blood transfusion
  • Accidental laboratory exposure
  • Organ transplantation
  • Congenital transfusion – from a pregnant woman to her baby
  • Consumption of uncooked food contaminated with feces from infected bugs.

CHAGAS disease is not contagious and cannot be transmitted from person-to-person or through casual contact with infected human or animal.  However, if an infected breastfeeding mother has a cracked nipple or blood in her breast milk, the milk should be pumped and discarded until the nipple heals and bleeding resolves.

 SYMPTOMS

In the acute phase which lasts for weeks or months, symptoms may exist or may not. When they occur, they are mild and includes:

  • Fever
  • A headache
  • Body aches
  • Eyelid swelling
  • Loss of appetite
  • Swollen glands
  • Nausea, diarrhea or vomiting
  • Rash
  • Enlargement of your liver or spleen
  • Swelling at the injection site

The symptoms that are present in the acute phase usually resolve on their own. If left untreated, it may advance to the chronic stage

In the chronic phase, symptoms may occur 10 to 20 years after the initial infection, they may include:

  • Irregular heartbeat
  • Sudden cardiac arrest
  • Abdominal pain or constipation
  • Congestive heart failure
  • Difficulty swallowing.

DIAGNOSIS AND TREATMENT

To make a diagnosis, the doctor will carry out a physical examination, questioning you about symptoms and any factor that may put you at a high risk of the disease.

A blood test can confirm the presence of the parasite or the proteins that your immune system creates to fight the parasite in your blood. This is done if symptoms of a Chagas disease is present.

Additional test may be carried out if you are diagnosed, this is to determine whether the disease has entered the chronic phase and caused heart or digestive problems.

Tests such as:

  • Electrocardiogram
  • Chest x-ray
  • Abdominal X-ray
  • Upper endoscopy
  • Echocardiogram
TREATMENT

The goal of treatment options is to kill the parasite and manage symptoms.

In the acute phase, FDA approved benznidazole may be of benefit. This will be prescribed by the doctor for children ages 2 to 12.

The doctor may also prescribe Nifurtimox.

In the chronic phase, medications won’t cure the disease but may be offered to people under the age of 50 to help slow down the progression of the disease and its complications.

Additional treatment may include:

Medications, a pacemaker or other heart regulating devices, surgery or even a heart transplant for heart-related complications.

Diet modification, medications, corticosteroids, or even surgery for digestive-related complications