Chagas Disease

_{The following information is from the Centers for Disease Control and Prevention’s informational pages about Chagas Disease}

• Chagas disease (American trypanosomiasis) is a disease caused by the parasite Trypanosoma Cruzi (T. cruzi) transmitted by triatomine bugs or “kissing bugs”
• It is transmitted to humans and animals by an infected triatomine bug’s feces and/or urine
  • The triatomine bug bites exposed skin, typically on the face (hence the name “kissing bug”) while a person is sleeping, feeds on their blood, and then defecates or urinates on the body, leaving behind the parasite-laden excrement that causes the disease
  • The parasite can then enter the human body directly at the site of the bite or in any mucous membrane, e.g. the eyes, mouth, or nasal passages, especially if the host unknowingly scratches the bite

SYMPTOMS

• Chagas disease can be seen in two phases– acute and chronic
  • Acute phase-
    • Lasts for a few weeks or months
    • Individuals may have no symptoms or mild symptoms that can include:
      • Fever
      • Fatigue
      • Body aches
      • Headache
      • Rash
      • Loss of appetite
      • Diarrhea
      • Vomiting
      • Chagoma- swelling at the site of the bite
      • Romaña’s sign- swelling of the eyelid and surrounding area because of a localized bite that has spread into the mucous membrane of the eye
  • Chronic phase-
    • Can last for decades or span the entirety of a lifetime
    • About 20-30% of the infected population develop serious complications, including:
      • Cardiomegaly (enlarged heart)
      • Heart failure
      • Arrythmia (irregular heart rate)
      • Cardiac arrest leading to sudden death
      • Megaesophagus (enlarged esophagus)
      • Megacolon (enlarged colon)
      • Gastrointestinal issues (trouble eating or eliminating waste)

TRANSMISSION AND RISK FACTORS

• Chagas disease is passed from a T. cruzi infected triatomine bug to a human
• It can also be passed through:
  • Blood transfusions or organ transplantation from a Chagas disease affected donor
  • Congenital transmission (pregnant woman passes it to her baby)
  • Consumption of uncooked food contaminated with feces an/or urine from infected triatomine bugs
  • Accidental laboratory exposure
• Triatomine bugs are typically found in houses made of mud, adobe, straw, and palm thatch– they hide in crevices in walls and roofs during the day and feed at night
• Most cases are found in rural areas of Mexico, Central America, and South America, but travel and widespread population movements have expanded the scope of the disease 

TREATMENT

• Treatment options include:
  • Antiparasitic treatment
    • Most effective when taken immediately after diagnosis
    • Benznidazole or Nifurtimox
  • Symptomatic treatment
    • Medications or treatments to manage symptoms

CONTROL AND PREVENTION

• Treat high-risk areas and dwellings with effective insecticides
• Use bed netting treated with effective insecticide
• Screen for Chagas Disease, particularly in cases of: organ donation/transplantation, blood donation, blood transfusions

RESOURCES:

Centers for Disease Control and Prevention. CDC – Chagas Disease – Detailed FAQs. CDC.Published 2019. https://www.cdc.gov/parasites/chagas/gen_info/detailed.html#intro