Chagas disease (American trypanosomiasis) is both an acute and chronic infectious condition caused by the protozoa Trypanosoma cruzi, native to the Americas but mostly due to emigration and other factors associated with globalization, a number of cases can be registered in other continents.
Transmission can occur in different ways: from bites of triatomines, also called “kissing bug”, “benchuca”, “vinchuca”, “chinche”, or “barbeiro”, which deposit their feces and/or urine at the site of the bite, ingestion of food contaminated with parasites from infected triatomines, through the eyes and mouth, congenital (mother to child) transmission during pregnancy or childbirth, blood transfusion or organ transplant from infected donors, laboratory accidents and sexual transmission.
When after infection, sits an incubation period that varies from four to ten days, the Chagas disease presents itself in two phases: acute and chronic - where an acute symptomatic phase is characterized by a persistent fever (present for more than 7 days), intense weakness, headaches, possible swelling of the face (Romaña’s sign) and legs and presence of red spots on the skin. Whether an acute phase can present diverse symptoms, an asymptomatic acute phase can be possible.
Romaña’s Sign
Usually, acute phases last ten to sixty days if left untreated, after this period the symptoms regress, and the disease enters into a latent phase, where no symptoms are present but protozoans are present in the blood. Some infected can remain in the latent phase for the rest of their life, while 20 to 40%, many years later, enter a symptomatic chronic phase.
The chronic phase of Chagas disease is divided into two main clinical presentations: cardiac and digestive.
The cardiac form of Chagas disease is the most common presentation in symptomatic individuals, with cardiac alterations that vary from rhythm changes, enlargement, thromboembolic phenomena, and heart failure.
The digestive form of Chagas disease is represented by changes in digestive secretion, motility, absorption, and in most severe cases, the permanent dilation of viscera structures, for example, the colon and the esophagus.
Chagas disease is treated solely with anti-parasitic medications but does not reverse cardiac and digestive modifications caused by the disease, for which supportive measures are required. While Chagas’ disease is treatable, prevention is always key. Here are some practical tips to avoid infection:
When traveling to regions with Chaga disease cases, it’s important to avoid staying in places with structural vulnerabilities: cracks and openings can hide infected triatomines.
The usage of insect repellent on exposed skin and bed nets with insecticide features is highly recommended to avoid bites while sleeping.
It’s also recommended to prioritize drinking bottled water and avoiding uncooked foods and fresh sugar cane juice.
Sources:
MSD Manuals
A R L Teixeira, N Nitz, M C Guimaro, C Gomes, C A Santos-Buch, Chagas disease, Postgraduate Medical Journal, Volume 82, Issue 974, December 2006, Pages 788–798, https://doi.org/10.1136/pgmj.2006.047357
Center for Disease Control and Prevention (.gov)
https://www.cdc.gov/parasites/chagas/resources/onepage.pdf Assessed and Endorsed by the MedReport Medical Review Board