Chagas

From WikiMD's medical encyclopedia

Chagas disease, also known as American trypanosomiasis, is a tropical parasitic disease caused by the protozoan parasite Trypanosoma cruzi. It is spread primarily by insects known as triatomine bugs or "kissing bugs". The disease is named after the Brazilian physician Carlos Chagas, who discovered it in 1909.

Transmission

Chagas disease is primarily transmitted to humans and other mammals by the feces of triatomine bugs. These insects typically bite an exposed area of skin such as the face, and the bugs defecate close to the bite. The parasites enter the host through the bite wound or mucous membranes, such as the conjunctiva or lips. Other modes of transmission include blood transfusion, organ transplantation, consumption of food contaminated with T. cruzi, and congenital transmission from mother to baby.

Symptoms

Chagas disease presents in two phases: acute and chronic.

Acute Phase

The acute phase lasts for the first few weeks or months of infection. It is often asymptomatic or presents with mild symptoms such as fever, fatigue, body aches, headache, rash, loss of appetite, diarrhea, and vomiting. A characteristic sign of acute Chagas disease is the Romaña's sign, which is swelling of the eyelids on the side of the face near the bite wound or where the bug feces were deposited.

Chronic Phase

If untreated, the infection persists and enters the chronic phase. This phase can last for decades or even for the entirety of the person's life. Chronic Chagas disease can lead to severe cardiac and digestive complications, including cardiomyopathy, heart failure, megaesophagus, and megacolon.

Diagnosis

Diagnosis of Chagas disease is made through blood tests that detect the presence of T. cruzi antibodies or the parasite itself. In the acute phase, the parasite can often be seen in a blood smear. In the chronic phase, serological tests are used to detect antibodies against T. cruzi.

Treatment

Treatment for Chagas disease includes antiparasitic medications such as benznidazole and nifurtimox. These drugs are most effective when given during the acute phase of the infection. In the chronic phase, treatment focuses on managing symptoms and complications, such as heart disease and digestive issues.

Prevention

Preventive measures include controlling the triatomine bug population, improving housing conditions to reduce bug habitats, screening blood donations, and educating at-risk populations about the disease and its transmission.

Epidemiology

Chagas disease is endemic in 21 Latin American countries, where it affects an estimated 6 to 7 million people. It is also increasingly being detected in the United States, Canada, many European countries, and some Western Pacific countries, primarily due to population movements.

See also

References



External links

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Contributors: Prab R. Tumpati, MD