Q&A on Chagas disease

6 April 2020 | Q&A

Chagas disease, also known as American trypanosomiasis, is a potentially life-threatening illness caused by the protozoan parasite, Trypanosoma cruzi or (T. cruzi).

Chagas disease is an infectious disease caused by the parasite called Trypanosoma cruzi.

 

 

After infection, you will experience two phases, consequently: acute and chronic.

The acute phase lasts about two months. Symptoms are mostly absent or mild and unspecific.

However, less than half of those bitten by a triatomine bug show the first visible signs, such as a skin lesion or a purplish swelling of the lid of one eye. Additionally, some may have fever, headache, enlarged lymph glands, pallor, muscle pain, difficulty in breathing, swelling, and abdominal or chest pain.

During the chronic phase, up to 30% of patients suffer from cardiac disorders and up to 10% are affected by digestive conditions (typically enlargement of the oesophagus or colon), neurological or mixed changes.

In later years infection can lead to a sudden death due to irregular heartbeat or progressive heart failure caused by the destruction of the heart muscle and its nervous system.

 

Chagas disease transmission can happen in different ways, through:

1) vectorial transmission, when the person comes into contact with the stools/urine of infected triatomine bugs, through an opened wound, the mouth or the eyes (not due to their bite);

2) oral transmission through the ingestion of food contaminated by the stools/urine of infected triatomine bugs, typically causing outbreaks of oral transmission;

3) congenital transmission from mothers to children, in pregnancy or childbirth;

4) transfusional transmission through blood or blood derivatives from infected donors;

5) organ transplantation transmission through organ or tissue transplants from infected donors;

6) laboratorial transmission in laboratory accidents, especially with the parasite culture and the handling of infected samples.

However, it is not transmitted through:

- hand shakes

- kisses

- hugs and

- sexual relations.

Breastfeeding is not contraindicated.

 

 

 

While most of the affected population lives in Latin America, in the last decades cases have been increasingly detected in the USA, Canada, many European countries and some African, Eastern Mediterranean and Western Pacific countries.

Insects transmitting Chagas disease (triatomine bugs, called “kissing bugs”, among many other popular names) are usually in rural or peri-urban areas of Latin America. However, due to urbanization, since the 1980s, infected people mostly live in urban areas. 

 

The following tests are especially recommended:

- parasitological tests: in the acute phase (around the first two months of infection);
- serological tests: in the chronic phase, to detect antibodies against the parasite. 

 

Treatment for Chagas disease ranges from eliminating the parasite T. cruzi to dealing with clinical manifestations and complications, including psychological, familial, labor and social security support.