Chagas Disease

Chagas disease is a sickness caused by a tiny parasite called Trypanosoma cruzi. This parasite lives in the droppings of a bug called a triatomine bug, sometimes called a "kissing bug" because it often bites people on the face. These bugs are mainly found in South America, Central America, and Mexico. However, there have been a few cases in the southern United States as well.

This disease, also known as American trypanosomiasis, can affect anyone. If it's not treated, Chagas disease can lead to serious problems with the heart and digestive system later in life.

In the early stages of infection, treatment aims to get rid of the parasite. Once the disease becomes long-term (chronic), the parasite can't be completely eliminated. Treatment at this stage focuses on managing any symptoms that develop. There are also ways to help prevent getting the disease in the first place.

Chagas disease can affect people in two ways: either as a short-term illness, or as a long-term condition. In the short-term, or acute, stage, the illness might only last a little while. In the long-term, or chronic, stage, the disease can continue for a very long time. The symptoms of Chagas disease can be mild, or they can be quite severe. However, many people don't notice any symptoms until the disease progresses to the chronic stage.

If you live in or have visited a region where Chagas disease is common, see your doctor right away if you're experiencing any of the following:

Chagas disease can cause several symptoms. These might include:

• A swollen area where the infection entered your body.
• A fever.
• Feeling very tired (fatigue).
• Muscle aches all over your body.
• A skin rash.
• Feeling sick to your stomach (nausea).

It's important to get checked by a doctor if you think you might have Chagas disease, especially if you've been in an area where it's more likely to spread.

Chagas disease is caused by a tiny parasite called Trypanosoma cruzi. This parasite is spread to humans by insects called triatomine bugs, sometimes called "kissing bugs."

These bugs live in homes, especially in mud, thatch, or adobe houses in Mexico, South America, and Central America. They hide during the day in cracks and crevices of walls and roofs, and come out at night to feed on blood. They often feed on sleeping people.

When a triatomine bug feeds, it poops. This poop contains the parasite. If the poop gets into your body—through your eyes, mouth, a cut, a scratch, or even the bite itself—you can get infected. It's important to avoid scratching the bite area, as this can help the parasite enter your body.

Once the parasite enters your body, it starts to multiply and spread.

There are other ways you could get Chagas disease:

• Eating contaminated food: If you eat uncooked food that has gotten contaminated with the poop of an infected triatomine bug, you could become infected.

• Inherited infection: If you're born to someone who has Chagas disease, you can inherit the infection.

• Blood transfusions or organ transplants: If you get a blood transfusion or an organ transplant from someone who has Chagas disease, you could get infected.

• Lab exposures: People who work in labs that handle the parasite can sometimes get infected accidentally.

• Wild animal contact: Spending time in forests where infected wild animals, such as raccoons and opossums, are present, could potentially expose you to the parasite.

Chagas disease risk factors include living in certain areas and having contact with infected people.

People living in rural parts of Central and South America, and Mexico, are more likely to get Chagas disease. This is because the disease is spread by insects called triatomine bugs, which are often found in homes built from materials like mud, adobe, or thatch. These homes are more common in rural areas.

Another way people can get Chagas disease is through blood transfusions or organ transplants. If the donor has the infection, the recipient can contract it.

Travelers to these areas usually stay in well-built hotels and other structures that don't typically have triatomine bugs. This means that travelers are less likely to be exposed to the bugs and catch the disease.

Chronic Chagas disease can lead to significant heart and digestive problems. These complications can include:

• Heart failure: This happens when the heart weakens or stiffens, making it unable to pump enough blood to support the body's needs. Think of it like a tired pump struggling to fill a house with water. Symptoms might include shortness of breath, fatigue, and swelling in the legs and feet.

• Megaesophagus: This is a less common problem where the tube connecting your mouth to your stomach (the esophagus) gets abnormally large. This can make it hard to swallow food and liquids, potentially leading to choking or difficulty digesting.

• Megacolon: In megacolon, the large intestine (colon) gets abnormally wide. This can cause a variety of uncomfortable symptoms, including belly pain, swelling, and severe constipation. The stool can become hard and difficult to pass, leading to blockages.

If you live in a place where Chagas disease is common, you can take steps to protect yourself.

Chagas disease is spread by tiny insects called triatomine bugs, often called kissing bugs. These bugs often live in certain types of homes. To reduce your risk:

• Choose your home wisely: If you live in a house made of mud, thatch, or adobe, you're more likely to have triatomine bugs. Consider alternatives, if possible. If you can't avoid such a home, take extra precautions. Mud, thatch, and adobe homes are more likely to have cracks and crevices where the bugs can hide.

• Protect your sleep: If you must sleep in a home with these materials, use a bed net treated with insecticide. This will help keep the bugs away from you while you sleep. Make sure the insecticide is specifically designed for this purpose.

• Remove the bugs: Use insecticides appropriate for indoor use to get rid of the insects in your home. Follow the instructions carefully on the insecticide label. This will help prevent them from biting you.

• Protect your skin: Use insect repellent on any exposed skin, especially when you're outdoors or in areas where the bugs might be present. Make sure the repellent is effective against triatomine bugs.

These steps can significantly reduce your risk of getting Chagas disease. Remember to always follow the instructions on any insecticide or repellent product you use. If you have concerns about Chagas disease or its prevention, talk to your doctor or a public health professional.

To check for Chagas disease, your doctor will first do a physical exam. They'll ask about your symptoms and any things that might make you more likely to have the disease.

If you have symptoms of Chagas disease, blood tests can be used to see if the parasite is present or if your body is fighting it. These tests look for the parasite itself or the proteins your body makes to fight it (called antibodies).

If the blood tests suggest Chagas disease, more tests are usually needed. These extra tests help figure out if the disease has progressed to a more serious stage and if it has affected your heart or digestive system. These tests might include:

• Electrocardiogram (ECG): This test measures the electrical signals of your heart. It helps your doctor check for any unusual heart rhythms or problems.

• Chest X-ray: This uses X-rays to create pictures of your chest. It can show if your heart is enlarged.

• Echocardiogram: This test uses sound waves to create moving pictures of your heart. It allows your doctor to see how well your heart is working and if there's any damage.

• Abdominal X-ray: This uses X-rays to create images of your abdomen, including your stomach, intestines, and colon. It can help see if there are any problems in these areas.

• Upper Endoscopy: This is a procedure where a thin, flexible tube with a light on the end (an endoscope) is inserted through your mouth into your esophagus. The endoscope sends images to a screen, allowing your doctor to look closely at the inside of your esophagus and see if there are any problems.

Chagas disease treatment aims to get rid of the parasite causing the illness and to manage any problems it creates.

In the early stages of Chagas disease, medicines called benznidazole and nifurtimox (also known as Lampit) can be helpful. These drugs are available in areas where Chagas disease is common. However, in the United States, you would need to get them through the Centers for Disease Control and Prevention.

If Chagas disease becomes a long-term (chronic) condition, medicine won't cure it. But, people under 50 might be offered these drugs. The hope is that they can help slow down the disease's progress and prevent serious problems from getting worse.

Treatment for Chagas disease depends on the specific health problems caused by the disease:

• Heart problems: Treatment might include medicine, a device called a pacemaker to regulate the heartbeat, surgery, or even a heart transplant. For example, if a person has an irregular heartbeat, they might need medicine or a pacemaker.

• Digestive problems: Treatment might involve changing your diet, taking medicine, using corticosteroids (strong anti-inflammatory drugs), or, in serious cases, surgery. For example, if someone has trouble digesting food, dietary changes might be recommended. If the digestion problems are severe, they might need medicine or surgery.