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The parasite Trypanosoma cruzi causes Chagas disease (American trypanosomiasis). It is named for Carlos Chagas, the Brazilian doctor who first identified the disease in 1909. The feces of insects called triatomine, or “kissing” bugs, transmits the parasite to people. These bugs feed on the blood of animals and people at night, and then they defecate. If people unknowingly wipe the feces into their eyes, nose, mouth, or a sore, they can get sick.
The insects are usually found in rural Latin America, in places of widespread poverty. Experts believe that as many as 11 million people in South and Central America and Mexico have the disease. Most don’t know they have it. The disease will not go away without treatment and can eventually lead to death. People in North America also have the illness, but in much smaller numbers. However, the disease is spreading as people travel more widely.
In addition to contact with feces from infected bugs, the following events can also cause you to get Chagas disease:
Exposure in the lab
You cannot get Chagas disease from another person, the way you can get a cold or the flu from someone else. You have to be exposed to the bug feces on your own, even if someone in your family has the disease. However, you could get the disease if you receive blood, or an organ, from a family member or anyone else with the infection.
Symptoms of Chagas vary and might be difficult to distinguish from another illness. In some people, symptoms may be mild at first and then disappear for years or even decades. In the chronic phase of the disease, the parasite gets inside your heart muscle. This is why later symptoms often involve the heart.
Symptoms of Chagas disease in the acute phase (the first few weeks or months) are:
Mild flu-like symptoms, such as fever, fatigue, body aches, and headaches
Loss of appetite
Swelling or a sore near the eye or on the side of the face where the bite or infection occurred (visible in fewer than half of infected people)
Symptoms of Chagas disease in the chronic (or long-term) phase may include:
Abnormal heart rhythm
Difficulty passing stool
You’re most at risk for Chagas disease if you:
Have visited or traveled in rural Central or South America
Have been exposed to the blood products, or received organs, from someone infected with Chagas disease
To diagnose the condition, your doctor will consider:
Your overall health and medical history
Your description of symptoms
Your travel history (because Chagas is often, though not always, caught in Central or South America)
A physical exam
Lab blood tests
Heart function tests, such as an electrocardiogram
Early treatment for Chagas disease is the most successful. Recommended treatment may include:
Antiparasitic medication, which you may need for up to two months
Continued monitoring of your heart function
Treatment of complications, such as arrhythmia
People who are immune-compromised, such as those who have HIV or AIDS, may need additional treatment. Chagas disease can be more severe in people with these conditions and may lead to earlier death.
If you have Chagas disease, you have about a 30 percent chance of developing complications.
Infected heart muscle (myocarditis)
Brain infection (meningoencephalitis)
If you are planning to visit rural areas in Central or South America, choose clean, well-built lodgings. Ask about pest management where you are staying. Consider using bed nets, wearing long sleeves and pants, and using bug repellant day and night.
Chagas disease is not an emergency. However, its effect on the heart and intestines might lead to an emergency. Seek immediate medical attention if you experience signs of heart failure, such as shortness of breath, ongoing coughing, tiredness, confusion, and speeding heart rate.
Follow your health care provider's recommendations for taking care of yourself, including taking medications as prescribed. Go to recommended follow-up medical visits and tests.
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.