Chagas: A New Killer in America?

by Sayuli Bhide

Labeled “the new AIDS of America” by the journal PLoS Neglected Tropical Diseases, Chagas disease is a potentially fatal parasitic infection that is estimated to affect about 7-8 million people worldwide, according to the World Health Organization (WHO). Since its discovery, it has been most commonly endemic only in developing areas of Latin America and is considered a neglected parasitic infection (NPI) by the Centers for Disease Control and Prevention (CDC).

The disease, also known as American trypanosomiasis or the “kissing bug disease,” was discovered in 1909 and is caused by the parasite Trypanosoma cruzi. It is usually transmitted to humans through the bite of
Triatomine bugs, according to the WHO. These “kissing bugs” deposit feces at the site of their bite, allowing Trypomastigotes in the feces to enter host cells, multiply, and then release into the bloodstream.

The infection can progress through three main stages. During the first phase (acute phase), a range of symptoms such as skin inflammation, fever, and nausea may be observed. Patients may also exhibit Romaña’s sign, or eyelid swelling, according to Charles Patrick Davis, MD, PhD. The next phase (indeterminate phase) is generally an asymptomatic phase. Unlike the other two phases, very few parasites are found in the host’s blood during this phase. The last phase (chronic phase) does not occur in all people infected by Chagas. During this stage, most of the parasites are located in the heart and digestive muscle rather than the blood.

According to the WHO, about 30% of people with Chagas will experience serious health problems including heart problems, which may lead to death.

Although the disease has historically existed maily within Mexico, Central America, and South America, it is no longer a problem that the United States can ignore. After the first recorded human case in Louisiana was found in 2006, a growing number of cases have been observed each year in the United States, according to the CDC. It can be spread between people through blood transfusions, organ transplants, and vertical transmission from a mother to her baby.

However, there is currently no vaccine to prevent the disease and even after infection, it can be difficult to diagnose. A significant problem is the fact that the parasites can most easily be viewed only during the acute phase, during which they are circulating in the bloodstream.

Treatments for Chagas disease need to be administered quickly after infection in order to be the most effective, but in the U.S., treatment is currently only offered through the CDC. Additionally, the treatment can take 2 months to complete and can lead to adverse effects in about 40% of patients, according to the WHO.

The best ways to protect oneself from the spread of Chagas disease are having blood screenings, practicing good hygiene, using Synthetic pyrethroid sprays to keep triatome bugs away from homes and maintaining the cleanliness and structural upkeep of houses and buildings.

If any symptoms of Chagas disease are observed, it is important to contact a medical professional immediately to diagnose and treat the disease as soon as possible.

No longer a disease exclusive to Latin America, Chagas disease presents health care providers in several countries with new challenges concerning how best to prevent, diagnose and treat this tropical disease before it can lead to an endemic.

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