Health Encyclopedia

Chagas Disease

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:

  • Blood transfusion

  • Organ transplant

  • Birth (mother-to-baby)

  • 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

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

  • Rash

  • Loss of appetite

  • Diarrhea

  • Vomiting

  • 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)

  • Enlarged glands

Symptoms of Chagas disease in the chronic (or long-term) phase may include:

  • Heart failure

  • Abnormal heart rhythm 

  • Difficulty eating

  • Difficulty passing stool

Who’s at risk

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

Diagnosis

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

Treatment

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.

Complications

If you have Chagas disease, you have about a 30 percent chance of developing complications.

Complications include:

  • Infected heart muscle (myocarditis)

  • Brain infection (meningoencephalitis)

  • Enlarged heart

  • Enlarged esophagus

  • Enlarged colon

  • Death

Prevention

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.

When to call the doctor

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.

How to manage or live with the condition

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.



Medical Reviewers:

  • Berry, Judith, PhD, APRN
  • newMentor board-certified, academically affiliated clinician