What is Chagas disease?
Chagas disease is a disease caused by the parasite Trypanosoma cruzi. It is named for Carlos Chagas, the Brazilian doctor who first identified the disease in 1909.
What causes Chagas disease?
Chagas disease is caused when people become infected by the parasite Trypanosoma cruzi. 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 can also cause Chagas disease:
- Blood transfusion
- Organ transplant
- Birth (mother-to-baby)
- Exposure in the lab
You can’t 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.
What are the risk factors for Chagas disease?
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
What are the symptoms of Chagas disease?
Symptoms of Chagas disease 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)
- 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
The symptoms of Chagas disease may resemble other medical conditions or problems. Always consult your health care provider for a diagnosis.
How is Chagas disease diagnosed?
To diagnose the condition, your health care provider 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 (ECG)
How is Chagas disease treated?
Specific treatment for Chagas disease will be determined by your health care provider based on the following:
- The extent of the problem
- Your age, overall health, and medical history
- Your tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disorder
- The opinion of the health care providers involved in your care
- Your opinion and preference
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.
What are the complications of Chagas disease?
If you have Chagas disease, you have about a 30% chance of developing complications.
- Infected heart muscle (myocarditis)
- Brain infection (meningoencephalitis)
- Enlarged heart
- Enlarged esophagus
- Enlarged colon
Can Chagas disease be prevented?
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 repellent day and night.
Living with Chagas disease
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.
When should I call my health care provider?
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.
- Chagas disease is a disease caused by the parasite Trypanosoma cruzi.
- You’re most at risk for Chagas disease if you have visited or traveled in rural Central or South America or been exposed to the blood products, or received organs, from someone infected with Chagas disease.
- The 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.
- If you have Chagas disease, you have about a 30% chance of developing complications.
- Treatment for Chagas disease includes taking an antiparasitic medication for up to two months.
Tips to help you get the most from a visit to your health care provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
- Foster, Sara, RN, MPH
- Freeborn, Donna, PhD, CNM, FNP