Chagas disease Health Article

Definition

Chagas disease is an illness spread by insects. It is common in South and Central America.

Alternative Names

American trypanosomiasis

Causes, incidence, and risk factors

Chagas disease is caused by Trypanosoma cruzi, a parasite related to the African trypanosome that causes sleeping sickness. It is spread by reduvid bugs and is one of the major health problems in South America. Due to immigration, the disease also affects people in the United States.

Risk factors for Chagas disease include:

• Living in a hut where reduvid bugs live in the walls
• Living in Central or South America
• Poverty
• Receiving a blood transfusion from a person who carries the parasite but does not have active Chagas disease

Symptoms

Chagas disease has two phases -- acute and chronic. The acute phase may have no symptoms or very mild symptoms. Symptoms include:

• Fever
• General ill feeling (malaise)
• Swelling of one eye
• Swollen red area at site of insect bite

After the acute phase the disease goes into remission. No other symptoms may appear for many years. When symptoms finally develop, they may include:

• Constipation
• Digestive problems
• Pain in the abdomen
• Swallowing difficulties

Signs and tests

Physical examination can confirm the symptoms. Signs may include:

• Cardiomyopathy
• Enlarged liver and spleen
• Enlarged lymph nodes
• Irregular heartbeat (arrhythmia)
• Rapid heartbeat (tachycardia)

Tests include:

• Blood culture
• Chest x-ray
• Echocardiogram
• Electrocardiogram (ECG)
• Enzyme-linked immunoassay (ELISA)
• Peripheral blood smear

Treatment

The acute phase and reactivated Chagas disease should be treated. Infants born with the infection should also be treated.

Treating the chronic phase is recommended for both children and adults. Adult patients should talk to their doctor about whether to treat chronic Chagas disease.

Two drugs are used to treat this infection: benznidazole and nifurtimox.

Both drugs often have side effects. The side effects may be worse in older people.

Side effects may include:

• Headaches and dizziness
• Loss of appetite and weight loss
• Neuropathy
• Problems sleeping
• Skin rashes