An Overview of Chagas Disease

A month after Amy, 21, returned from a semester as a student in Central America, she wondered why she had a persistent fever and body aches. She just didn't feel like herself and had trouble concentrating on her studies. The student health service diagnosed her as suffering from Chagas disease.

What is Chagas disease?

According to the Centers for Disease Control and Prevention (CDC), Chagas disease is an illness spread by contact with an infected triatomine bug, sometimes referred to as the kissing bug. Those at highest risk are individuals who have lived in certain parts of Mexico, Central and South America. Residing in a mud or thatched home also increases a person's chance of contracting this disorder.

The Mayo Clinic indicates that while Chagas disease can strike anyone, children are its most frequent victims. The parasite that causes this inflammatory and infectious condition lives in the feces of the reduviid bug. Right after a bite, minute parts of the bug's feces enter the person's bloodstream.

Though far less common, the illness can also be spread from a mother to her baby, via a blood transfusion and as the result of an organ transplant.

Symptoms

The first signs of Chagas disease appear several weeks or months after an individual has been bitten by an infected bug. The most typical include fever, body aches, swelling around the bite itself and swelling of an eyelid.

After the initial phase of the illness, most patients experience no further symptoms. However, some do become ill later. The most common signs include an irregular and potentially fatal heart beat, an enlarged heart that isn't optimally functional, digestive problems and an elevated risk of strokes.

Diagnosis and Treatment

If a patient's description of symptoms and physical exam suggest being at risk for Chagas disease, doctors typically start by ordering blood tests to establish the presence of either the parasite or antibodies the body has produced to fight the parasite. Individuals with positive test results face additional testing to determine whether they have suffered any complications. The most common are an electrocardiogram, abdominal X-ray and upper endoscopy.

The goal of treatment is two-fold: eliminating the parasite and managing any signs and symptoms of the illness. During the first stage of the illness, many patients benefit from the drugs benznidazole and nifurtimox. In the United States, these medications are available only through the CDC.

Treatment during subsequent phases involves addressing the patient's particular symptoms. When there are cardiac complications, treatment might include medications, implanting a pacemaker or other devices or performing a heart transplant. Treatment for digestive symptoms usually involves dietary changes, drugs like steroids and, occasionally, surgery.

Individuals living or planning to live in a high-risk area can take steps to help avoid contracting Chagas disease. The first is to avoid sleeping in mud, thatch or adobe houses, which can also be home to reduviid bugs. If this is impossible, netting soaked in insecticide and placed over the bed provides some protection. The final step is to eliminate all insects from the living quarters with insecticides.

Sources:

http://www.cdc.gov/chagas/resources/onepage.pdf

http://www.mayoclinic.com/health/chagas-disease/DS00956