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Trypanosomiasis Americana (Chagas disease)

Also called American trypanosomiasis (tri-PAN-o-SO-my-a-sis), Chagas disease, is an infection caused by the parasite Trypanosoma cruzi. It is estimated that 16-18 million people are infected with Chagas disease; of those infected, 50,000 will die each year. Reduviid bugs, or "kissing bugs" live in cracks and holes of substandard housing primarily found in South and Central America. Those people who sleep in poorly constructed houses found in the rural areas are at elevated risk of infection. Houses constructed from mud, adobe, or thatch present the greatest risk.Insects become infected after biting an animal or person who already has Chagas disease.

Manifestation: Infection is spread to humans when an infected bug deposits faeces on a person's skin, usually while the person is sleeping at night. The person often accidentally rubs the faeces into the bite wound, an open cut, the eyes, or mouth. Animals can become infected the same way, and they can also contract the disease by eating an infected bug. Other symptoms are usually not specific for Chagas infection. There are three stages to the infection although some people infected never develop any symptoms.
• Acute symptoms only occur in about 1% of cases. Most people infected do not seek medical attention. The most recognized symptom of acute Chagas infection is the Romaña's sign, or swelling of the eye on one side of the face, usually at the bite wound or where faeces were rubbed into the eye.
• Fatigue
• Fever
• Loss of appetite
• Enlarged liver
• Enlarged spleen
• Swollen lymph glands
• Meningitis may occur
• Encephalitis may occur
• In infants swelling of the brain can occur which can cause death.
• Intermediate – After 8-10 weeks the imtermediate stage begins, generally there are no further symptoms showing.
• After between 10-20 years after infection, people may develop the most serious symptoms of Chagas disease. Cardiac problems, including an enlarged heart, altered heart rate or rhythm, heart failure, or cardiac arrest are symptoms of chronic disease. Chagas disease can also lead to enlargement of parts of the digestive tract, which result in severe constipation or problems with swallowing. In persons who are immune compromised, including persons with HIV/AIDS, Chagas disease can be severe.
Not everyone will develop the chronic symptoms of Chagas disease.

Diagnosis and treatment: There is neither a vaccine nor recommended drug available to prevent Chagas disease. Blood tests can be taken to look for the parasite or for antibodies in your blood.

Prevent Chagas disease by:
• Avoid sleeping in thatch, mud, or adobe houses.
• Use insecticides to kill insects and reduce the risk of transmission.
• Be aware that, in some countries, the blood supply may not always be screened for Chagas disease, and blood transfusions may carry a risk of infection.