Chagas Disease (American trypanosomiasis): Symptoms, Causes, Diagnosis, and Treatment

What Is Chagas Disease?

Chagas disease, or American trypanosomiasis, is an infectious disease caused by small bugs known as Trypanosoma cruzi. These bugs are also known as reduviids. Sometimes, these bugs bite us near the mouth or face, which is why some people call them kissing bugs. As this infection generally goes from animals to humans, it is also a zoonotic illness. Brazilian doctor Carlos Chagas first described this disease in 1909, which is why this infection is popularly called Chagas disease.

How common is it?

This infection is very common in both American continents. As the World Health Organization (WHO) says, almost six to seven million people all over the world suffer from this. Not only that, but nearly 12000 people die every year because of this disease. As this disease can be transmitted from one person to another, around 75 million people are at risk of contracting this.

Regions at high risk:

This infection is very common in specific areas of South America, and it is also found in countries like Argentina and Chile. Recently, doctors have found evidence of this disease in other parts of the world, like Canada, Africa, Western Europe, and Eastern Mediterranean countries.

What Are the Chagas Disease Risk Factors?

As already mentioned, this disease spreads to humans from animals. In the rural or village areas, this disease spreads from infected feces or the urine of chickens, horses, and pens. These bugs remain inactive during the day and become active at night. You can find these bugs around you in structures like walls and roof cracks. As the name kissing bug suggests, these bugs often bite us. Also, they pee or poop on our skin. Chagas disease transmission happens when we accidentally rub the feces or urine of the bug, which enters our body via cuts, the mouth, or an open area of the skin. Even some doctors believe that these bugs can enter our bodies through contaminated foods and drinks.

Who is most vulnerable?

People who live in poor areas with unhygienic environments are susceptible to this infection. It can spread through blood transmission via blood products. That is why pregnant ladies or children are commonly affected. Also, if you are old, have immunity issues due to conditions like AIDS (acquired immune deficiency syndrome), or have undergone an organ transplant, you are susceptible to this infection.

What Are the Stages of Chagas Disease?

The responsible bug for Chagas disease is Trypanosoma cruzi, and it lives inside the gut of the triatomine bugs (kissing bugs). After the transmission, these tiny bugs enter our bodies. They invade near the transmission site within our nerve or muscle cells. Within those cells, they transform. After the transformation, these bugs rupture the host cells and go into our bloodstream.

• Acute stage:

This is the early stage of the infection. When these bugs are within our bloodstream, our body tries to protect us. That is why we observe initial symptoms of Chagas disease due to our body’s defense mechanism.

• Chronic stage:

You can see the initial symptoms for four to six weeks. After that, you will see a gradual improvement in your condition. This happens due to your body’s defense and immune activity. However, during this period, the bug spreads to different organs in your body. After the initial improvement, complications can happen ten to thirty years later. This reactivation mostly occurs due to a drop in our body’s defense mechanism.

What Are the Signs of Chagas Disease?

The most common Chagas disease symptoms are:

1. You will experience fever, weakness, and headache.

2. Additional symptoms will be body pain, enlargement of the lymph nodes, breathing issues, and abdominal pain.

3. In case of eye contamination, you will experience painless, purplish swelling of one eye. Chagas disease eye swelling is known as Romaña’s sign.

What does Chagas Disease rash look like?

Chagas disease skin rash is a classic symptom. We call this Chagas disease rash a chagoma. These rashes are swollen, firm, and reddish-purple in color. Sometimes, skin lesions of Chagas disease may appear the same as those of measles rash. Those are known as Schizotrypanides.

In the chronic phase, you will experience heart and abdominal issues. These can be,

1. You can experience breathing issues and difficulty while working due to a large heart size or heart failure.

2. Problems in your digestive tract can cause abdominal pain, difficulty swallowing, and constipation. This happens due to abnormal enlargement of your food pipe, which can cause megacolon (enlargement of the colon) or megaesophagus.

What Are the Chagas Disease Complications?

The long-term complications in Chagas disease can be seen in the chronic phase. Here, you can experience severe problems due to damage to the different organs. These damages are;

1. Heart damage in Chagas disease is very common. This damage is caused by injury to the heart muscles. As a result, you can have issues like heart failure, right-sided heart failure, and an enlarged heart (cardiomegaly). Doctors can detect problems like an abnormal heartbeat (arrhythmia) or decreased efficiency of the heart.

2. Sometimes, the brain gets affected, which can cause meningoencephalitis. Due to brain damage, one can experience nerve damage.

3. Chagas disease can damage your digestive tract, too. Due to inflammation, often your colon and foodpipe are enlarged. As a result, you can experience heartburn, digestive issues, constipation, and abdominal pain.

How to Diagnose Chagas Disease?

In the acute phase of the disease, doctors can detect the presence of the bug in your blood. The polymerase chain reaction (PCR) test can also be useful. In the chronic phase, Chagas disease can be detected through antibodies present in your body. Additionally, doctors can use other tests to detect damage to the other organs.

1. Chest X-ray.

2. ECG (electrocardiogram).

3. MRI (magnetic resonance imaging) of the abdomen.

4. CT (computed tomography) of the abdomen.

What Are the Treatments for Chagas Disease?

In the acute phase of Chagas disease treatment, doctors use antiparasitic drugs to kill these bugs. These medicines include Benznidazole and Nifurtimox. However, in the chronic stage, it is difficult for the doctor to cure this. In such situations, treatment of the damaged organs is necessary. Doctors generally try to improve the heart rhythm and heart function.

Emerging or experimental treatments

Doctors are using newer medications for Chagas disease treatment, including Fexinidazole and Posaconazole. Other medicines can also be given to improve symptoms and organ complications, including Amiodarone and Allopurinol.

How to Prevent Chagas Disease?

There is no Chagas disease vaccine. As a result, the only way to prevent this disease is to live a healthy and hygienic life. As these bugs are transmitted from animal poop and pee, staying away from animals is necessary. Also, one can use clean water for drinking and maintain the cleanliness of their house to keep this bug away. Also, special care should be given to the elderly, children, and pregnant women. Health care providers should be cautious about the transmission of this disease via blood transfusion.

Living with Chagas disease:

If you are living in an area where Chagas disease is common, you should be cautious from the beginning. If you suspect any complications, please visit the doctor. In case you are suffering from Chagas disease, proper treatment is necessary. Even after completion of your treatment in the acute phase, check-ups at a regular interval are necessary.

Conclusion

A bug, Trypanosoma cruzi, is responsible for Chagas disease. Though it is common in South America, in recent times, you can find this infectious disease all over the world. As this disease is transmitted from the poop and pee of the animals, unhygienic conditions are responsible for transmission. In the initial phase, this disease causes fever, weakness, skin rashes, and eye issues. However, in the later stage, this can damage our heart and digestive tract fatally.

Key Takeaway From iCliniq

If you live in an area where Chagas disease is common, you should be cautious. Watch out for symptoms like fever, weakness, and skin rash. Remember that a healthy and hygienic lifestyle can prevent this infection. In case of any queries related to this, remember that our infectious disease specialists at iCliniq are always there to help.