What is Chagas disease?
Chagas disease is caused by the parasite Trypanosoma cruzi, which is transmitted to animals and people by insect vectors called triatomines or kissing bugs. It is found only in the Americas and is also referred to as American trypanosomiasis. It is estimated that as many as 8 million people living in Mexico, Central America, and South America have Chagas disease, most of whom do not know they are infected. If untreated, infection is lifelong and can be fatal. Chagas disease and the vector that transmits the disease is present in the Southern United States. It is estimated that more than 300,000 people in the United States have Chagas disease and may not know they are infected.
How is Chagas disease transmitted?
People can become infected in several ways, however the most common way is from the insect vector called triatomine bugs, commonly referred to as kissing bugs. These blood-sucking bugs get infected with T. cruzi by biting an infected animal or person. Once infected, the bugs pass the parasites in their feces and will often defecate while taking a blood meal. The person can become infected if T. cruzi parasites in the bug feces enter the body through mucous membranes or breaks in the skin. The unsuspecting, sleeping person may accidentally scratch or rub the feces into the bite wound, eyes, or mouth.
Join the Chagas ECHO
Sessions of the Chagas ECHO will occur monthly from January – April, 2020 and are free to attend. Attendees may earn CME credit for each session attended.
Chagas ECHO Hub Team
The Chagas ECHO is supported by a interdisciplinary collaboration of experts from across the United States.
People also can become infected through:
- Congenital transmission (from a pregnant woman to her baby)
- Blood transfusions
- Organ transplantation
- Consumption of uncooked food that is contaminated with feces from infected triatomine bugs
- Accidental laboratory exposure
Chagas disease is not transmitted from person-to-person like a cold or the flu or through casual contact with infected people or animals.
Why is Chagas disease a threat?
There are two phases of Chagas disease. The acute phase that may have flu-like symptoms (if any) and may only last about 8-10 weeks followed by the chronic phase that can be without symptoms for years to decades.
Only about 20 to 30% of people with chronic Trypanosoma cruzi infection eventually develop clinical disease, predominantly cardiac. Cardiac disease usually begins with conduction abnormalities such as right bundle branch block and/or left anterior fascicular block, which may be followed years later by dilated cardiomyopathy. Later cardiac disease is sometimes accompanied by apical aneurysm and thrombus formation.
Less frequently, patients with Chagas disease experience gastrointestinal disease (megasyndromes). Once the characteristic pathology is established (e.g., dilated cardiomyopathy, megaesophagus), antiparasitic treatment will not reverse it.
Source: Centers for Disease Control and Prevention https://www.cdc.gov/parasites/chagas/
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Resources for physicians
From January through June 2020, UT Health San Antonio is hosting a Chagas Disease ECHO for physicians. Presentations slides are available below. Check back for updates.
National data & resources
The Centers for Disease Control and Prevention (CDC) provides access to national databases with emphasis on trends, treatments, and resources/publications
Below is a selection of publications that explore the threat of Chagas and opportunities for identification, screening, and treatment.
Addressing the Challenges of Chagas Disease: An Emerging Health Concern in the United States. Edwards, M. S., Stimpert, K. K., & Montgomery, S. P. (2017). Infectious Diseases in Clinical Practice, 25(3), 118-125.
Current Gaps and Needs for Increasing Access to Healthcare for People with Chagas Disease in the USA. Forsyth, C. J., Granados, P. S., Pacheco, G. J., Betancourt, J. A., & Meymandi, S. K. (2019). Current Tropical Medicine Reports, 6(1), 13-22.
Prevalence of Chagas disease in the Latin American–born population of Los Angeles. Meymandi, S. K., Forsyth, C. J., Soverow, J., Hernandez, S., Sanchez, D., Montgomery, S. P., & Traina, M. (2017). Clinical Infectious Diseases, 64(9), 1182-1188.
Chagas Disease. Bern, C. (2015). New England Journal of Medicine, 373(5), 456-466.