Chagas Disease (cont.)
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Chagas disease (kissing bug disease) facts
- What is Chagas disease?
- What is the history of Chagas disease?
- What causes Chagas disease?
- Is Chagas disease contagious?
- What are the risk factors for Chagas disease?
- What are symptoms and signs of Chagas disease?
- How do health-care professionals diagnose Chagas disease?
- What is the treatment for Chagas disease?
- What types of physicians treat Chagas disease?
- Can transmission of Chagas disease be prevented with a vaccine?
- What is the prognosis for Chagas disease?
- What are the complications of Chagas disease?
- What research is being done for Chagas disease?
What are the risk factors for Chagas disease?
Living in an area where the vectors (kissing bugs) that spread the disease are plentiful is a major risk factor for Chagas disease. Such areas are impoverished areas in Mexico and Central and South America. Any residence that is infested with these vectors is a high-risk area; eliminating the areas where the vectors reside reduces the risk. Another risk factor is obtaining a blood transfusion, especially in an endemic region, if the blood donors are not screened for Chagas disease. This risk also occurs for recipients of donated organs. Immunocompromised patients have a higher risk for development of the disease, and some infected women with chronic Chagas (as many as 10%) may transmit the parasites to their newborns (congenital Chagas disease). Also, eating unwashed foods that are contaminated with feces from the infected bugs may cause Chagas disease (food-borne disease).
What are symptoms and signs of Chagas disease?
The symptoms and signs of Chagas disease can be quite variable and range from no symptoms at all to severe and distressing symptoms. The first symptoms and signs, when present in the acute phase, may include some of the following:
- Swelling and/or redness at the skin infection site (termed chagoma)
- Skin rash
- Swollen lymph nodes
- Headaches and body aches
- Nausea, vomiting, and/or diarrhea
- Abdominal discomfort or pain
- Liver and/or spleen enlargement
- Romaña sign (unilateral painless edema [swelling] of tissues around the eye)
- EKG changes suggestive of myocarditis and/or arrhythmias may occur
- Muscle aches
Most individuals who get the above acute-phase symptoms have them resolve spontaneously in about three to eight weeks. Occasionally, acute infections show chronic symptoms (listed below) if the patient's immune function is weakened.
Most investigators suggest that the intermediate or indeterminate phase has no symptoms. This stage may last throughout the person's life, and the individuals may never know they have Chagas disease, especially if they had mild or no symptoms in the acute phase. However, this stage may only last about 10-20 years in some patients before the chronic symptoms develop in about 10%-30% of those infected. Some researchers compare the chronic phase of Chagas disease to HIV/AIDS. Whereas HIV/AIDS slowly attacks the immune system, Chagas disease slowly attacks the heart and the tissues of the gastrointestinal tract. Other investigators consider such a comparison as unwarranted publicity or hype to spotlight Chagas disease.
Symptoms of chronic Chagas disease vary according to the organs most affected; in most cases, the heart or the gastrointestinal tract (or both) show the most serious symptoms. Chronic Chagas disease symptoms may include the following:
- Irregular heartbeats
- Palpitations (abnormal heartbeat sensations)
- Fainting (syncope)
- Cardiomyopathy (chronic disease of the heart muscle)
- Congestive heart failure (dilated heart)
- Shortness of breath (dyspnea)
- Sudden death
- Chronic abdominal pain
- Chronic constipation
- Dilated esophagus and/or colon
- Difficulty swallowing
These symptoms are due to organ damage caused by the persistent presence of the parasites within the tissues of these organs. Chronic inflammation develops as the body reacts to the parasites; it affects the nerve cells or neurons in these tissues, causing electrical conduction changes in the heart (arrhythmias) and poor muscle tone in the intestines.
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