Chagas Disease Often Goes Unrecognized

Parasitic infections are rare in the United States, but one, called Chagas disease, is believed to be active in several southern states and as far north as the Washington, D.C., area. Also known as American trypanosomiasis, Chagas disease—named for the Brazilian doctor who first identified it more than a century ago—affects as many as 8 million people worldwide, mostly in Latin America, but increasingly in the United States and even Canada. The parasite, Trypanosoma cruzi, that causes the disease is spread through insect bites, as well as from pregnant women to their children, and though blood transfusions and organ transplants if they aren’t sufficiently screened.

Screening, sadly, is rare in the U.S., as doctors in this country are not all aware of the disease’s expanded range. Although Chagas disease can be fatal if let unchecked, it is quite easily cured if caught early. It is usually asymptomatic in its early stages, however, so screening for anyone who is at risk is important. Crudely constructed buildings in warm climates—mud or thatch structures, for example—often house the bugs that carry the parasite, so anyone who has spent significant amounts of time in such a building may be at risk. People who do show symptoms, such as eyelid swelling, enlargement of the liver or spleen, fever, fatigue, or rash should also be tested, especially if they’ve been in Central America.

Left untreated, Chagas disease can lead to colon inflammation or heart failure. This can happen years after the initial infection if it isn’t properly treated. Treatment involves anti-parasitic medication, and is highly likely to be effective if done in the immediate aftermath on the initial infection, during he first few weeks. However it is sometimes successful after the initial phase has passed but before the parasite has settled in. Once the disease has become chronic, the only real medical option is management of the symptoms, such as heart medication for patients whose hearts are effected. There is no vaccine currently available for the disease, and prevention generally involves using nets and insecticides to try to eliminate the insects that carry the disease.

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