Chagas Disease

Chagas disease was first discovered in Brazil by Carlos Chagas and thereafter had acquired the name kissing bug disease since human transmission requires kissing bugs. The disease can be acute, intermediate or chronic.  ^{[1] [2]}

Epidemiology

The medical condition has become a major concern in South America. ^[3]

Causes

The disease is caused by infection of a minute parasite called Trypanosoma cruzi which is transmitted from the wastes of reduvid or kissing bugs. These bugs often bite in the facial area leaving their feces behind. When it gets through a break in the skin or to the eyes or nose thru rubbing, it can get into the body to replicate and eventually can reach other vital organs by travelling in the blood stream. ^{[1] [4]}

The infection can be passed on by a mother to her child while pregnant or it may be spread through contaminated food. Another means of transmitting the disease is thru organ donation and blood transfusion thus blood screening is an effective measure especially in high risk areas. ^[4]

Signs and Symptoms

Some may not experience any symptoms. During the acute phase, the individual may notice swelling at the site of infection. He may also develop nonspecific symptoms like fever, body malaise, headache, appetite loss, rash, nausea and vomiting. ^[5] Physical examination may reveal enlargement of the liver or spleen. A more specific sign called Romaña's sign is a localized swelling of the eyelids on the side of the face adjacent to the site of infection. ^[1] The acute phase lasts for weeks to months. Chronic phase may be unnoticeable for years until the individual starts to observe symptoms like irregular heartbeats, swallowing problems, shortness of breath, abdominal pain and loss of consciousness. ^[1]

Diagnosis

History taking and physical examination are done. Blood tests are carried out. [4] Direct visualization of the parasite through microscopy and demonstration of antibodies are both confirmatory. Other exams include ECG, chest x-ray and 2D echo. ^{[1] 3]}

Treatment

Most often used drugs are benznidazole and nifurtimox. ^[3] Patients in the chronic phases are treated based on the organ affected. ^{[1] [3]}

References:

1.      http://www.medicinenet.com/chagas_disease/article.htm

2.      http://www.cdc.gov/parasites/chagas/

3.      http://health.nytimes.com/health/guides/disease/chagas-disease/overview.html

4.      http://www.nlm.nih.gov/medlineplus/chagasdisease.html

5.      http://www.mayoclinic.com/health/chagas-disease/DS00956/DSECTION=symptoms