Chagas Disease (American Trypanosomiasis or Kissing Bug Disease)

  • Medical Author:
    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.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    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.

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What is Chagas disease?

Chagas disease (also termed American trypanosomiasis) is an infection caused by a protozoan parasite (Trypanosoma cruzi) that can result in acute inflammatory skin changes (chagomas) and eventually may cause infection and inflammation of many other body tissues, especially those of the heart and intestinal tract. The disease was named after Dr. Carlos Chagas, who discovered the disease in 1909. The disease may have three phases in an individual: acute, with mild or no symptoms that may last weeks to about two months; intermediate or indeterminate phase that has few if any symptoms and may last 10-20 years or longer; and chronic phase that appears after about 20 years, with the more severe symptoms appearing from gradual chronic organ damage (especially to the heart and intestine, although other organs may be affected) with symptoms that usually remain for life. People with Chagas disease seen in the U.S. usually have acquired it while living in a country where the disease is endemic (Mexico and Central and South America).

The U.S. Centers for Disease Control and Prevention (CDC) estimates about 8-11 million people are infected in countries where the disease is endemic. The parasites are transferred to humans by the bite of blood-sucking triatomine bugs in the subfamily Triatominae, also termed "kissing bugs." The disease has been diagnosed in the U.S., mainly in immigrants from South and Central America. Triatomine bugs have been detected in Texas, and recently the CDC communicated that the bugs have now been found in 28 states, including California and Pennsylvania.

Picture of kissing bug, a vector for Chagas disease
Picture of kissing bug, a vector for Chagas disease; SOURCE: CDC/donated by the World Health Organization, Geneva, Switzerland

American trypanosomiasis (Chagas disease) is distinguished from African trypanosomiasis (sleeping sickness or African sleeping sickness) by the part of the world where they occur, their vectors, and their different symptoms and different treatments (see Table 1).

Table 1 - Comparison of American (Chagas disease) and African trypanosomiasis (sleeping sickness)
American trypanosomiasisAfrican trypanosomiasis
CauseT. cruziT. brucei (subspecies)
Main vectorTriatomine bugs (also termed kissing bugs)Tsetse fly
Main symptomsChagomas, heart, gastrointestinalChancres, nighttime insomnia, seizures
TreatmentBenznidazole, nifurtimox; symptomatic treatments in chronic phaseSuramin, melarsoprol, pentamidine, eflornithine
Medically Reviewed by a Doctor on 12/2/2015

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