Chagas Disease (American Trypanosomiasis or Kissing Bug Disease)
Charles Patrick Davis, MD, PhD
Melissa Conrad Stöppler, MD
Chagas disease (kissing bug disease) facts
- Chagas disease is an infection caused by a protozoan parasite (Trypanosoma cruzi) that can result in acute inflammatory skin changes (chagomas) and may eventually cause infection and inflammation of many other body tissues, especially those of the heart and intestinal tract.
- Chagas disease was first described in 1909 in Brazil.
- Chagas disease is caused by a protozoan parasite named Trypanosoma cruzi that is transmitted to humans from the feces of triatomine bugs (kissing bugs).
- The parasites usually enter the mammalian (human) host through the bug bite, or breaks in the skin or conjunctiva, replicate in mammalian cells, and may eventually reach other organs through the blood.
- Chagas disease may proceed through three phases in an individual: acute, intermediate or indeterminate, and chronic.
- Chagas disease symptoms vary widely from no symptoms to severe in the chronic phase.
- Acute-phase symptoms of Chagas disease may be swelling and/or redness at the skin infection site (termed chagoma), rash, swollen lymph nodes, fever, head and body aches, fatigue, nausea, vomiting and/or diarrhea, liver and/or spleen enlargement, and the Romaña sign.
- Chronic-phase symptoms and signs of Chagas disease may be irregular heartbeats, EKG changes, palpitations, fainting (syncope), cardiomyopathy, congestive heart failure, shortness of breath (dyspnea), emphysema, stroke, sudden death, chronic abdominal pain, chronic constipation, dilated colon, and difficulty swallowing.
- Patient history, physical exam, direct microscopic visualization of the parasites, and detection of antibodies against the parasites are methods used to diagnose Chagas disease.
- Treatment with antiparasitic drugs benznidazole (Rochagan, Ragonil) and nifurtimox (Lampit) kill or inhibit T. cruzi parasites; drugs are available from the CDC.
- Chronic-phase patients are usually treated using treatments directed at the specific symptoms or organ damage.
- There is no vaccine against Chagas disease parasites for humans, but many experts suggest that elimination of primitive housing and increasing education about the disease may prevent most cases of Chagas disease.