Chagas disease, also called American trypanosomiasis, is a life-threatening disease caused by the protozoan parasite Trypanosoma cruzi that transmits an insect known as a triatomic insect.
They are also known as vinchucas (or in certain areas such as "chinche gaucha", "chinche besucona", "sucker", "voladora", "barbeiros" or "chipos") because they often bite people's faces. When one of these insects bites, it leaves infected droppings. And the person can become infected if they scratch on the eyes or nose, the wound of the bite or a cut.
Chagas disease is an inflammatory and infectious disease, which is found in the feces of triatomine insects. If left untreated, Chagas disease can cause serious heart and digestive problems.
There are no vaccines or medicines to prevent Chagas disease. If you travel to affected areas, you are at greater risk if you sleep outdoors or in bad housing. It is important to use insecticides to prevent stings, and to practice safety with food.
Chagas disease can also be transmitted:
For consumption of food contaminated by T. cruzi; for example, by contact with feces or urine of triatomines or marsupials;
For the transfusion of infected blood;
For the transmission of the infected mother to her child during pregnancy or childbirth;
For the transplant of organs from an infected person; and for laboratory accidents.
It should not be scratched or rubbed the area of the bite helps the parasites to enter the body.
Chagasic cardiomyopathy is a type of cardiomyopathy or inflammation of the heart muscle caused by an infection with the parasite Trypanosoma cruzi.
It is a parasitic disease common in Latin America. It is also found in the United States
Among the people who manifest Chagas disease, the most frequent problems are:
Heart problems and problems of the digestive system
Congestive heart failure
Sudden cardiac arrest
Difficulty swallowing due to enlargement of the esophagus
Abdominal pain or constipation due to enlarged colon
If there is involvement of the heart or digestive system, the most frequent symptoms are:
- Chest pain
- Difficulty to swallow.
- Body pain
- Loss of appetite
- Swollen eyelid
Chagas disease has two clearly differentiated phases. Initially, the acute phase lasts about two months after contracting the infection. During this acute phase, a large number of parasites circulate in the bloodstream. In most cases there are no symptoms or they are mild and not specific. In less than 50% of people stung by a triatomine, a characteristic initial sign may be a skin lesion or a bruised eyelid swelling. In addition, they may have fever, headache, enlarged lymph nodes, pale skin, muscle aches, shortness of breath, swelling and abdominal or chest pain.
During the chronic phase, the parasites remain hidden mainly in the cardiac and digestive muscles. Up to 30% of patients suffer cardiac disorders and up to 10% have digestive disorders (typically, enlargement of the esophagus or colon), neurological or mixed. Over the years, the infection can cause sudden death by cardiac arrhythmias or progressive heart failure by destruction of the heart muscle and its innervations.
Initially, Chagas disease was confined to the Region of the Americas, mainly in Latin America, but has spread to other continents since then.
Trypanosoma cruzi infection can be cured if the treatment is given shortly after the infection.
In the chronic phase of the disease, an antiparasitic treatment can slow or prevent the progression of the disease.
Up to 30% of chronic patients have cardiac alterations and up to 10% have digestive, neurological or combined disorders. All these manifestations may require specific treatment.
Vector control is the most useful method to prevent Chagas disease.
Blood screening is critical to prevent infection through blood transfusions and organ transplantation.
Screening of newborns and other children of infected women who have not received antiparasitic treatment is essential.
Chagas disease can be treated with benznidazole, and also with nifurtimox, which kill the parasite. Both drugs are almost 100% effective in curing the disease if they are administered at the beginning of the infection in the acute stage, even in cases of congenital transmission. However, its effectiveness decreases as more time elapses from the onset of infection.
Treatment with these drugs is also indicated in case of reactivation of the infection (for example, by immunosuppression) and in patients at the beginning of the chronic phase. Treatment should be offered to infected adults, especially those who have no symptoms, since antiparasitic treatment can prevent or slow the progression of the disease and prevent congenital transmission in pregnant women. In other cases, the possible benefits of medication to prevent or delay the progression of Chagas disease must be weighed against the prolonged duration of treatment (up to two months) and possible adverse reactions (occurring up to 40% of the time). treated patients).
Benznidazole and nifurtimox should not be given to pregnant women or people with kidney or liver failure. Nifurtimox is also contraindicated in people with a history of neurological nervous system diseases or psychiatric disorders. In addition, it may be necessary to administer a specific treatment for cardiac or digestive manifestations.