What Is Chagas Disease?

Medically Reviewed By Darragh O'Carroll, MD
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Chagas disease is a potentially life-threatening condition. It is caused by contact with the feces of the triatomine bug, which carries the parasite known as Trypanosoma cruzi. Triatomine bugs are also known as kissing bugs, as they often bite people’s faces.

Chagas disease, also referred to as CD, is found mostly in 21 continental Latin American countries. Around 6–7 million people worldwide have CD. In the Americas, there are 30,000 new cases each year.

This article will discuss what CD is and who it affects, along with its symptoms, causes, and treatments. It will also discuss prevention and outlook for those with CD.

What is Chagas disease?

person scratching their arm
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Insects known as triatomine bugs can become infected with the parasite Trypanosoma cruzi, or T. cruzi after biting an infected animal or person. After the bugs become infected, they can pass the parasite to humans and animals through their feces.

Triatomine bugs often live in raw materials such as mud, straw or palm thatch. During the night, they become active and often bite people’s faces.

After biting and ingesting blood, they may defecate on that person’s skin. If their  feces contains the parasite, it can enter the person’s body in a number of different ways, including:

  • through the wound caused by the bite
  • through mucous membranes
  • through other breaks or cuts in the skin

Once the parasite enters the body, that person becomes infected and may then develop CD.

Is Chagas disease fatal?

Often, people with CD are unaware they have the disease. Only 1 in 10 people with the disease receive a diagnosis and only a small percentage of these receive treatment.

If the disease is not treated within the first few weeks, the condition can progress and may no longer be curable. It can eventually lead to complications such as heart damage.

Around 12,000 people die from complications resulting from CD every year.

Where does Chagas disease occur?

CD is found mainly in 21 continental Latin American countries. It can also be found in some other areas of the world including:

  • the Americas
  • Europe
  • Africa
  • Eastern Mediterranean countries
  • Western Pacific countries

Who gets Chagas disease?

Children are most likely to become infected with CD, followed by women, then men.

If you live in a house made from materials such as straw, mud, or palm thatch you are more likely to become infected. Triatomine bugs tend to reside in these materials.

There is a low risk of getting the disease from blood transfusions. People who are pregnant can also pass the disease to the fetus during pregnancy.

What are the symptoms of Chagas disease?

There are two phases of CD: the acute phase and the chronic phase. Each phase presents with different symptoms.

Acute phase

After initial infection, the acute phase can last around 2–8 weeks. You may experience symptoms such as:

  • headaches
  • enlarged lymph glands
  • muscle pain
  • pale skin
  • breathing problems
  • swelling
  • stomach or chest pain
  • skin lesions
  • purplish swelling on one of your eyelids

The acute phase of CD can be life threatening for those with weakened immune systems. This can include those receiving chemotherapy and those with advanced HIV.

Chronic phase

There are two stages to the chronic phase of CD.

In the first stage, you will have no symptoms. The parasite will live deep inside your organ tissue, especially in the heart.

During the second stage, around 70–80% of people infected may not have any symptoms. In the remaining 20–30%, the disease progresses and may begin to exhibit symptoms.

The second stage often starts 10–20 years after the initial infection. Symptoms often involve problems with the heart, such as:

Other problems can occur, such as an abnormal enlargement of the colon or esophagus.

Read more about conditions of the heart here.

What causes Chagas disease?

Below is an image of a triatomine bug, which carries the parasite known as Trypanosoma cruzi.

image of a triatomine bug
schlyx/Shutterstock

CD is caused by the parasite T. cruzi. It can be transmitted in a few different ways, such as:

  • by entering your body through a mucous membrane or open wound
  • by passing it to an unborn baby during pregnancy
  • through blood and blood product transfusions
  • through an organ transplant
  • by eating uncooked contaminated food
  • through accidental laboratory exposure

How is Chagas disease treated?

There are currently two approaches to treating CD: antiparasitic treatments to kill the parasite, and treatments to manage symptoms.

During the acute stage, antiparasitic treatments are 100% effective at curing the disease. These medications can also be used during the chronic stage, but will only slow the progression of the disease, not cure it.

In the United States, there are two types of medications available:

  • Benznidazole: This drug is approved by the FDA for adults, and children aged 2–12.
  • Nifurtimox: This drug is FDA approved for children from birth to 18 years of age.

You may need to take antiparasitic medication for as long as 60–90 days. These medications are successful in preventing CD from progressing during the acute phase. However, they can cause serious side effects, which may be unpleasant.

Side effects from antiparasitic medication may include:

If you are in the late stages of CD and are experiencing heart or digestive problems, contact your doctor. They may suggest lifelong treatment or surgery to help manage your health.

How is Chagas disease diagnosed?

If your doctor suspects you have early stage CD, they may suggest a blood test. A blood test can determine whether or not there are parasites in your blood.

During the chronic stage, the parasite can be difficult to detect. In this case, your doctor may instead test for antibodies your body has produced to fight the parasite. They will likely perform two or three different tests to ensure you receive the right diagnosis.

What are the risk factors for Chagas disease?

Risk factors for CD include:

  • living in houses made of certain materials such as thatched roofs or mud walls
  • living in an area where triatomine bugs are
  • receiving a blood transfusion from a person with CD
  • eating contaminated food or drink

How can you prevent Chagas disease?

You can reduce your chance of getting CD by taking steps to prevent the parasite from spreading. These include:

  • building houses with materials such as bricks and concrete
  • spraying insecticide inside the home to kill any triatomine bugs
  • screening blood transfusions and organ donations
  • screening for the parasite if you are pregnant
  • detecting and treating infections early

What is the outlook for Chagas disease?

If you are in the chronic stage of CD, you may be at risk for cardiac complications such as heart failure or enlargement of the heart.

Other complications can include digestive problems such as an enlarged colon or esophagus. This can happen between 20–30 years after becoming infected.

Complications during the chronic phase of the disease can occur 10–20 years after the initial infection.

If you are experiencing complications of CD, your doctor may recommend surgery or suggest lifelong treatments to help manage symptoms.

Summary

Chagas disease is found mostly in Latin America and affects around 6–7 million people worldwide. CD is caused by contact with the feces of the triatomine bug. The bug leaves its feces containing a parasite on your skin. When the parasite enters your body, it can lead to CD.

After becoming infected, you may not experience any symptoms, or symptoms may be mild. If treated early in the acute stage, CD can be curable.

If not treated early, the condition can become chronic and you may be at risk for complications. Currently, there is no cure for chronic CD. However, medications can slow the progression of the disease.

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Medical Reviewer: Darragh O'Carroll, MD
Last Review Date: 2022 Jul 27
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