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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Chagas disease

American trypanosomiasis

Last reviewed: October 6, 2012.

Chagas disease is an illness spread by insects. It is common in South and Central America.

Causes, incidence, and risk factors

Chagas disease is caused by Trypanosoma cruzi, a parasite related to the African trypanosome that causes sleeping sickness. It is spread by the bite of reduvid bugs and is one of the major health problems in South America. Due to immigration, the disease also affects people in the United States.

Risk factors for Chagas disease include:

  • Living in a hut where reduvid bugs live in the walls
  • Living in Central or South America
  • Poverty
  • Receiving a blood transfusion from a person who carries the parasite but does not have active Chagas disease

Symptoms

Chagas disease has two phases: acute and chronic. The acute phase may have no symptoms or very mild symptoms. Symptoms include:

  • General ill feeling (malaise)
  • Swelling of one eye if the bite is near the eye
  • Swollen red area at site of insect bite

After the acute phase, the disease goes into remission. No other symptoms may appear for many years. When symptoms finally develop, they may include:

Signs and tests

Physical examination can confirm the symptoms. Signs may include:

Tests include:

Treatment

The acute phase and reactivated Chagas disease should be treated. Infants born with the infection should also be treated.

Treating the chronic phase is recommended for children and most adults. Adult patients should talk to their doctor about whether to treat chronic Chagas disease.

Two drugs are used to treat this infection: benznidazole and nifurtimox.

Both drugs often have side effects. The side effects may be worse in older people.

Side effects may include:

  • Headaches and dizziness
  • Loss of appetite and weight loss
  • Problems sleeping
  • Skin rashes

Expectations (prognosis)

About 30% of infected people who are not treated will develop chronic or symptomatic Chagas disease. It may take more than 20 years from the time of the original infection to develop heart or digestive problems.

Abnormal heart rhythms (arrhythmias, ventricular tachycardia) may cause sudden death. Once heart failure develops, death usually occurs within several years.

Complications

Calling your health care provider

Call for an appointment with your health care provider if you think you may have Chagas disease.

Prevention

Insect control with insecticides and houses that are less likely to have high insect populations will help control the spread of the disease.

Blood banks in Central and South America screen donors for exposure to the parasite. The blood is discarded if the donor tests positive. Most blood banks in the United States began screening for Chagas disease in 2007.

References

  1. Kirchhoff LV. Trypanosoma species (American trypanosomiasis, Chagas' disease): Biology of trypanosomes. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 277.
  2. Kirchhoff LV. Chagas’ disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 355.

Review Date: 10/6/2012.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Trypanocidal drugs for late stage, symptomatic Chagas diseaseTrypanocidal drugs for late stage, symptomatic Chagas disease
    Infection with the parasite Trypanosoma cruzi causes American trypanosomiasis or Chagas disease. There is evidence that trypanocidal drug treatment, using nitrofuran and imidazolic compounds, can treat acute trypanosomiasis cruzi infections. However, it is not clear if these interventions are effective for chronic infection specifically overt, chronic Chagasic cardiomyopathy. We systematically reviewed the literature for randomized, double blind, controlled clinical trials with or without placebo published since 1965 when these treatments first became available. We found a single double blind randomized clinical trial and five case‐control or case series which addressed trypanocidal treatment of chronic Typanosoma cruzi infection (chronic Chagas disease) in human beings. After reviewing this limited evidence we concluded that treatment with these drugs is not sufficiently well supported regarding clinical value and capacity to eliminate tissue parasitism or induce disappearance of circulating antibodies. Currently new drugs are being developed and clinical trials are needed to evaluate their use in chronic Typanosoma cruzi infection and related diseases.
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