Chagas Disease

Chagas disease is an infectious disease caused by a protozoan parasite, Trypanosoma cruzi.

Infection by this parasite result in inflammatory changes in skin, and then infection and inflammation of other tissues like heart and intestinal tract.

This disease is prevalent in South and Central America, and Mexico. The parasite is spread by an insect vector, a triatomine bug.

The infection is more commonly seen in children.

Chagas disease leads to heart and digestive problems as complications. Treatment kills or inhibits the parasite, and alleviates the symptoms.

Symptoms or Chagas disease ranges from mild to very serious. Some people may remain asymptomatic. Acute phase of Chagas disease have a sudden onset of symptoms, but the duration of illness remains short. It lasts for about 2 months, and most of the symptoms are mild.  In chronic phase, the symptoms and disease are long-lasting.  

Acute form of the disease is characterized by mild symptoms like:

• Swelling at the site of infection and eyelids
• Fever and fatigue
• Skin rashes
• Body pain
• Head aches
• Loss of appetite
• Nausea or vomiting
• Diarrhea
• Enlarged liver and spleen

These symptoms usually resolve on their own. But if the symptoms persist, this may lead to a chronic phase of Chagas disease. 

Symptoms of chronic form may start few years after the initial infection. 

The main symptoms include:

• Irregular heartbeat
• Congestive heart failure
• Cardiac arrest
• Enlarged esophagus
• Abdominal pain
• Constipation
• Difficulty in swallowing

Chagas disease is caused by the infection of a parasite, Trypanosoma cruzi. This parasite is transmitted by triatomine bugs.

The parasites are present in the feces and urine of the insect that lives in the walls of poorly constructed house in the rural areas. These vectors are blood-sucking and becomes active in the night. The bugs bite the exposed areas of the skin and defecates close to this.

The parasite enters when the person rubs the feces/urine into the site or a wound.

Chagas disease may also be spread through:

• Food contaminated with feces of the vector bug
• Blood transfusion from a donor infected with the parasite
• Passage from mother to child during pregnancy
• Organ transplants from an infected donor
• Laboratory accidents
• An infected pet

The major risk factors of the disease include living in Central or South America, living in a house infested by the triatomine bug, and receiving blood transfusion from an infected person.

Physical examination, history of symptoms, and exposure to risk factors help in diagnosis of Chagas disease.

The confirmatory diagnosis is the blood test showing the presence of the parasite or antibodies in blood.

Additional tests are recommended to check the progress of the disease and the extent of damage to other organs.

This includes ECG, X-ray, Echocardiogram, and endoscopy.

Treatment methods depend on the phase of Chagas disease and the age of the patient.

Benznidazole and nifurtimox are prescription medications used to kill the parasite, particularly during the acute phase. These medications are also used for those who have congenital form of Chagas disease. In chronic phase, these drugs are suggested for patients under the age of 50 years as they help to reduce the progression of the disease. They also help to control serious complications of Chagas disease.

Further treatment is based on signs and symptoms of the chronic phase. Cardiovascular complications are treated with medications, pacemaker, surgery, or a heart transplant.

Diet, medications, and surgery are suggested for digestive complications associated with this disease.

To prevent Chagas disease you must take adequate precautions while being in the high-risk area of the disease.

Avoid sleeping in ill-constructed, mud, or thatched houses which may have the vector bug.

Use an insect repellent net on the bed to keep the bugs away.

Use insect repellants on the skin to prevent insect bite.

A few alternative and homeopathic remedies exist for Chagas disease.

Ledum, Lycopodium, Anthracinum, Tarentula cubensis, Arsenic Album, Calcaria Carb, Cocculus Indicum, Belladonna, Apis Mel, Rhus Tox, Iodum, and Ceonathus are some of the medications used in homeopathy to treat the symptoms of Chagas disease.

Some of the common herbal remedies for Chagas disease are green coconut oil mixed with olive oil, garlic tea, oil of oregano, turmeric, black walnut extract, and grapefruit seed extract.

These are considered to have anti-parasitic effects and may be used as a tea or applied topically.

Lifestyle modifications are necessary in order to cope with Chagas disease.

Try to prevent the progress of the disease to a chronic phase.

Prognosis of people who are treated in the acute phase is very good.

Most of the complications associated with Chagas disease develop during the chronic phase.

This include heart failure, enlargement of esophagus, and enlargement of colon.

Enlargement of esophagus may result in difficulty in swallowing, while colon enlargement result in abdominal pain and constipation.