Chagas disease is an infectious disease caused by a parasite (Trypanosoma cruzi) transmitted by a type of bug called a triatomine bug, which generally hides during the day and becomes active at night. These bugs bite unsuspecting victims on exposed skin when they’re asleep, usually on the face around the lips — hence their nickname "kissing bugs."
Common in Central and South America, Chagas disease has also spread to other parts of the world where it can be transmitted through blood transfusion. About 6 to 7 million people worldwide are estimated to have Chagas, according to the World Health Organization.
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When they bite their victim, triatomine bugs also defecate at the site of the bite. If the bug is carrying the parasite, it enters the human body through the skin from the bug’s feces.
There are two phases of Chagas disease: the acute phase and the chronic phase.
The first (acute) phase often goes unnoticed because there are either no symptoms at all — or only mild ones such as fever, fatigue, body aches, and headaches.
When serious symptoms don’t show up, many people don’t concern themselves with the disease, even after receiving a diagnosis. Thirty of the 63 participants in a 2017 PLoS Neglected Tropical Diseases study said they didn’t think or worry about their diagnosis.
In fact, the study’s participants often said they felt “tranquilidad” about their diagnosis — essentially calm or peace.
Alma, a 55-year-old homemaker in Bolivia, said she felt like she didn’t have Chagas at all.
"I feel that I don’t have Chagas. Tranquila, I don’t feel palpitations in my heart. I think that — it’s like I don’t have the disease, no? So, I feel tranquila because others say they have Chagas and feel agitation in their hearts," Alma told PLoS NTD researchers.
Unfortunately, the acute stage develops into the chronic phase after decades. This can lead to much more serious chronic heart disease. The chronic symptoms can be an enlarged heart (cardiomyopathy) or an irregular heart rate or cardiac arrest, which can ultimately lead to sudden death.
Intestinal complications are common as well, and can include an enlarged esophagus (the tube that carries food and liquids from your mouth to your stomach) or bowels, leading to difficulties with eating or passing stool.
There is a 30% risk for those with Chagas disease to develop these complications, according to the Centers for Disease Control and Prevention.
There are two drugs — benznidazole and nifurtimox — that can be used effectively to treat the disease, but there is no preventative vaccine.
Still, people who live in endemic areas can take steps to prevent infection.
Those living in mud, thatch, or adobe houses (the types of residences that are more likely to harbor triatomine bugs) should use insecticide-soaked netting over their beds. Spraying the walls of homes with insecticide and using insect repellent on exposed skin can also help prevent the disease.
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