The Chagas disease or Chagas disease is a common infectious disease in Latin American countries, becoming considered a major public health problem in the continent, which has managed to spread and be present throughout the world.

The scientific name of this disease is Human Trypanosomiasis , a parasitosis caused mainly by the parasite Trypanosoma cruzi , a microorganism that is transmitted to humans through a vector .

It is called a vector, the organism that naturally has an infectious agent that does not affect it and that in some way is capable of transmitting to another living being. In this case, the vector of trypanosomiasis is the Chipo or chinche, which  are blood-sucking insects of the Triatominae subfamily.

How is chagas disease transmitted?

This small animal carries the parasite that causes Chagas disease in its urine and feces, for which the main transmission mechanism is through direct contact of the mucous membranes or wounds present on the individual’s skin with them, it can also be transmitted through ingestion of contaminated food, during blood transfusions with infected blood or through vertical transmission, that is, during pregnancy.

These insects usually live on the roofs of houses in rural areas and during the night they come out to feed on human blood, when they bite the exposed skin, the chipo begins to suck blood and in turn to swell, this leads to an increase in the pressure on the animal’s organs for which it begins to urinate and defecate near the injury.

In general, the Chipo bite causes stinging, which causes the individual to start scratching, in this way it drags urine and feces to the wound caused by the bite, allowing the entry of the parasite into the body.

Symptoms and signs of chagas disease

Depending on the development of the disease and the symptoms that the patient presents, the disease is divided into two stages, the acute phase which, if not treated, can progress to the chronic phase.

Acute phase

In the acute phase, there is fever lasting more than 7 days, enlargement of the liver and spleen, rapid onset heart disorders, nausea, vomiting, diarrhea, abdominal pain, loss of appetite, muscle and joint pain, fatigue, increased volume of the eyelids of one of the eyes and the appearance of “inoculation chagóma” which is nothing more than a small subcutaneous nodule at the site of the chipo bite.

Chronic phase

Chronic phase, in turn, this phase is subdivided into two, Chagas disease in an indeterminate or asymptomatic chronic phase and Chagas disease in a determined or symptomatic chronic phase.

  • Asymptomatic chronic phase, although the patient is infected, he does not present any cardiovascular or digestive symptoms, etc.
  • Chronic symptomatic phase, the patient presents cardiovascular or digestive symptoms (the large intestine or colon and esophagus are the main organs affected after the heart).
  • Chagasic heart disease: it is the main cause of death in these patients, it manifests itself with palpitations and difficulty in breathing when making some kind of effort. This is because Chagas disease causes the growth of the heart muscle and when this happens, the functioning of this organ will be affected.
  • Chagasic esophagopathy: also known as achalasia or mega esophagus, it is the abnormal growth of the musculature and mucosa of the esophagus as well as destruction of its innervation, causing motor alterations of said organ. In general, patients will have difficulty and pain in swallowing, regurgitation of stomach contents and belching.
  • Chagasic colopathy: affects the distal part of the large intestine (sigmoid colon and rectum). This alteration causes the dilation of this portion of the organ causing abdominal distention, difficulty in evacuating and intestinal obstruction.

Treatment

The Chagas disease can be treated, as long as the patient is in a very advanced stage of the disease or terminal stages. This treatment consists of the oral administration of two antiparasitics , under strict medical supervision, since they usually have a large number of side effects.

These two antiparasitic are benznidazole and  Nifurtimax , whose function is to combat parasites (trypanosomes) that cause the disorder.

This treatment is highly effective during the acute phase of the infection, while in the chronic phase its effectiveness decreases, this is where the importance of making an early diagnosis of the pathology lies.

In general, treatment in children and young people makes them manifest fewer adverse effects than an adult would have, that is why it is considered that people at an early age have a greater tolerance to it, but it should be omitted in pregnant women or during breastfeeding.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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