infections
Chagas Disease
Introduction
Chagas disease is an infection caused by the protozoaTrypanosoma cruzi, which is transmitted by the bite of a kissing bug (also called an assassin or Triatominae bug). The protozoa (single-cell infectious organisms) may enter the body through the bite wound or through tissues around an eye or less commonly by eating food or drinking fresh fruit juices that are contaminated. The area around the point of entry (a bite wound or an eye) may swell, and people may have a fever. Then, after a long period of no symptoms, serious complications, mainly heart or digestive problems, may develop years later. Doctors confirm the diagnosis by identifying the protozoa in a sample of blood or fluid taken from an infected organ or by doing blood tests. A medication (benznidazoleornifurtimox) is used to kill the protozoa but does not reverse heart or digestive tract damage. (See also Overview of Parasitic Infections .) Chagas disease affects people in Mexico and Central and South America, mainly in rural areas where poverty is widespread. These areas provide a favorable environment for kissing bugs, which transmitTrypanosoma cruzi. The kissing bug thrives in cracks and crevices in mud walls, in thatched roofs of houses and farm buildings, and in rock or wood piles, chicken coops, and dog kennels. Worldwide, about 8 million people are infected withTrypanosoma cruzi. This number includes more than 300,000 people who live in the United States after immigrating from regions of Latin America where they acquired the infection. Among them are an estimated 40,000 women of child-bearing age. It is estimated that 1 to 5% of their children are born with the infection. Immigrants to Europe have also carried the disease with them. Fortunately, measures to control the spread of infection are reducing the number of Chagas cases. (SeeCenters for Disease Control and Prevention: Epidemiology & Risk Factors.) 