Chagas' Disease (American Trypanosomiasis)

Description

Chagas' disease is caused by the protozoan parasite Trypanosoma cruzi. Acute infection can be asymptomatic or accompanied by a febrile illness with meningoencephalitis or myocarditis, or both. Manifestations of chronic infection include cardiomyopathy and intestinal "mega" syndromes (for example, megaesophagus and megacolon). Chagas' disease is usually transmitted by contact with the feces of an infected reduviid ("cone nose" or "kissing") bug; transmission can also occur through blood transfusion or via transplacental infection.

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Occurrence

Chagas' disease occurs throughout much of the Western Hemisphere, from Mexico to Argentina.

Risk for Travelers

Reduviid bugs typically infest buildings constructed of mud, adobe brick, or palm thatch, particularly those with cracks or crevices in the walls and roof. Avoiding overnight stays in dwellings infested by the reduviid bug vector greatly reduces the risk of acquiring the infection, and reports of acute Chagas' disease in travelers are rare. In some regions, travelers should be aware that blood for transfusion might not be routinely tested or treated for T. cruzi.

Preventive Measures

No vaccine is available. Preventive measures include insecticide spraying of infested houses and the use of bed netting. The latter should be recommended for travelers camping or sleeping out of doors in highly endemic areas.

Treatment

Anti-trypanosomal treatment exists for acute disease, and treatment can also be helpful for people with long-standing infection. Travelers should be advised to consult an infectious disease or tropical medicine specialist. People with chronic cardiac or mega-syndromes might benefit from symptomatic therapy.

Credits: National Center for Infectious Diseases