Chagas disease, also called American trypanosomiasis, is a potentially fatal disease caused by the protozoan parasite Trypanosoma cruzi.
is found mostly in Latin America, where it is transmitted to humans mainly by the feces of triatomine insects called kissing bugs, bugs or other names, depending on your geographic location. Originally
(more than 9000 years), T. cruzi only affected wild animals was then when it spread to domestic animals and humans. Because of the large number of wild animals that serve as a reservoir for this parasite in the Americas can not be eradicated.
Worldwide, an estimated 10 million people are infected, mostly in Latin America, where Chagas disease is endemic. More than 25 million people are at risk of acquiring the disease. It is estimated that in 2008 the disease killed more than 10 000 people.
The disease is named after Carlos Ribeiro Justiniano Chagas, a Brazilian doctor who discovered it in 1909.
geographic areas affected by
Chagas disease Chagas disease is found mainly in Latin America, but in recent decades have seen most often in the United States, Canada, many European countries and some Western Pacific .
This is mainly due to the mobility of the population between Latin America and the rest of the world. Less often due to infection through blood transfusions, vertical transmission (from infected mother to her child) or organ donation.
Symptoms
Chagas disease Chagas disease has two distinct phases.
initial acute phase
Initially, the acute phase lasts about two months after contracting the infection.
During this acute phase circulating in the bloodstream a lot of parasites.
In most cases no symptoms or symptoms are mild. There may be fever, headache, enlarged lymph nodes palidez, dolores musculares, dificultad para respirar, hinchazón y dolor abdominal o torácico. En menos del 50% de las personas picadas por un triatomíneo, un signo inicial característico puede ser una lesión cutánea o una hinchazón amoratada de un párpado.
Fase Crónica
Durante la fase crónica, los parásitos permanecen ocultos principalmente en el músculo cardiaco y digestivo. Hasta un 30% de los pacientes sufren trastornos cardiacos y hasta un 10% presentan alteraciones digestivas (típicamente, agrandamiento del esófago o del colon), neurológicas o mixtas.
Con el paso de los años, la infección puede causar muerte súbita o insuficiencia heart by the progressive destruction of heart muscle. Forms of contagion
In Latin America, the parasite T. cruzi is transmitted mainly through infected feces of triatomine insects that feed on blood.
Usually they live in cracks and crevices of poorly constructed houses in rural and suburban areas. Normally remain hidden during the day and become active at night feeding on human blood.
generally bite in an exposed area of \u200b\u200bskin, including face and defecate near the bite. The parasites enter the body when a person rubs instinctively bite and push the stool toward the bite, eyes, mouth or open skin lesion.
Other modes of transmission of Chagas disease
by food contaminated with the parasite, for example, by contact with feces of triatomines;
by transfusion of infected blood;
by transmission from infected mother to her child during pregnancy or childbirth;
by transplantation of organs from an infected person
laboratory accident.
Treatment
Chagas disease Chagas disease can be treated with benznidazole or nifurtimox, which kill the parasite. Both drugs are almost 100% effective in curing the disease if given early in infection in the acute stage.
However, its effectiveness decreases as more time elapses from the onset of infection. Treatment with these drugs is also indicated in case of reactivation of infection (eg immunocompromised) in children with congenital disease and in patients at the beginning of the chronic phase.
treatment should be offered to infected adults, especially those who have no symptoms. The potential benefits of medication to prevent or slow the progression of Chagas disease must be weighed against the long duration of treatment (two months) and possible adverse reactions (which occurring in up to 40% of patients).
benznidazole and nifurtimox should not be administered to pregnant women or people with kidney or liver failure.
Nifurtimox is also contraindicated in persons with a history of neurological diseases of the nervous system or psychiatric disorders.
addition, it may be necessary to give a specific treatment for cardiac or gastrointestinal manifestations.
How to prevent this disease?
There is no vaccine against Chagas disease.
The most effective method to prevent it in Latin America is the vector control.
objectives control are to eliminate the transmission and get infected and sick people have access to health care.
screening of donated blood is necessary to prevent infection by blood transfusions and organ donation.
prevention and control methods
spraying and surrounding houses with insecticides, improving housing
to prevent infestation by the vector,
personal preventive measures, such as use of mosquito nets;
good hygiene in the preparation, transport, storage and consumption of food;
screening of donated blood;
screening tests organ, tissue or donated cells and their receptors;
screening of newborns whose mothers are infected, as well as siblings of infected children to achieve early diagnosis and provide appropriate treatment.
Source: World Health Organization
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