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Chagas disease, caused by a parasite, has spread outside of Latin America and carries a high risk of heart disease. Here’s what PMPs need to know.

October 8, 2018

Photo: CDC Biomedical Photographer, James Gathany
“Kissing bugs,” Triatoma pallidipennis, were so named because of their proclivity for biting the lips of sleeping human victims for a blood meal. In the process, it can transfer Chagas, a disease that kills tens of thousands of people in Central and South America.

Chagas disease, caused by infection with a parasite called Trypanosoma cruzi (T. cruzi), causes chronic heart disease in about one- third of those infected. Over the past 40 years, Chagas disease has spread to areas where it had not traditionally been seen, including the United States, according to a new American Heart Association scientific statement published in the American Heart Association journal Circulation.

T. cruzi infection occurs when feces from the infected blood-sucking insect triatomine enters the skin through the bite site or in the eye. Triatomine insects are found in Central and South America and in the Southern United States. The disease also can be passed through contaminated food or drink, from pregnant mothers to their babies, and through blood transfusions and organ transplants.

The health risks of Chagas disease are well-known in Latin America, where most cases are found, including in Brazil, Argentina, Bolivia, Paraguay, Mexico and El Salvador. However, doctors outside of Latin America are largely unaware of the infection and its connection to heart disease. Countries where infected individuals have been diagnosed include the United States with an estimated 300,000 cases.

“This statement aims to increase global awareness among physicians who manage patients with Chagas disease outside of traditionally endemic environments,” said Maria Carmo Pereira Nunes, M.D., Ph.D., co-chair of the committee that produced the statement.

Although 60 to 70 percent of people infected with T. cruzi never develop any symptoms, those who do can develop heart disease, including heart failure, stroke, life-threatening heart rhythm abnormalities and cardiac arrest. In the Americas, Chagas disease is responsible for more than seven times as many disability-adjusted life-years lost as malaria. However, if caught early, an infection can be cured with medications that have a 60 to 90 percent success rate, depending on when in the course of infection the patient is treated.

“Early detection of Chagas disease is critical, allowing prompt initiation of therapy when the evidence for cure is strong,” said statement co-author Caryn Bern, M.D., M.P.H., professor of epidemiology and biostatistics at the University of California in San Francisco. Source: American Heart Association