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Chagas disease is a parasitic infection caused by an organism known as Trypanosoma cruzi. The disease is transmitted by triatomine insects (reduviid bugs), which inhabit crevices in the walls and roofs of substandard housing in South and Central America. The triatomine insect lays its feces on human skin as it bites, usually at night. A person becomes infected when he or she unknowingly rubs the feces into the bite wound or any other open sore. The disease may also be transmitted by blood transfusions or by infected mothers passing it to their babies in the uterus or through breastfeeding, but these are much less common (see Risk for Transfusion-Transmitted Infectious Diseases in Central and South America, Emerging Infectious Diseases Vol. 4/No. 1 January-March 1998).
The acute stage of the disease is seen most often in children. Symptoms may include fever, lymph node swelling, enlargement of the liver or spleen, and fatigue. Swelling around one eye (Romana's sign) may occur if insect feces are rubbed into the eye. Most people who are infected show no initial symptoms. However, ten to twenty years later, about one-third of those infected show evidence of irreversible damage to the heart, esophagus, or large intestine. Cardiac symptoms may include abnormal heart rhythms, heart failure, angina, left ventricular aneurysm, and cardiac arrest. Esophageal involvement may lead to difficulty swallowing and malnutrition. Intestinal involvement may cause constipation and abdominal distention.
Most travelers are at extremely low risk for Chagas disease. However, those sleeping in poorly constructed houses, especially those made of mud, adobe, or thatch, may become infected and should use bed nets and insecticides to prevent transmission. There is no vaccine for Chagas disease. Early infections may be treated with nifurtimox or benznidazole, but there is no effective antibiotic for late-stage disease at this time.
From the Centers for Disease Control (CDC)
American Trypanosomiasis (life cycle, geographic distribution, clinical features, diagnosis, treatment)
From the Pan American Health Organization
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