Chagas disease is an infectious disease caused by the parasite Trypanosoma cruzi. It is initially transmitted to humans by insects referred to as "kissing bugs." In some cases, chronic Chagas disease can appear years or decades after the initial infection and lead to long-term complications, including heart disease.
Overview and Symptoms
The insects responsible for Chagas disease are primarily found in rural areas of South America and Central America. As many as 8 million individuals in these areas are estimated to be infected, though many are unaware of their infections. In the United States an estimated 300,000 people have the disease, including individuals who have traveled to or lived in South America or Central America.
Chagas disease is not directly transmitted from person to person, but may also be acquired through:
- Blood transfusion
- Organ transplant
- Birth (mother to baby)
Chagas Disease Symptoms
Chagas disease has two phases: acute and chronic. During the acute phase (the first weeks or months following infection), patients may have no symptoms or very mild symptoms, including:
- Fever, fatigue, body aches or headaches
- Swollen red area at the site of the insect bite
- Swelling of the eye on the side of the face where the bite or infection occurred
After the acute phase, symptoms may disappear for as long as 10 to 20 or more years. If left untreated, the disease may then enter its chronic phase, at which point the parasite has moved through the body and infected other organs, including the heart or gastrointestinal system. Symptoms and complications of chronic Chagas disease can include:
- Heart failure
- Abnormal heart rhythm (palpitations, pounding or racing heart)
- Constipation and digestive problems
Diagnosis and Treatment
In the U.S., all blood donations are screened for the presence of Chagas disease, and many individuals learn that they have the infection when they donate blood. This testing may identify patients with chronic phase infections.
In addition, patients suspected of having the infection may undergo:
- A physical examination
- Immunoassay tests to look for signs of infection
- Patients with positive blood tests who exhibit heart symptoms may also undergo an echocardiogram
- Patients with positive blood tests who exhibit GI symptoms may undergo specialized testing
Chagas Disease Treatment
Treatment during the acute phase of infection includes taking antiparasitic drugs for up to two months. For patients in the chronic phase of the disease, antiparasitic drug therapy is usually not considered useful.
BIDMC offers treatment of chronic Chagas disease affecting the heart. Management of cardiac symptoms in patients with chronic disease may include medication as well as procedures to manage heart failure, arrhythmias and other cardiac complications. Andre d'Avila, MD, Director of the Electrophysiology Institute and Arrhythmia Service at BIDMC, is an international leader in the treatment of Chagas-related heart complications including ventricular tachycardia ablation, a procedure for the treatment of irregular heartbeat. BIDMC's cardiovascular specialists consult with the Division of Infectious Diseases to determine the best course of treatment for each patient.
Arrhythmia Services provides compassionate, patient-centered care to help manage and treat heart complications related to Chagas Disease.
Latinx Cardiovascular Clinic
The Latinx Cardiovascular Clinic provides culturally sensitive treatment for Spanish-speaking patients.