By Francisca Bermudez
Although Chagas disease has only recently emerged as a possible public health concern in some southern states of the U.S., this infectious disease has been a major threat of high priority for health officials throughout many nations of Latin America for many years.
Prevalent in countries such as Mexico and Brazil, Chagas disease, also known as American trypanosomiasis, is a potentially life-threatening tropical parasitic infection caused by the protozoan parasite Trypanosoma cruzi (T. cruzi) found mostly in endemic areas of Central and South America. According to the Center for Disease Control and Prevention (CDC), it is estimated that as many as 8 million people suffer from this disease worldwide, many of whom are unaware of their condition.
Most victims are infected by this parasite in the same way: through contact with the feces of triatomine bugs, also known as “kissing bugs”. As described by the CDC, they are known as “kissing bugs” because they tend to feed on people’s faces; after they ingest blood, they defecate on the person, infecting them with the T. cruzi parasite. While usually transmitted to animals and people by insect vectors, Chagas disease can also spread through congenital transmissions, contaminated blood transfusions, infected organ transplants, or even laboratory accidents.
Chagas disease has spread quickly over the years and has recently become so widespread in areas of Latin America that many now feel it has become a “public health emergency”6.This is because Chagas disease, in its later stages, can often result in chronic diseases and even death.
In an interview, Dr. Juan Mejia, Secretary General of the Latin American Society of Cardiovascular and Thoracic Surgery, explains that besides causing gastrointestinal disease such as “megacolon” or “megaesophagus,” Chagas disease can also lead to severe cardiac disease and can “cause acute myopericarditis as well as chronic fibrosing myocarditis”.
According to Dr. Mejia, “Chagas myocarditis is the most common cause of non-ischemic cardiomyopathy in Latin America”. In fact, of the people suffering from Chagas disease, according to the World Health Organization, approximately 30% of chronically infected people develop cardiac abnormalities7.
These cardiac abnormalities, Dr. Mejia states, can often include “cardiac arrhythmia, left ventricular enlargement, and chronic heart insufficiency”. In addition, Chagas disease often leads to cardiomyopathy as a result of “chronic myocardial aggression” along with “chronic inflammation and fibrosis of the heart,” he adds.
Due to these mentioned cardiac complications, Chagas disease, throughout the Americas in recent years, has emerged as one of the leading causes of heart disease in the region.
According to Dr. Mejia, this epidemic of Chagas disease – one of the leading causes of heart failure in Central and South America – has quickly spread throughout Latin America and is “typical of Andean, semi, and tropical countries”. Noting that “the transmission of Chagas disease is related to the insect family of Triatominae,” he explains that these insects usually “live in hovels where they are able to multiply without the risk of predators.” For this reason, we commonly see the spread of Chagas disease in places where “kissing bugs” thrive, which is mostly in mud dwellings in undeveloped areas in Latin America.
While this epidemic has mainly affected those living in Central and South America, the CDC has recently reported that Chagas disease is now progressively spreading to other areas of the world9. As a result, due the mentioned serious cardiac complications, it appears that Chagas disease will continue to be a major public health concern in the long run. However, it is possible that it will now have an impact not only in the lives of people in Latin America, but also in the lives of people in many other parts of the world as well.