Chagas

Chagas disease, also known as American trypanosomiasis, is a parasitic illness caused by the protozoan Trypanosoma cruzi. It is primarily transmitted to humans by infected triatomine bugs, commonly called kissing bugs, but transmission also occurs congenitally, through blood transfusion, organ transplantation, consumption of uncooked food contaminated with the parasite, and rarely via laboratory exposure. Most infections occur in rural areas of the Americas, especially in Latin America, though international migration has spread cases worldwide. The disease was first described by Carlos Chagas in 1909.

Acute Chagas disease may present with fever, malaise, and localized swelling at the bite site (chagoma) or Romaña sign; many infections are asymptomatic. The chronic phase can occur after years, and a substantial minority develop cardiac disease (cardiomyopathy, arrhythmias, heart failure) or digestive megasyndromes (megaesophagus, megacolon). In the indeterminate chronic stage, individuals are asymptomatic but harbor the parasite.

Diagnosis relies on serology for chronic infection (two different tests such as ELISA or immunofluorescence). In acute infection, direct detection by microscopy or PCR is used. Treatment with antiparasitic drugs, notably benznidazole or nifurtimox, is most effective in the acute and congenital forms, and can slow disease progression in some chronic cases. Side effects may limit use.

Prevention focuses on vector control, reducing housing suitability for triatomines, screening of blood and organ donors, and ensuring safe food handling to prevent oral transmission. Chagas disease remains a major public health concern in parts of the Americas and is a priority of global neglected tropical disease programs.