… bug droppings are left near the wound. When these droppings get into the wound or mucous membranes (as when a person touches the droppings and then rubs his or her eye), the parasites enter the body.
Chagas can also be spread:
- By getting a blood transfusion or organ transplant from an infected person.
- By eating undercooked foods contaminated with infected bugs or their droppings.
- By eating undercooked game infected with Chagas parasites.
- From mother to child during pregnancy or during breastfeeding.
- In laboratory accidents.
In South America, people have been infected with Chagas parasites through contaminated cane juice, acai juice, guava juice, and palm wine.
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While the burden of Chagas disease falls mainly on people in Central and South America, the disease is spreading worldwide. Cases have been seen in Japan and Western Europe. And Chagas is becoming more of a problem in the Southern U.S., particularly in Texas and the Gulf Coast.
What Are the Symptoms of Chagas Disease?
People with acute-phase Chagas disease may not have any symptoms at all. Mild symptoms of acute Chagas disease are similar to other illnesses: fever, fatigue, body aches, headache, rash, loss of appetite, diarrhea, and vomiting.
One unique sign of Chagas disease is called Romaña’s sign: swelling of the eyelids and around the eye on the side of the face near the bite or where infected bug droppings have been rubbed into the eye.
But these acute-phase symptoms usually go away on their own even though the infection does not.
When chronic symptoms occur, they are the symptoms of severe heart disease or severe intestinal disease.
What Is the Treatment for Chagas Disease?
Children and adults under age 50 should be treated as soon as possible after infection with Chagas parasites. For adults 50 and older, treatment decisions should be individualized based on age, health, and personal preference.
Treated early enough, the disease can be cleared in most children and in about 80% of adults. Even when treatment does not totally eliminate the parasite, it can greatly reduce the odds of severe chronic disease.
There are only two drugs used to treat Chagas disease: nifurtimox and benznidazole. Neither of these drugs is approved by the FDA and, in the U.S., must be obtained by doctors through the CDC.
Treatment must continue for 60 to 90 days. Side effects, some of them severe, are common.
Some 9 million people worldwide have Chagas disease, with about 20% to 40% suffering from chronic disease. Both drugs used to treat the disease are in short supply. Even when they are available, the cost of treatment can be as high as $1,000 or more.
Why Is Chagas Compared To AIDS?
In some ways, the comparison of Chagas to AIDS is unfortunate.
Unlike HIV, the AIDS virus, Chagas parasites cannot be spread via sex. Untreated HIV infection is almost always fatal, while 70% to 80% of people with Chagas disease do not develop severe heart disease.
But Chagas disease does share some features with AIDS:
- Both are diseases of poverty. In the Americas, Chagas is mainly a problem of the “bottom 100 million” people who suffer from at least one of the so-called neglected tropical diseases.
- Both diseases carry significant stigma. In the U.S., undocumented workers infected with Chagas disease may not seek treatment due to fear of deportation.
- Both diseases are treated with drugs that are in short supply.
- Both diseases are treated with expensive drugs.
- Lack of access to medical care complicates both the Chagas and AIDS epidemics.
- There is no vaccine either for Chagas disease or for HIV/AIDS.
Whether Chagas disease really is the “AIDS of the Americas,” as Baylor College of Medicine’s Peter J. Hotez, MD, PhD, and colleagues suggest, is in the eye of the beholder.