Interesting Facts

Chagas Disease affects approximately 20 million worldwide, killing 50,000 each year, yet is practically unknown to most in the general public in the US.

 If infected, you may not even know initially you have Chagas disease. It can slowly destroy your internal organs, and if you do not die from the acute stage, can cause death in the chronic stage, 10-20 years later.

Chagas is spreading worldwide -- due to lack of knowledge and indifference.

Endemic in 21 countries, with 18-20 million infected and another 120 million people at risk

• 25% of the population of Latin America is at risk of acquiring Chagas Disease
• More than 100,000 Latin American immigrants living in the United States are chronically infected and a potential source of transmission of the disease by means of blood transfusions
• The disease is lethal, especially for children, and debilitates patients for years.
• Previously thought to be endemic in Mexico, South and Latin America, other areas of the world such as the US and Europe are considering testing all blood donations for the parasite, T. cruzi, for the parasite that  causes the disease due to travel patterns and rural migrations of populations to urban areas. 
• Infected triatomine bugs, that transmit T.cruzi, are found in North, Central and South America.  Blood banks in selected cities of the continent vary between 3.0 and 53.0% -making the prevalence of T. cruzi infected blood higher than that of Hepatitis B, C, and HIV infection
• In parts of South America, Chagas' heart disease is the leading cause of death in men less than 45 years of age.
• Blood transfusions in the US should be screened for antibodies to T.Cruzi; currently U.S. blood banks do not routinely conduct this screening.  
• Numerous acute and chronic cases of the disease have been reported in domestic dogs in Texas, Oklahoma, Louisiana, South Carolina and Virginia
• It is not known how many dogs or humans in the US actually have the disease due to lack of testing and reporting
• The disease may be transmitted by the bite of an infected triaomine, (reduviid, "kissing", or "assassin") bugs, or through blood transfusion or transplacentally
• In Texas infection rates in kissing bugs are reported to be 17-48%, in other states infection rates may not be known due to lack of knowledge about the disease and inadequate studies with regards to sampling bugs for the disease
• The kissing bugs, or carriers of this disease, could be as close as your backyard.

Taken from: http://www.allaboutchagasdisease.com/4-4.htm

Zoonosis

Zoonosis (pronounced as zoh-ON-ah-sis) is any infectious diseasethat may be transmitted from other animals, both wild and domestic, to humans.

The word is derived from the Greekwords zoon (animal) (pronounced as zoo-on) and nosos(disease). Many serious diseases fall under this category.

The plural of zoonosis is zoonoses, from which an alternative singular zoonose is derived by back-formation.

The simplest definition of zoonosis is a diseasethat can be transmitted from other animals to humans. A slightly more technical definition is a disease that normally exists in other animals, but can also infect humans. On other occasions it may be used to mean a disease that can complete its life cycle without a human host. None of these are wrong, although the first is overly simplistic.

The emerging interdisciplinary field of conservation medicine, which integrates human and veterinary medicine, and environmental sciences, is largely concerned with zoonoses.



Taken from: http://www.lumrix.net/medical/parasitology/zoonosis.html

The Prevention of Chagas

There are many facets to the spread of Chagas' disease. The bite of infected vinchucas (T. infestans) is one factor but vinchucas infest houses because of external precipitating factors, such as poverty, migration, and environmental destruction. Andeans link its spread to to the fact that people no longer consider earth as sacred.

Corporate farms and timbering cause millions of acres of forests to disappear in the Americas. Deforestation reduces natural habitats for animals and insects so vinchucasbecome domiciary. Peasants lose land, so they move to the cities, often introducing vinchucas and T. cruzito previously non-endemic areas. Chagas' disease is found in New York, Washington, Los Angeles, and other cities in the U.S. and Europe. Resources given to the fight of chagas are often inadequate due to domestic and international political climates. International and national health policies have often considered chagas a low priority. They have not allocated necessary resources to prevent it, even though it is considered the number one obstacle to development in many countries.

Chagas' disease is similar to other parasitic and tropical diseases that affect poor people in the Americas, Africa, and Asia. These people have been inured to the socio-economic conditions brought about by a political economy that unjustly treats them. Not only does T. cruzi establish a destructive parasitic relationship in their bodies, but also land owners, politicians, and industrialists place peasants in an exploitive/parasitic relationship. Because peasants are ignorant of the connection between Chagas' disease and socio-economic causes, efforts are needed to educate them on how to halt this victimization. Below are some of the ways this is being done.

• Domestic and personal

  • Housing

  • Hygiene

• Inseticides

• Effects of deforestation

• Effects of economic stratification

  
  

  
  

Social and Cultural Issues

Cultural and social factors influence Chagas' disease. Chagas' disease is often considered from only a biomedical perspective, with little concern for cultural and social factors that influence behavior and values. Social behavior and cultural beliefs or values influence the way people respond to the parasitic cycle of T. cruzi. For example, Andean peasants view insects as an integral part of life and many object to insecticide campaigns as destructive to life. Their worldview reflects maintaining balance with nature. Peasants love their animals and protect them in their houses, so it is difficult to have them keep them in corrals. They believe that their ancestors are connected to abandoned buildings, so they resist removing unused buildings, even though they are infested withvinchuchas. Others believe that vinchucas are signs of fertility. Their children play with them, racing the adults and gathering their eggs.

Culture Context Model

Chagas' disease presents many culturally related concerns. Because symptoms of chagas may appear years after the initial infective bite, people rarely associate its symptoms of heart disease, volvulus, and constipation with vinchucas. Latin Americans posit the symptoms of illnesses with more immediate causes, such as improper diet or an imbalance of the hot, cold, wet, or dry. Parasitic cycles are difficult to understand for traditional people with distinct ethnomedical beliefs concerning disease and its treatment. Ethnomedicine also provides many sources for irradicating chagas. A Culture Context Model of Chagas' Control attempts to lessen the gaps in cross-cultural communication between health workers and community members. This model triangulates upward from three corners. Project personnel and technical assistance, community members and participation, and community health workers and ethnomedical practitioners form a pyramid whose apex is prevention and treatment of Chagas' disease. The parts converge toward common goals, maintaining distinct identities, and operate within a shared cultural context distinct to the community. (See Kiss of Death: Chagas Disease in the Americas, pages 143 through 145, for an explanation of this model.) The Social Costs Social costs of Chagas' disease are huge for peoples of Latin America. It is a debilitating disease that fatigues peasants, especially those working at higher altitudes, where they often must stop farming their plots or leave the work to relatives and children. The inability to work results in decreased crops, which cause malnourishment that leads to susceptibility to Chagas' disease. Even more costly, many adult victims die during their most productive years. (This is documented as Disease Adjusted Life Years, or DALYs.) Children are left without mentors and families without breadwinners. Remaining members of the community then must assume responsibility for the survivors. For this reason, Chagas' disease is a major obstacle to development in Latin America. The World Bank considers it the fourth most serious health problem in Latin America as measured by years of life lost adjusted for disability. Social stratification creates divisions in Latin America that are difficult to bridge. Chagas' disease is mistakenly considered a disease of peasants and Indians, as if T. cruzi respects class differences. Rich and middle classes do not recognize that vinchucas inhabit their houses, as easily as cockroaches invade ours. Argentineans call chagas "The Unrecognized Disease," being not only detected but considered something "others" suffer, especially poor people and peasants. Social stratification combines with racism in Latin America to influence the political economy that represents upper classes and whiter races and that neglects supporting chagas campaigns identified with lower classes (Indians and peasants). Because Latin America is targeted for investment and tourism, information about contagious diseases, such as chagas, might deter this. Other social issues Another social issue affecting chagas is the attitude of peasants that they are not in control of their destiny. Locus of control implies that an individual's general expectations about his or her ability of control the future greatly influence that individual's response to house improvement programs. People's notion of whether the future is controlled by themselves, the state, fate, or luck greatly influences their desire to act to prevent anything or improve houses. R. Briceño-León and S. González have dealt with the fatalistic attitudes of peasants. They found that, after they improved their houses, many people gained a sense of empowerment. Peasants need to rediscover a sense of empowerment through cousciousness-raising education. Chagas' prevention depends upon community participation. Too frequently, housing projects are purely vertically structured programs. Community participation refers to community members making decisions about, accepting, and complying with certain behavioral changes necessary to combatting chagas. Obstacles to this are superior attitudes of project supervisors and technicians towards peasants, not being able to speak the language of the community, and not including community members into planning phases. Taken from: http://www.uta.edu/chagas/html/sociSoci.html

Treatments and Symptoms

Treatment for Chagas disease focuses on killing the parasite and managing signs and symptoms.

During the acute phase of Chagas disease, the prescription medications benznidazole and nifurtimox may be of benefit. Both drugs are available in the regions most affected by Chagas disease. In the United States, however, the drugs can be obtained only through the Centers for Disease Control and Prevention.

Once Chagas disease reaches the chronic phase, medications aren't effective for curing the disease. Instead, treatment depends on the specific signs and symptoms:

• Heart-related complications. Treatment may include medications, a pacemaker or other devices to regulate your heart rhythm, surgery, or even a heart transplant.
• Digestive-related complications. Treatment may include diet modification, medications, corticosteroids or, in severe cases, surgery.

Taken from: http://www.mayoclinic.com/health/chagas-disease/DS00956/DSECTION=treatments-and-drugs

Chagas disease can be acute or chronic. Symptoms range from mild to severe, although many people don't experience symptoms until the chronic stage.

Acute phase 

The acute phase of Chagas disease, which lasts for weeks or months, may be symptom-free. When signs and symptoms do occur, they are usually mild and may include:

• Swelling at the infection site
• Fever
• Fatigue
• Rash
• Body aches
• Headache
• Loss of appetite
• Nausea, diarrhea or vomiting
• Swollen glands
• Enlargement of your liver or spleen

Signs and symptoms that develop during the acute phase usually go away on their own. However, if untreated, the infection persists and advances to the chronic phase.

Chronic phase 

Signs and symptoms of the chronic phase of Chagas disease may occur 10 to 20 years after initial infection, or they may never occur. In severe cases, however, Chagas disease signs and symptoms may include:

• Irregular heartbeat
• Inflamed, enlarged heart (cardiomyopathy)
• Congestive heart failure
• Sudden cardiac arrest
• Difficulty swallowing due to enlarged esophagus
• Abdominal pain or constipation due to enlarged colon

When to see a doctor 

See your doctor if you live in or have traveled to an area at risk of Chagas disease and you have signs and symptoms of the condition, such as swelling at the infection site, fever, fatigue, body aches, rash and nausea.

Taken from: http://www.mayoclinic.com/health/chagas-disease/ds00956/dsection=symptoms

The History of Chagas

Chagas' disease is named after the man who productively researched the affliction in northern Brazil during the building of the railroad in 1909. Dr. Carlos Chagas found the cause of the disease to be the parasite T. cruzi residing in the host's tissue.

Dr. Chagas not only found the pathogen but also found that it is transmitted to humans through triatomine insects, commonly called barbeiros andvinchucas, bites. Much had been learned through the hard work and insightfulness of Dr. Chagas. It is fitting that the disease bears the name of the gifted parasitologist.

Taken from: http://www.uta.edu/chagas/html/chagHist.html

Causes

The cause of Chagas disease is the parasite Trypanosoma cruzi, which is transmitted to humans from a bite from an insect known as the triatomine bug. These bugs can become infected by T. cruzi when they ingest blood from an animal already infected with the parasite.

Triatomine bugs live primarily in mud, thatch or adobe huts in Mexico, South America and Central America. They hide in crevices in the walls or roof during the day, then come out at night — often feeding on sleeping humans.

When infected bugs bite a person, they leave behind T. cruzi parasites on the skin. The parasites can then enter your body through your eyes, mouth, a cut or scratch, or the wound from the bug's bite. Scratching or rubbing the bite site helps the parasites enter your body. Once in your body, the parasites multiply and spread.

You may also become infected by:

• Eating uncooked food contaminated with feces from T. cruzi-infected bugs
• Being born to a woman infected with T. cruzi
• Having a blood transfusion containing infected blood
• Getting an organ transplant containing viable T. cruzi
• Working in a laboratory where there's an accidental exposure to the parasite
• Spending time in a forest that contains infected wild animals, such as raccoons and opossums
• Being with an infected pet.

Taken from. http://www.mayoclinic.com/health/chagas-disease/ds00956/dsection=causes