American trypanosomiasis (Chagas disease)


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What is American trypanosomiasis (Chagas disease)?

American trypanosomiasis, more commonly known as Chagas disease, is caused by a parasite spread by infected triatomine bugs. Chagas disease is caused by a parasite called Trypanosoma cruzi.

There is no vaccine or medication that protects against Chagas disease.

What is my risk? 

The risk for most travellers is low, however it is higher for travellers visiting countries where Chagas disease occurs and who are:

  • visiting or living in rural areas
  • sleeping in poorly-constructed housing (for example, housing with cracked walls, mud walls, or thatched roofs)
  • sleeping outdoors

How is it transmitted?

Chagas disease is most commonly spread through the infected feces of a triatomine bug, also called a “kissing bug”, reduviid bug or assassin bug

  • Triatomine bugs are most active at night and hide in cracks in poorly-constructed houses.
  • Triatomine bugs feed on human blood. After they bite, they deposit feces close to the bite.  
  • When a person touches the bite, they accidentally rub the infected feces into the bite. A person can also inadvertently rub infected triatomine feces into any skin break, such as a scratch or open wound, or into the eyes, nose, or mouth.

In rare cases, Chagas disease can also be spread:

  • through a blood transfusion or organ transplant from an infected donor.
  • from an infected mother to her baby during pregnancy or delivery.
  • by food or drinks contaminated with infected triatomine feces.

What are the symptoms?

Chagas disease occurs in two phases. Each phase has different symptoms.

First (acute) phase:

Symptoms of the disease occur one or more weeks after the triatomine bug bite and can last for about two months.

The symptoms are usually mild or do not occur at all, but in rare cases can cause death.

Acute symptoms include:

  • swelling around the infected bite (called a chagoma)
  • swelling of the eyelid (called the Romaña’s sign)
  • fever
  • headache
  • swollen lymph nodes
  • muscle pain
  • difficulty breathing
  • in rare cases, swelling of the heart or brain. These symptoms generally occur more often in children, the elderly and the immunocompromised.

Second (chronic) phase:

Most people do not have symptoms, but still remain infected.

Some people will have symptoms but these usually appear 10-30 years after the initial infection.

These symptoms, which can be life-threatening, include:

  • enlargement of the esophagus (throat)
  • enlargement of the colon
  • enlargement of the heart, which can cause heart failure and abnormal heart beat rhythms (arrhythmia)

Can American trypanosomiasis (Chagas disease) be treated?

There are medications available to treat Chagas disease.

The medical problems that can develop in the chronic phase of Chagas disease cannot be treated, but there are medications available to manage some of the symptoms.

Where is American trypanosomiasis (Chagas disease) a concern?

Chagas disease occurs in Mexico, Central America, and South America. The triatomine bug is found mainly in rural areas with poorly-constructed housing.

Recommendations

Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.

  1. Protect yourself from triatomine bug bites.
    • Avoid sleeping in poorly-constructed housing (especially those made from mud or thatch) or sleeping outdoors.
    • If you cannot avoid sleeping in poorly-constructed housing or sleeping outdoors, sleep under a bed net, preferably one treated with insecticide.
  2. Practise safe food and water precautions.
  3. In areas where Chagas disease occurs, avoid blood transfusions and organ transplants unless it is an emergency.
    • If you must receive a blood transfusion or organ transplant while travelling, try to confirm the donated blood or organ has been tested for Chagas disease.
    • If you cannot confirm the blood or organ has been screened, and you do not require emergency care, return home for treatment.

4. Know the symptoms of Chagas disease and see a health care provider if they develop.

  • Chronic symptoms of Chagas disease may develop years after visiting a region where the disease occurs.
  • Tell your health care provider where you have been travelling or living.

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