Chagas (CHAH-gus) disease is an inflammatory, infectious disease caused by a parasite found in the feces of the triatomine (reduviid) bug. Chagas disease is common in South America, Central America and Mexico, the primary home of the triatomine bug. Rare cases of Chagas disease have been found in the southern United States, as well.
Also called American trypanosomiasis, Chagas disease can infect anyone, but is diagnosed most often in children. Left untreated, Chagas disease later can cause serious heart and digestive problems.
Treatment of Chagas disease focuses on killing the parasite in acute infection and managing signs and symptoms in later stages. You can take steps to prevent the infection, too.
Chagas disease can cause a sudden, brief illness (acute), or it may be a long-lasting (chronic) condition. Symptoms range from mild to severe, although many people don't experience symptoms until the chronic stage.
The acute phase of Chagas disease, which lasts for weeks or months, is often symptom-free. When signs and symptoms do occur, they are usually mild and may include:
Swelling at the infection site
Loss of appetite
Nausea, diarrhea or vomiting
Enlargement of your liver or spleen
Signs and symptoms that develop during the acute phase usually go away on their own. If left untreated, the infection persists and, in some cases, advances to the 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:
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.
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 insects 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.
Infected bugs defecate after feeding, leaving 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 around an infected pet
The following factors may increase your risk of getting Chagas disease:
Living in impoverished rural areas of Central America, South America and Mexico
Living in a residence that contains triatomine bugs
Receiving a blood transfusion or organ transplant from a person who carries the infection
It's rare for travelers to the at-risk areas in South America, Central America and Mexico to contract Chagas disease because travelers tend to stay in well-constructed buildings, such as hotels. Triatomine bugs are usually found in structures built with mud or adobe or thatch.
If Chagas disease progresses to the chronic phase, serious heart or digestive complications may occur. These may include:
Heart failure. Heart failure occurs when your heart becomes so weak or stiff that it can't pump enough blood to meet your body's needs.
Enlargement of the esophagus (megaesophagus). This rare condition is caused by the abnormal widening (dilation) of your esophagus, which can result in difficulty with swallowing and digestion.
Enlargement of the colon (megacolon). Megacolon occurs when your colon becomes abnormally dilated, causing abdominal pain, distension and severe constipation.
If you live in a high-risk area for Chagas disease, these steps can help you prevent infection:
Avoid sleeping in a mud, thatch or adobe house. These types of residences are more likely to harbor triatomine bugs.
Use insecticide-soaked netting over your bed when sleeping in thatch, mud or adobe houses.
Use insecticides to remove insects from your residence.
Your doctor will conduct a physical exam, asking about your symptoms and any factors that put you at risk of Chagas disease.
If you have the signs and symptoms of Chagas disease, blood tests can confirm the presence of the T. cruzi parasite or the proteins that your immune system creates (antibodies) to fight the parasite in your blood.
If you're diagnosed with Chagas disease, you'll likely undergo additional tests to determine whether the disease has entered the chronic phase and caused heart or digestive complications. These tests may include:
Electrocardiogram, a procedure that records the electrical activity of your heart
Chest X-ray, which lets your doctor see if your heart is enlarged
Echocardiogram, a test that uses sound waves to capture moving images of your heart, allowing your doctor to see any changes to the heart or its function
Abdominal X-ray, a procedure that uses radiation to capture images of your stomach, intestines and colon
Upper endoscopy, a procedure in which you swallow a thin, lighted tube (endoscope) that transmits images of your esophagus onto a screen
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 won't cure the disease. But, the drugs may be offered to people under 50 because they may help slow the progression of the disease and its most serious complications.
Additional 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.