A rare parasitic disease that can lead to heart failure or stroke can occur more often in the United States than many medical providers realize, with an estimated 300,000 affected people.
Chagas disease is spread by an insect known as the kissing beetle. An estimated 8 million people in Central and South America are infected, but the disease has also been reported in several US states: Florida, Texas, Mississippi, Tennessee, Arkansas, Arizona and Massachusetts.
Most infected people do not develop signs or symptoms, but about 30 percent of those with the parasite can become chronically ill. The American Heart Association in a new report urges doctors in the US to be aware of the possibility that their patients carry this potentially dangerous infection.
Here is what you need to know about the disease.
What is Chagas disease?
Chagas disease is an infectious disease caused by a parasite called Trypanosoma cruzi. The parasite spreads to humans and animals via the Triatomine beetle, an insect that carries the parasite in the droppings. It is also known as the kissing insect because it tends to bite people around the mouth or eyes, usually at night. Parasites enter via the bite, rub or scratch.
The disease is most common in Central and South America, but is also diagnosed in people in the United States, Spain, Italy, France, Switzerland, the United Kingdom, Australia and Japan.
In the United States, the disease is usually reported in southern states but also in Massachusetts. Most people in the US with the disease were probably infected before they arrived in the country, according to the American Heart Association.
The parasite can hide in the body for decades.
How does Chagas disease spread?
Most cases of Chagas come after an insect bite. It can also spread from a pregnant woman to her baby, and through blood transfusion, organ transplantation, consumption of uncooked food contaminated with the stool of infected insects or inadvertent laboratory exposure, according to the CDC.
Chagas does not spread from person to person through normal contact with people or animals.
Experts also say that it is safe for a mother who has Chagas disease to breast-feed, as long as she has no blood in breast milk or in the cracked nipples.
What are the signs, symptoms and long-term health effects of Chagas disease?
The first symptoms can be fever, fatigue, body aches, headaches and skin rashes. There may also be local swelling where the bite occurred and the parasite invaded the body. These symptoms usually disappear in days to weeks. Rarely can young children develop severe inflammation of the heart muscle or brain in the initial stages.
The chronic phase of the disease can occur in about 30 percent of the infected people and are associated with cardiac complications, including cardiac arrhythmias, heart muscle disorders, stroke, cardiac arrest or even sudden death.
Approximately 70 percent of people do not develop signs or symptoms, and hence the recent warning that doctors should be tailored to the disease.
"Chagas disease causes early mortality and significant disability, which often occurs in the most productive population, young adults, results in a significant economic loss," said Maria Carmo Pereira Nunes, the physician and co-chairman of the committee representing the American heart. Produced Association Declaration in a written commentary at ABC News.
What is the treatment?
Chagas disease is treated with anti-trypanosomal medication (nifurtimox or benznidazole), which is only available through CDC.
Who is at risk and how can you minimize the risk?
Experts believe that most of about 300,000 people with Chagas disease in the US had the infection before they arrived in the country.
For people living or traveling in severely affected countries, the World Health Organization recommends avoiding unpasteurised sugar cane juice or acai fruit juice that may be contaminated with insect faeces containing the parasite and avoiding houses with unplastered mud walls or thatched roofs.
Aditi Vyas, M.D. specializes in radiology and occupational and environmental medicine and is a resident of the ABC Medical Unit.