Chagas disease

It is an infectious disease caused by a parasitic protozoan called Trypanosoma cruzi, name given by its discoverer, the Brazilian scientist Carlos Chagas, in honor of another scientist, also, Brazilian, Oswaldo Cruz.

Parasitic protozoan light microscopy Trypanosoma cruzi.

How do you get it?

Through the entrance of Trypanosoma In the blood of humans from the injury of the "sting" by triatomas, the popular barbers or hiccups, as they are known in the interior of Brazil.

These triatomas, or barbers, feed on blood and contaminate with the parasite when they suck blood from infected mammalian animals, which are the natural reservoirs (cattle, for example) or even other contaminated humans. Once in the barber's digestive tract, the parasite is eliminated in the feces near the "sting" point, when they suck the blood of humans who become infected there.

Other forms of contact occur in intrauterine life through contaminated pregnant women, blood transfusions or accidents with puncture instruments in laboratories by health professionals, the latter two being much rarer.

Chagas Disease Cycle.

What do you feel?

The disease has an acute phase and a chronic phase. At the place of the bite by the “vector” (the disease-transmitting agent, in this case, the barber), the area becomes red and hardened, constituting the so-called chagoma, a name given to the injury caused by the entrance of the Trypanosoma. When this lesion occurs near the eyes, it takes the name of sign of Romaña. Chagoma is usually accompanied by water near the region.

After a variable but no less than one week incubation period (symptom-free period), fever, body-wide languages, swelling of the liver and spleen, and short-term allergy-like redness in the body occur. At this stage, in the most severe cases, inflammation of the heart may occur with changes in the electrocardiogram and increased number of beats per minute. Even in the most severe cases, symptoms of inflammation of the brain's protective layers (meningitis) and inflammation of the brain (encephalitis) may occur. Fatal cases are rare, but when they occur they are at this stage due to inflammation of the heart or brain. Even without treatment, the disease gets milder and symptoms subside after a few weeks or months. The infected person may remain for many years or even the rest of his life without symptoms, appearing to be contaminated only in laboratory tests. Detection of the parasite in the blood, unlike the acute phase, is now much more difficult, although the presence of antibodies against the parasite is still high, indicating active infection.

In the chronic phase of the disease, the manifestations are of heart muscle disease, that is, uncontrolled heartbeat (arrhythmias), loss of the “pumping” capacity of the heart, progressively, even causing fainting, which may progress to fatal cardiac arrhythmias. The heart can be greatly enlarged, making its functioning impracticable. Other manifestations of this phase may be enlargement of the esophagus and large intestine, causing difficulties in swallowing, choking and pneumonia due to aspiration and chronic constipation and abdominal pain.

More recently, the association of Chagas disease with AIDS or other states of immunosuppression has shown forms of severe reacudization that were previously unknown, such as the development of neurological conditions related to inflammation of the lining of the brain (meningitis).

How is the diagnosis made?

One should always arouse suspicion when facing an individual who has walked through an endemic zone and has compatible symptoms. Antibody detection tests at Trypanosoma in the blood most commonly, as well as detection of the parasite itself in the blood, in the most acute stages, make the diagnosis.

How is it?

The medication used in our country is benzonidazole, which is very toxic, especially for the duration of treatment, which can last from three to four months. Its use is of proven benefit in the acute phase. In the chronic phase, treatment is directed at manifestations. Decreased working capacity of the heart is treated as a failure of the heart due to other causes, and in some cases may even necessitate transplantation.

How to prevent?

Basically, by eliminating the vector, the barber, through measures that make it less conducive to living close to humans, such as the construction of better housing.

Important: The recent form of contamination of this disease on the coast of Santa Catarina state, by ingestion of sugarcane juice contaminated with barber droppings or by the insect itself, is an uncommon, although possible, way of contagion. In addition to what is under investigation, it is not possible to state, from what has been disclosed, all the circumstances of the facts that occurred.