Epidemiology & Risk Factors
Chagas disease, or American trypanosomiasis, is caused by the parasite Trypanosoma cruzi. Infection is most commonly spread through contact with the poop of an infected triatomine bug (or “kissing bug”), a blood-sucking insect that feeds on humans and animals.
What are the signs and symptoms of Chagas disease?
Romaña’s sign, the swelling of the child’s eyelid (pictured above), is a marker of acute Chagas disease. Swelling is due to Trypanosoma cruzi infecting the eyelid when bug feces are accidentally rubbed into the eye, or because the bite wound was on the same side of the child’s face as the swelling. Credit: WHO/TDR
Acute phase: During this phase, which lasts for the first few weeks or months infection, a person may have no symptoms or mild ones, such as fever, fatigue, body aches, headache, rash, loss of appetite, diarrhea, and vomiting. Because these symptoms are similar to those of other illnesses, most people do not know their illness is from infection with the T. cruzi parasite.
However, a doctor may be able to pick up other signs of infection, including mild enlargement of the liver or spleen, swollen glands, or swelling at the site of the bite (called a chagoma), where the parasite entered the body. Some people with acute phase infection may have swelling of the eyelids on the side of the face near the bite wound or where the bug poop was accidentally rubbed into the eye, called Romaña’s sign. Even if a person develops symptoms during the acute phase, they usually feel well within a few weeks or months but if the person is not treated with antiparasitic medication, the infection remains in the body. Rarely, young children (less than 5%) die from severe inflammation and infection of the heart muscle (myocarditis) or brain (meningoencephalitis).
Chronic phase: During this phase, which can last for decades or even for the entirety of someone’s lifetime, most people have no symptoms. Approximately 20–30 percent of infected people develop
- Cardiac complications, which can include an enlarged heart, heart failure, altered heart rate or rhythm, and cardiac arrest (sudden death); and/or
- Gastrointestinal complications, which can include an enlarged esophagus (megaesophagus) or colon (megacolon) and can lead to difficulties with eating or pooping.
A bloodsucking “kissing bug” bit a Delaware girl on the face last summer while she was watching television.
Now, the US Centers for Disease Control and Prevention is calling the incident the first confirmed identification of the bug in the state. They were concerned about possible Chagas disease transmission from the insect, according to a recent CDC report.