Neglected tropical diseases (NTDs) are among the most common conditions afflicting the estimated 99 million people who live on less than US$2 per day in the Latin American and Caribbean (LAC) region . Almost all of the “bottom 100 million” living in the Americas suffer from at least one NTD , and according to some estimates, the NTDs cause a burden of disease in the LAC region that closely approximates or even exceeds that resulting from HIV/AIDS .
While most of the world's cases of Chagas disease occur in the LAC region, there is increasing recognition that many people with Trypanosoma cruzi infection also live in the US and Europe . In practical terms, the “globalization” of Chagas translates to up to 1 million cases in the US alone, with an especially high burden of disease in Texas and along the Gulf coast , , although other estimates suggest that there are approximately 300,000 cases in the US , in addition to thousands of cases documented in Canada, Europe, Australia, and Japan .
The disease can also be transmitted via blood transfusion, organ transplant or from mother to child during pregnancy.
Once infected, Chagas disease (also known as American trypanosomiasis) can go undetected for years, or even decades, during which time it can cause damage to the heart, intestines and esophagus. Cardiomyopathy and arrhythmias caused by the damage can eventually prove fatal. In some cases, a Chagas-enlarged heart or intestines can actually explode.
Chagas is usually transmitted from the bite of blood-sucking insect species called Triatome bugs which release a parasite called Trypanosoma cruzi into the victim's bloodstream.
Researchers from the University of Maryland School of Medicine said last year that they believed Charles Darwin suffered from three different illnesses, including a Chagas infection.
"Chagas disease is one of the most devastating diseases of poverty in Latin America and the Caribbean region, including new foci in the Amazon Region," said Dr. Peter Hotez, dean of the newly established Baylor College of Medicine National School of Tropical Medicine and Texas Children's Hospital Endowed Chair of Tropical Pediatrics. "Chagas disease has also emerged in Texas and elsewhere in the U.S. There is an urgent need to develop new therapeutics for this infection, including a therapeutic vaccine."
Although the NIH states that it can "take more than 20 years from the original time of infection to develop heart or digestive problems," the onset of symptoms can be catastrophic. According to The New York Times, one quarter of people that contract Chagas disease eventually develop enlarged organs that can potentially burst, causing sudden death.
Like AIDS, the authors say, Chagas disease has a long incubation time and is hard or impossible to cure. Chagas infects up to eight million people in the hemisphere, mostly in Bolivia, Mexico, Colombia and Central America. But more than 300,000 of the infected live in the United States, many of them immigrants.
The earliest cases of Chagas in New York City, back in the 1980s, were transmitted by transfusion. There’s been an FDA-approved test for Chagas in donated blood for just two years. The latest map from AABB (formerly the American Association of Blood Banks), showing where positive donations have been identified, vividly demonstrates how the disease has spread.
Chagas is usually transmitted from the bite of blood-sucking insects that release a parasite called Trypanosoma cruzi into the victim’s bloodstream. The parasite can eventually make its way to the heart, where it can live and multiply.
The acute phase and reactivated Chagas disease should be treated. Infants born with the infection should also be treated.
Treating the chronic phase is recommended for both children and adults. Adult patients should talk to their doctor about whether to treat chronic Chagas disease.