Chagas Disease: What You Should Know Before You Go to the Southern U.S., Mexico, and Central and South America
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Chagas Disease: What You Should Know Before You Go to the Southern U.S., Mexico, and Central and South America

The Kissing Bug looks a lot like a leaf bug to my American eyes. The big difference between a Kissing Bug and a Leaf Bug is that Kissing Bugs have straight, “unflared” legs. Leaf bugs, in contrast have leafy-looking legs.

Even though Chagas Disease currently infects an estimated 300,000 to 1,000,000 people in the United States, very few people, including doctors would recognize this disease if they saw it. It’s a vector-borne illness carried by the Kissing Bug, an insect that looks a little bit like a leaf bug (except without the flared legs…kissing bugs have straight, smooth legs).

How People Get Chagas Disease

Bug bites vary in terms of how they look and how people react to them. They may get red, swollen, and itchy like a mosquito bite or they may be small and almost unnoticeable. Some people even get anaphylactic shock from Kissing Bug bites. Often, the bites happen around the mouth because the bugs are attracted to carbon dioxide, but the location of the bites can vary too. It isn’t the bite itself that’s likely to cause you problems if you encounter a Kissing Bug though. It’s the fact that Kissing Bugs poop all over the place and then sometimes smear their poop in the bite-wound. This poop may contain the protozoan, Trypanosoma cruzi that causes Chagas Disease.

We found this bug hanging out by the lamp in our living room last night here in Guanajuato, Mexico. It looks a lot like a Kissing Bug.

In the United States, a person doesn’t even need to be bitten by a Kissing Bug to get infected with Trypanosoma cruzi. Blood transfusions and transplanted organs can harbor the disease-causing organism too. Currently, there are recommendations in the U.S. to test blood transfusions for the presence of Trypanosoma cruzi, but testing isn’t required. Most likely, there are corporations that see some profitability to keeping the disease around in the U.S. because it’s hard for doctors or patients to identify it and if patients enter into the chronic phase of Chagas disease, they become a cash cow.

Acute Chagas Disease Symptoms

In terms of symptoms, Chagas Disease looks like a lot of other diseases when people first get sick with it (the acute phase). It can affect the digestive system so patients may have vomiting or diarrhea and a fever as well as fatigue, headaches, general achiness, a rash, and loss of appetite. This acute phase can last for weeks or even months. As such, it can look like other parasitic diseases like Cyclosporiasis (diarrhea, loss of appetite, nausea, vomiting, fatigue) or even Giardia (diarrhea, fatigue, nausea, vomiting). In fact, there are a lot of diseases that involve nausea, vomiting, diarrhea, fatigue, and fever…so many that your U.S. doctor (if you’re in the states) is likely to call it a stomach “bug” and leave it at that.

Disease like Chagas, Cyclosporiasis, and Giardia can all enter into a “chronic” phase after the initial infection happens. Doctors in the United States who haven’t been trained in tropical medicine (MOST OF THEM HAVE NO TRAINING IN TROPICAL MEDICINE), won’t identify these diseases without doing a lab test to specifically look for them under a microscope. With Cyclosporiasis, for example, after the vomiting and diarrhea stops, the only real clue that there’s something still wrong may be weight loss and a general apathy toward food. If a patient goes back to the doctor with this problem in the U.S., it may or may not be identified as a “problem” (especially if the patient needed to lose some weight as 30% or more them now do). Giardia can cause chronic symptoms if left untreated too, even if the parasite is no longer present in the body. This is why it’s so important for patients to take responsibility for their own health. Solving the mystery of disease often requires a collaborative effort between doctor and patient.

Note the swelling of the child’s eye on the same side of the face as the bite on his lip. This is Romaña’s Sign…an indicator that the child has been infected with Trypanosoma cruzi.

Romaña’s Sign

One of the important signs of Chagas that can set it apart from other digestive diseases during the acute phase is “Romaña’s Sign”. This is a swelling of an eyelid on the same side of the face as a Kissing Bug bite. Should you have “Romaña’s Sign” and a Kissing Bug bite, visit your doctor for treatment immediately. It’s better to be treated during the early stages of the disease than to wait. On the other hand, if you don’t have “Romaña’s Sign”, that doesn’t mean that you don’t have Chagas. It’s just a telltale sign that can help solve the puzzle if you have a major digestive upset.

Chronic Chagas Disease Symptoms

But Chagas Disease, if left untreated, can lead to serious problems later in life. Not all Kissing Bugs are infected with the Trypanosoma cruzi protozoan, so not everyone who’s bitten by the bug will get Chagas Disease. In fact, some of the people infected with the protozoan won’t have symptoms of the infection during the acute phase, but despite that, of the people who are infected, 30% will go on to develop cardiac or intestinal issues later in life due to the presence of the parasite.

Heart disease, including enlarged ventricles, heart rate problems, cardiac arrest, and heart failure are a common symptom of the chronic version of Chagas. Undoubtedly, people who are experiencing heart failure or heart disease, rarely look into the possibility of parasites like Trypanosoma cruzi as possible culprits behind their symptoms. It can take decades for these problems to manifest, but anyone who’s been bitten by a Kissing Bug, received a blood transfusion, or an organ transplant is at risk.

Digestive issues are another common symptom of Chagas Disease, but some of these may take many years to manifest as well. An enlarged esophagus or an enlarged colon can cause all kinds of problems with digestion ten or twenty years after a person contracts Chagas Disease.

Chagas Disease Treatment Options

If you have any of these cardiac or digestive issues and you’ve gotten bitten by the Kissing Bug or received a blood transfusion or an organ transplant, get your doctor to test you. The only way to get the medication (nifurtimox and benznidazole) to treat Chagas is through your physician. Pharmaceuticals used to treat the disease are only available through the CDC via a physician.

Research in Buenos Aires, Argentina is currently underway to find less toxic treatment options for Chagas Disease than nitrofurimox and benznidazole. In May, 2016 researchers were exploring the use of resveratrol as a natural antioxidant that’s completely non-toxic to humans, but toxic to Trypanosoma cruzi. According to the research, low quantities of resveratrol was able to kill Trypanosoma cruzi in lab cultures by inhibiting the activity of the enzyme arginine kinase. The next stage of research will explore the use of resveratrol to treat Chagas Disease in mice. If the results are promising, this treatment could be made widely available to everyone because it’s not a toxic substance to humans. Resveratrol exists naturally in red grapes, red wine, peanut butter, and dark chocolate. U.S. citizens can get a concentrated form of resveratrol from their local health food store.

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