If Chagas disease progresses to the long-lasting (chronic) phase, serious heart or digestive complications may occur. These may include: Heart failure. Heart failure occurs when your heart becomes so weak or stiff that it can't pump enough blood to meet your body's needs.
In later years the infection in those patients can cause the destruction of the nervous system and heart muscle, consequent cardiac arrhythmias or progressive heart failure and sudden death.
In the chronic phase of the disease, the parasite causes problems inside your heart muscle or intestine. If you have Chagas disease, you have about a 30% chance of developing complications. Treatment for Chagas disease includes taking an antiparasitic medicine for up to 2 months and supportive therapies.
If untreated, infection is lifelong and can be life threatening. The impact of Chagas disease is not limited to only rural areas of Latin America in which vectorborne transmission (diseases transmitted by insects) occurs.
In the chronic phase, it presents as neuritis that results in altered tendon reflexes and sensory impairment, and is reported in up to 10% of the patients. Isolated cases of central nervous system involvement can also include dementia, confusion, chronic encephalopathy and sensitive and motor deficits.
Chagas disease is an infectious disease caused by the protozoan Trypanosoma cruzi. The disease mainly affects the nervous system, digestive system and heart.
In rare cases, young children or immunosuppressed people infected with Chagas disease develop life-threatening complications, including: Myocarditis (severe inflammation and infection of the heart muscle). Meningoencephalitis (severe inflammation and infection of the brain).
Chagas disease has an acute and a chronic phase. If untreated, infection is lifelong. Acute Chagas disease occurs immediately after infection, and can last up to a few weeks or months. During the acute phase, parasites may be found in the circulating blood.
The prognosis of patients with heart failure or advanced stages of chagasic cardiomyopathy is poor, but a timely diagnosis during the initial stages of the disease would allow for prescription of appropriate therapies to offer a better quality of life.
After the acute phase, the person enters into the chronic phase of the disease. There are 2 possible chronic disease phases, the indeterminant (or asymptomatic) phase and the determinant (or symptomatic) phase. About 70-80% of people will remain asymptomatic for life and never develop Chagas-related symptoms.
Diagnosis of chronic Chagas disease is made by serologic tests for antibody to the parasite. A single test is not sufficiently sensitive and specific to make the diagnosis.
These results suggest that the inflammatory cardiomyopathy of Chagas' disease is a genetically driven autoimmune disease.
In young people, treatment also gives good results. In both children and young people, treatment of Chagas is associated with fewer adverse effects than in adults. In adults, a cure is not guaranteed, but treatment can stop the disease from progressing and prevent or delay cardiac complications.
Chagas disease is an emerging disease in Australia. GPs are best placed to offer opportunistic Chagas disease screening to those at risk from endemic regions as they are likely to be the first point of contact.
In rare cases, the infected can experience life-threatening illness in the days to weeks after they are infected. The infection can persist for years and some go on to develop serious heart problems or gastrointestinal tract problems years or decades after infection.
The pathology of Chagas disease is based in an inmunoinflammatory reaction producing fibrosis and remodelling, mainly in the myocardium. In many cases these mechanisms result in a dilated cardiomyopathy with HF and reduced ejection fraction, frequent cardiac arrhythmias and different types of heart block.
Early treatment for Chagas disease is the most successful. Recommended treatment may include: Antiparasitic medicine which you may need to take for up to 2 months.
Second stage (latent period)
During the second stage, people have no symptoms of Chagas disease and results of electrocardiography (ECG) and imaging tests of the heart and digestive system are normal. However, protozoa are present in their body and sometimes blood.
In the Americas, Chagas disease show an annual incidence of 30,000 new cases average, 14,000 deaths per year, and 8,000 newborns become infected during gestation.
Confirmatory serologic testing for chronic Chagas disease and molecular testing (PCR) for acute Chagas disease are available at the CDC.
The parasites enter the body when the person instinctively smears the faeces or urine into the bite, the eyes or the mouth. It can be between 10 and 30 years before people develop symptoms so most are unaware they have Chagas, often called a “silent and silenced disease”.
Chagas disease is common in parts of Mexico, Central America, and South America where an estimated 8 million people are infected.
Trypanosoma cruzi, the etiological agent of Chagas' disease, causes an intense inflammatory response in several tissues, including the liver. Since this organ is central to metabolism, its infection may be reflected in the outcome of the disease.
One of the key issues concerning Chagas disease is that of diagnosis. Without effective diagnostics, infected individuals cannot be identified and thus treated, and the effectiveness of treatment cannot be efficiently assessed.
Treatment for Chagas disease focuses on killing the parasite and managing signs and symptoms. During the acute phase of Chagas disease, the prescription medications benznidazole and nifurtimox (Lampit) may be of benefit. Both drugs are available in the regions most affected by Chagas disease.