Re-Emerging Chagas Disease (American Trypanosomiasis): Old Problems without Modern Solutions
Tropical Medicine and Health
Chagas disease, or American trypanosomiasis, is an arthropod-borne infectious disease, hyperendemic in Latin America, caused by the trypanosome, Trypanosoma cruzi, and transmitted to man by reduviid (or triatomine) bugs. Throughout the Americas, Chagas disease is most commonly transmitted via T. cruzi-infected reduviid bug defecations near bite wounds or exposed mucosal surfaces. Chagas disease may also be transmitted congenitally, by ingestion of T. cruzi-infected reduviids or their feces, by
... lood product transfusions, and by organ donations. Indeterminate and chronic infections may be re-activated by immunosuppression, particularly HIV/AIDS, and by pregnancy. Characterized by an influenza-like illness acutely in adults, Chagas disease may result in heart disease or gastrointestinal megasyndromes following a prolonged or indeterminate stage of subclinical infection. Chagas disease is now among the most common causes of myocarditis in the Americas and the most common cause of death from parasitic diseases in Latin America. Chagas disease will pose increasing communicable disease risks to man and domestic animals throughout the Americas and will be a difficult disease to eradicate due to an army of competent arthropod vectors; a large, nonspecific animal reservoir; a large human reservoir of asymptomatic human infection in the indeterminate stage; limited treatment strategies; and no vaccines.