(RxWiki News) You may have never heard of it before, but Chagas disease is threatening to become the next deadly epidemic. What is it, and why is it being compared to the early decades of AIDS?
Chagas disease is a parasitic infection that's carried and transmitted by blood-sucking insects. Chagas is potentially fatal, leading to heart failure or enlarged intestines.
The disease's range currently spans Central America to the southern US, but researchers are warning that the disease is poised to go global, with many aspects predicted to echo the AIDS epidemic.
"Symptoms of Chagas include swelling of the area of the insect bite, fever, and swelling of one eye."
An editorial in the online journal PLoS Neglected Tropical Diseases labeled Chagas disease “The New HIV/AIDS of the Americas.” Lead author Dr. Peter Hotez, of the Sabin Vaccine Institute, is one of the leading experts on a class of diseases known as neglected tropical diseases.
The parasite that causes Chagas disease is called Trypanosoma cruzi. It's carried by tropical bugs, whose range has limited the disease to Central and Southern America, as well as parts of Texas.
But there's evidence that it's on the move. Tropical “kissing bugs” carrying the parasite were recently discovered in Arizona and California, regions that had never before seen the bug.
In the editorial, the authors write, “Stark similarities exist between today's global Chagas disease epidemic and the first two decades of the HIV/AIDS epidemic. This translates into a humanitarian catastrophe for the poorest people in the Americas and elsewhere.”
So why is it like AIDS?
- Both disproportionately impact people living in poverty. The conditions of poverty are hospitable to the bugs that carry it.
- Most patients with Chagas disease do not have access to health care, similar to patients in the first two decades of HIV/AIDS.
- Both diseases come with stigma, which may prevent those who are infected from getting necessary treatment.
- Both Chagas and HIV can be transmitted from mother to her infant.
- As was the case during the early days of the AIDS epidemic, treatment for Chagas is not well developed and there is a shortage of drugs.
But unlike early HIV, not all cases of Chagas progress to being chronic and life-threatening without treatment. Seventy to 80 percent of Chagas infections do not lead to heart or intestine problems.
The disease is transmitted when the bugs bite humans (typically near their lips, hence the name), and then defecate. The victim is prone to scratch or rub the itchy bite, rubbing in the parasite to the wound.
Ten million people already have Chagas disease and its appearance in Texas has been relatively recent. Evidence points to climate change for enabling the move.
Because it is so rarely diagnosed in America, Dr. Hotez worries that many physicians may not have been trained how to recognize the symptoms of Chagas disease. What's more, symptoms of the infection may not develop for many years after the initial insect bite.
There are two phases of Chagas disease: acute and chronic. The acute phase may have mild symptoms, including fever, a general ill feeling, swelling of one eye and swelling at the site of the bite.
The chronic phase is the one that public health officials are worried about, and it can develop years after the acute phase. Symptoms include constipation, digestion problems, abdominal pain, and difficulty swallowing.
You may be at risk if you live in one of the areas affected by Chagas disease, especially if you live below the poverty line. Another risk factor is having had a blood transfusion.
There are a number of tests that can help identify the disease and two drugs, benznidazole and nifurtimox, are currently used for treatment. There are known side effects including skin rashes, headache, difficulty sleeping and loss of appetite.
The editorial was published in May 2012.