What is Chagas Disease? Let's talk about it simply.

There are diseases that we have not heard of, but are common in some countries of the world. Today we are going to talk about a disease that is spread in a somewhat strange way, especially in North, Central and South American countries. This is called Chagas Disease. Some people also call it "American Trypanosomiasis". Although the name may sound scary, it is very important to be aware of this, especially if you are traveling to such a country.

Simply put, what is Chagas disease?

Chagas disease is an infection caused by a small parasite called `(Trypanosoma cruzi)` . This parasite is carried by a very special insect. This insect is called the "Triatomine bug". But this one is better known as the "Kissing Bug".

Now you might be wondering why this insect is called the "kissing bug." The reason is that this insect usually comes at night while people are sleeping and bites their faces, especially the areas around the lips or eyes. It gets its name because it bites in a way that looks like it's giving them a kiss.

But the disease is not spread simply by the insect bite. This is what happens:

1. As the "kissing bug" sucks blood from your body, it defecates near the bite site.

2. The parasite `(Trypanosoma cruzi)` that I mentioned earlier is found in the feces of this insect.

3. If you accidentally scratch or touch the bite site, the parasite's feces can enter your body through the wound, your eyes, nose, or mouth.

The most dangerous thing about this disease is that many people do not show any symptoms in the early stages of the infection. So they do not even know they have this disease. If left untreated, this infection can become chronic and cause serious damage to the heart and digestive system for years, even decades.

What are the symptoms of Chagas disease?

Chagas disease has two main phases: the acute phase and the chronic phase.

Early symptoms (acute stage)

These symptoms can appear within the first few weeks or two months after infection. But many people have no symptoms at all , or the symptoms they do have are very mild, like a normal flu.

• Fever
• Body pain
• Tiredness
• Headache
• Diarrhea and vomiting
• The area where the insect bit you becomes red, swollen, and sometimes develops into a sore (chagoma).
• Severe swelling of the eyelid. This is called "Romaña's sign" in medical terms. This is a very specific symptom.

Symptoms that develop over time (chronic stage)

If the initial stage is not treated, the infection remains in the body. But it can remain for years without showing any symptoms. About 30% - 40% of infected people will eventually develop serious complications. These are the most dangerous symptoms:

Is it only the "kisin bug" that spreads this disease?

This disease is mainly spread by the "kissing bug". However, it can also be spread in several other ways.

• From mother to child: If a pregnant mother has this infection, it can be transmitted to her baby through the placenta, during childbirth, or through breastfeeding.
• Through infected food: By drinking food or fruit juice (especially unpasteurized) contaminated with the parasite.
• Blood transfusion or organ transplant: Receiving blood or organs from an infected person. However, this risk is now much lower in many countries because blood donors are now screened for Chagas disease.

Who is at higher risk of developing this disease?

This disease is not common in Sri Lanka, but the risk is higher for those who have the following conditions:

• If you live or have lived in rural areas of South America, Central America, or Mexico, especially in houses with mud walls, thatched roofs, and no screens on the windows, the "kissing bug" is more likely to live in such places.
• If the mother has Chagas disease and the child is born.
• If the blood was collected before blood testing methods were available (in most countries between 1990-2007).

Serious complications that can occur due to Chagas disease

We need to be more concerned about this disease because of the long-term complications it can cause.

The main complications that can occur in the chronic phase are:

• Heartbeat irregularities (Arrhythmia): Irregular heartbeat.
• Cardiac arrest: Sudden cessation of heart function.
• Dilated cardiomyopathy: The heart muscle becomes weak, the heart becomes enlarged, and it cannot pump blood properly.
• Heart failure: The heart is unable to pump enough blood to the body.
• Enlarged esophagus: Difficulty swallowing food.
• Enlarged colon: Severe constipation occurs.

How do you find out if you have this disease?

The main way to confirm whether you have Chagas disease is to have a blood test . This checks for antibodies in the blood, which are the body's immune system's defense against the T. cruzi parasite.

If you have any symptoms related to your heart or digestive system, your doctor may order further tests.

• Echocardiogram: A scan to look at the function and structure of the heart.
• Electrocardiogram (EKG/ECG): A test of the electrical activity of the heart.
• X-ray or CT scan: Taking pictures of the chest or abdomen.
• Upper endoscopy: Examination of the esophagus using a tube with a camera.
• Colonoscopy: Examination of the large intestine.

Is there any treatment?

Yes, fortunately there is a treatment for this. Two drugs that kill parasites are mainly used. They are `benznidazole` and `nifurtimox` .

Some people may experience side effects when taking this medication. For example, loss of appetite, nausea, vomiting, headache , and muscle pain. If anything like this happens, do not stop taking the medication, but talk to your doctor immediately. He or she will give you a solution.

When should you see a doctor?

If you have lived in or traveled to an area where Chagas disease is common, it is very important to see a doctor for advice in the following situations:

• If you have heart disease or digestive system problems.
• If you suspect you have this disease and want to get tested (especially before or during pregnancy).

When should you go to the Emergency Treatment Unit (ETU)?

If any of the following severe symptoms occur, immediately go to the Emergency Department (ETU) of the nearest hospital.

• Very severe headache
• Neck stiffness
• Severe chest pain
• Severe diarrhea or vomiting
• Confusion or dementia

Can this disease be prevented?

Yes, there are ways to protect yourself, especially if you live in or travel to high-risk areas.

• Spraying insecticides in and around homes.
• Sealing the holes in doors and windows well so that "kissing bugs" cannot enter the house.
• Using nets, such as mosquito nets, when sleeping.
• Avoid drinking unpasteurized fruit juice and eating foods that may be contaminated with the parasite.

If you have traveled to a risk area and are hoping to become pregnant, talk to your doctor about getting tested for Chagas disease.

Chagas Disease, Chagas Disease, American Trypanosomiasis, Kissing Bug, Trypanosoma cruzi, Parasitic Infection, Heart Disease