Chagas disease is a rare disease according to US and European standards. However, it is a real treat to people in Latin America: 18 million infected persons confirm that statement.
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is is a bad news, but there's more: the disease is spreading thanks to migration of people from the poor villages to the cities, blood transfusion are strong vector of spreading, more and more tourists are in danger and all doctors in Latin America know the disease too well.
As it is the case with any tropical area, the large part of Latin America is full of bloodsucking insects. The problems appear when those insects suck blood from an animal infected with a parasite called Trypanosoma cruzi.
The parasite enters their system and when the insect bites human it transmits the parasite. The most bites occur on the face and thus the name "kissing bugs" (other names are cone nose, assassin bug, and reduviid bug).
The problem is kissing bugs live in palm trees and palm leaves are used as a roof on many homes in Latin America. When the night falls, bugs are going out to feed on humans.
When the bug bites, after seven days a violet swelling appears (chagoma). The parasite then starts its travel inside the human body and infects heart, liver, brain and spleen. We call that an acute form of the disease and it appears in two percent of the patients.
The small children are especially endangered group and the symptoms they have are wide-spread rash, fever, swollen lymph nodes, diarrhea (and, related to that, anorexia), vomiting, enlarged liver and in some cases meningoencephalitis which can lead to death.
If a person is adult, the prognosis is better: Chagas disease usually causes an acute infection of the heart which damages the heart muscle, but most of the adult patient survives the infection and they beat the disease in one or two months.
But there is more bad news: The disease can be undiagnosed for as long as 20 years, or it can be diagnosed just by pure accident on blood tests. We call that a chronic Chagas disease and such a long life of the parasite in the body is the cause of serious health problems.
The patient has a chronic heart disease because heart muscle is becoming weaker and weaker, and since the body replaces infected tissue with scars, the heart loses its function and the patient dies.
In its chronic phase, Chagas disease can be diagnosed if the patient has inflamed and enlarged heart, irregular heartbeats, abdominal pain, or if he falls in the sudden cardiac arrest.
So, it is of great importance to try to diagnose Chagas disease as early as possible. In the early stage it is possible to kill the parasite with drugs, but when the disease covers other organs, there is no cure. We can make patient's life easier by treating just symptoms, and there's nothing else to be done.
So, if you are travelling to Latin America and you don't feel well, when to suspect that you have Chagas disease? You should see the doctor if you have fever, wide rash, nausea or if you notice that something you have a small dot with a swollen area around it (this is the place when the insect bit you).
So, how to protect yourself?
The rule number one - never to be forgotten is: don't sleep in small native homes with roofs made of palm leaves. People from affected areas know that sleeping in the forest is less dangerous than sleeping in poor house. Never eat uncooked food, don't spend much time with animals like raccoons and opossums, and don't touch any wild animal.
If you are in the city, choose well-known hotel, and if you find any insects in dark places (under the mattress, for example) leave that hotel. Take a repellent with you and spray your bed, drawers, closet and behind pictures. If by any case you need blood transfusions insist to be driven to university or civic hospital in a big city because those are only place when donor's blood is screened for parasites on a regular basis. ■