American Trypanosomiasis/Chagas’ Disease

American Trypanosomiasis, Chagas’ Disease (acute or chronic protozoan disease)

Trypanosoma cruzi

Eukaryote Protozoa; Intracellular parasite, motile- single flagellum attached to an undulating membrane, complex multi host life cycle

Wild and domesticated animals, humans, and reduviid bugs

Mucose or compromised skin

Zoonotic, arthropod vector= Reduviid “kissing” bug bites and defecates; scratching infects bite wound, vertical transmission, contaminate food, latent infections

1 week for acute; months-years for chronic

Protozoan replicates in cells at site of infection. Cellular damage and release of new protozoa results in inflammation and spread of infection to the ciculatory system and other organs. persistence of protozoa as intracellular parasites inhibits normal organ function resulting in various chronic disease states and reduced host life spans

Possible swelling at site of infection, fever, fatigue or malaise, headache, diarrhea, vomiting, Romana’s sign, mild organ enlargment

Unilateral periocular edema with conjunctivitis

Constipation, digestive problems, abdominal pain

Severe inflammation, myocarditis, meningoencephalitis, mortality in young children <5%

Megacolon and megaesophagus (5-10% of chronic patients), cardiomyopathy, heart failure, Mortality- ARP =42.5%

Attributable Risk Percent

Contol reduviid bug population- reduce hiding areas around home, insectcides, use bed nets; testing/treatment, screen blood and organ supply

Antiparasitics- Nifurtimox, Benznidazole (Acute phase efficacy)