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Rise of Chagas Disease in Southern U.S.
Chagas disease, a tropical parasitic disease caused by blood sucking tri- atomine insects, is an emerging pub- lic health threat across a broad swath of the southern U.S., yet remains largely under diagnosed and treated.
A series of studies report- ing these and other findings was presented in November 2014 at the American Society of Tropical Medicine and Hygiene (ASTHM) annual meeting in New Orleans.
Caused by the protozoan Typanosoma cruzi, Chagas disease is transmitted by insects known as “kissing” bugs, a name given due
to the insects’ habit of feeding on people’s faces while they sleep. It may also spread through congenital transmission (from a pregnant woman to her baby); the blood sup- ply; organ transplantation; consump- tion of uncooked food contaminated with feces from infected bugs; and by accidental laboratory exposure.
Blood screening for the Chagas parasite began in 2007 for all poten- tial U.S. blood donors; however, a study of Texas blood donors be- tween 2008 and 2012 showed one in 6,500 tested positive for the Chagas
parasite. The rate is consistent with other studies in the southern U.S., but is 50 times greater than the national rate of one in 300,000.
Yet another startling finding was the high rate of heart disease, which appears to be related to the Chagas parasite, in persons with Chagas disease. Melissa N. Garcia, an epidemiologist at Baylor College in Houston, reported approximately one-third of people with Chagas disease will develop heart disease over the course of 10 to 30 years. Electrical and structural abnormali- ties occur in the heart, causing an enlarged heart, heart failure, altered heart rate or rhythm, or sudden death from cardiac arrest. Aside from heart rhythm abnormalities, the majority of persons with Chagas disease present very few symptoms and signs. Physicians are urged to consider Chagas disease in patients who present heart rhythm abnor- malities with no obvious underlying condition, such as diabetes or hypertension.
Another study presented at
the conference revealed that most people who test positive for Chagas
disease go untreated. Dr. Jennifer Manne-Goehler, of Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, reported that 1,908 Chagas cases were identi- fied in the blood donation system from 2007 to 2013, yet the CDC only provided 422 courses of benznida- zole or nifurtimox to treat Chagas during this period.
Once considered a disease of Latin and South America, Chagas disease now appears in people who have never left the U.S. According to the CDC, more than 300,000 people in the U.S. may be infected, yet a vast majority remains unaware.
In addition to heart disease, the CDC reports Chagas disease can cause intestinal complications, which can include an enlarged esophagus or colon, and can lead to difficulties eating or passing stool.
Additional information, includ- ing specific signs and symptoms of Chagas disease, can be found at cdc.gov/parasites/chagas.
Source: Medscape Multispecialty, Chagas Disease an Emerging, Overlooked Threat in Southern US, November 6, 2014, accessed December 2014 at medscape.com
infected in U.S.
50 times
greater infection rate
in southern U.S.
33% develop heart disease
Chagas disease by the numbers
CDC estimates more than
300,000
Majority unaware, undiagnosed,
Reported Potential
untreated
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