The underreported and undertreated condition known as Chagas disease is a health threat similar to the early years of the HIV/AIDS pandemic, according to an editorial by doctors writing for the journal PLoS Neglected Tropical Diseases.
Chagas disease — which is mostly found in Latin America but also occurs in southern Texas — is most commonly transmitted by so-called "kissing bugs," a subfamily of blood-sucking insects also known as assassin bugs that like to target the lip region (hence the name). The bugs carry a parasite called Trypanosoma cruzi, which is what causes Chagas disease. The parasite is transmitted via the bugs' feces: the insects defecate while they are feeding, allowing the parasite to move on to its new host.
The disease can also be transmitted via blood transfusion, organ transplant or from mother to child during pregnancy.
Once infected, Chagas disease (also known as American trypanosomiasis) can go undetected for years, or even decades, during which time it can cause damage to the heart, intestines and esophagus. Cardiomyopathy and arrhythmias caused by the damage can eventually prove fatal. In some cases, a Chagas-enlarged heart or intestines can actually explode.
According to the PLoS editorial, about 10 million people are currently living with Chagas disease, making it one of the most common neglected tropical diseases in Latin America and the Caribbean. It kills about 20,000 people worldwide every year. Lead author Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston, warns that the disease is spreading globally and there may be between 300,000 and 1 million cases in the U.S.
The doctors' comparison to the first two decades of the HIV/AIDS pandemic comes from several factors: both diseases disproportionately affect people living in poverty; the cost for treatment is incredibly high; both diseases are chronic conditions; and access to health care for people infected with Chagas remains low, as it was initially with HIV/AIDS.
"It's a forgotten disease among forgotten people," Hotez told The Star. "Can you imagine having 300,000 people in the suburbs with a serious case of heart disease caused by a bug? We wouldn't tolerate it as a society, but because it's happening to an indigenous people, we're silent."
Chagas is treatable, but only within the early stages of the disease. According to the Centers for Disease Control and Prevention (CDC), the early stage of Chagas occurs immediately after infection and may have mild or no symptoms at all. Symptoms during this stage can include fever, malaise, and a swelling of one eye. According to Doctors Without Borders, many countries with high levels of Chagas face shortages of benznidazole, the primary drug used to treat the disease.
The American Red Cross routinely screens blood donations for Chagas, but screening policies and requirements vary by location and organization. Texas does not require screening, nor are physicians in the state required to report instances of the disease, according to Wired.
The CDC has targeted Chagas disease and four other neglected parasitic diseases for public health action.