Aaron Manning

OverviewAlso called American trypanosomiasis and

the Kiss of DeathA tropical parasitic disease caused by the

flagellate protozoan Trypanosoma cruzi.Spread to humans through the bite of an

insect vector

Signs and SymptomsAcute Stage

Nonspecific symptoms i.e. fever, diarrhea, vomiting

Swelling and inflammationRomaña's sign

Signs and SymptomsChronic Stage

About 30% develop medical problemsCardiac damageDigestive system damageNeurological disorders

Potentially fatal if untreated

DiagnosisT. cruzi in blood smearsPCR to ID strains

DiscoveryBrazilian physician Carlos Chagas - 1909Chagas’ work uniqueDarwin

Epidemiology1960s16–18 million people affected as of

2008~100 million at riskKills around 20,000 annually

18 countries from US to ArgentinaOccurs almost exclusively in rural areas

Why?

The VectorBlood-sucking insects of the subfamily

Triatominaevinchuca, barbeiro, chinche, the kissing bug

TransmissionA triatomine becomes infectedHides during dayEmerges at nightBites, feeds, then defecates

TransmissionScratchingBlood transfusions, organ transplants, or

breast milkCongenital Transmission

13% of stillborn deaths in parts of Brazil

Clinical ManifestationsCell death in target tissuesInflammatory response

Treatment and Prevention

PreventionMost effective approachInsecticidesImproving housing conditionsTesting of blood donorsNo vaccine

Treatment and ManagementTwo approaches

Antiparasitic treatment Symptomatic treatment

Antiparasitic TreatmentMost effective early Drugs include azole or nitro derivativesResistance

Symptomatic TreatmentDisease cannot be cured in chronic phaseManaging the clinical manifestationsPacemakers and anti-arrhythmia drugsSurgery for megaintestine. Heart transplantation surgery

On the HorizonNew DrugsNew vaccines being testedStem cell therapy

Resources Antonio RL Teixeira; Nascimento; Sturm. Evolution and pathology in Chagas disease - a

review . Mem. Inst. Oswaldo Cruz vol.101 no.5 Rio de Janeiro Aug. 2006Centers for Disease Control. http://www.cdc.gov/chagas/ Prata A. Clinical and epidemiological aspects of Chagas disease. Lancet Infect Dis. 2001

Sep;1(2):92-100.Vanessa Leiria Campo, Carvalho, Allman, Davis and Robert A. Field. Chemical and

chemoenzymatic synthesis of glycosyl-amino acids and glycopeptides related to Trypanosoma cruzi mucins Org. Biomol. Chem., 2007, 5, 2645

Wikipedia. http://en.wikipedia.org/wiki/Chagas_diseaseWorld Health Organization. www.who.int/tdr/svc/diseases/chagas