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