Chagas Disease: A New Health Disparity

Ever heard of Chagas Disease? Well, you're not alone. There may be as many as 10 million people, including an estimated 1 million in the United States, who have it. Chagas is a disease cause by a parasite; Trypanosoma cruzi, which lives inside a certain insect native to Central and South America. This insect, the Triatomabug, thrives in tropical areas, especially poor housing conditions where they come out and infect their victims at night. While it may seem that the impoverished conditions where these insects reside would confine it to certain areas, or even countries, immigration and the lack of familiarity of most physicians with the disease has exacerbated its spread. Another complicating feature of Chagas Disease are its two stages: Acute and Chronic. The early "Acute" stage may last may be asyptomatic and last for a few weeks or months. During the "Chronic" stage, most infected people "enter into a prolonged asymptomatic form of disease (called "chronic indeterminate") during which few or no parasites are found in the blood." (Centers for Disease Control) While most people will remain asymptomatic for life, up to one-third of those infected, 3 million, are at risk of Chagas’ worst complications, enlarging of the colon, esophagus and heart, cardiomyopathy and heart failure. Chagas disease is treatable, but clearly the longer its goes undetected, the more difficult it is to treat. Which leads me to the public health implications. A recent paper in PLoS by Sarkar and Strutz entitled: Chagas Disease Risk in Texas stated that Chargas is "endemic in the southern United States, especially in Texas" where, curiously enough, it has not been designated as reportable. Of course the State of Texas has never been a leader in public health, evidenced but their failure to adequately screen their own blood supply. If we have learned anything from HIV/AIDS, its that we generally have a short window in which prevent these types of diseases from becoming epidemic. Well, that window may have closed. However, the authors of the above article note that Chargas has so many ways of being transmitted including blood tranfusions, organ donations, ingestion of tainted food and a variety of animals from dogs, to raccoons to rodents. It's time for an aggressive campaign to produce a vaccine for humans and animals. Moreover, we need more research so that we have a better idea of how many people are infected, how tainted the blood supply may be and how widespread it has become in various animal species. Finally, we need to dissiminate "INFORMATION," eg... a social awareness campaign to educate the public.The horse may already be 'out of the barn,' but lets get him back before he runs too far away.