Chagas (disease)

Chagas (disease) . Infectious disease transmitted to man by insect bites considered unicellular parasites , it is also known by the name of American trypanosomiasis.

Summary

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  • 1 History
  • 2 Way of transmission
    • 1 Other forms of contagion
  • 3 Form of transmission in Cuba
  • 4 Presence of the disease
  • 5 Countries with cases of infested persons
  • 6 Symptoms
    • 1 Acute phase
    • 2 Chronic phase
  • 7 Disease prevention
  • 8 Treatment of disease
    • 1 Antiparasitic treatment
    • 2 Symptomatic treatment
  • 9 Impact of the disease on society
  • 10 Sources

History

American trypanosomiasis owes its name to the Brazilian doctor Carlos Chagas , and was discovered in 1909 .

The impact of this disease is not limited to rural areas in Latin America , where transmission occurs through a vector . Large-scale population migrations from rural to urban areas in Latin America and to other regions of the world have increased geographic distribution and changed the epidemiology of Chagas disease.

In some regions where Chagas disease is present, although not at endemic levels , control strategies should focus on preventing transmission caused by blood transfusions , organ transplants, and mother-to-baby transmission in the same gestation period .

Transmission way

This disease is caused by the parasite Trypanosoma cruzi , which is transmitted to animals and humans through vector insects that are found only in the Americas (especially in rural areas, where poverty is widespread). Chagas disease is also known as the new AIDS in America . “It is estimated that between 8 and 11 million people in Mexico , Central America and South America have Chagas disease and most of them do not know that they are infected. Yes Untreated, the infection lasts a lifetime and can be life threatening.

To the insect vectors they are known as triatomine . These blood-sucking insects become infected by biting an infected animal or an infected person. Once infected, the insect expels the T. cruzi parasites in the faeces. Insects are found in houses made of materials such as mud , adobe , straw, and thatched roof . During the day, insects hide in cracks in walls and ceilings, and at night, when residents are sleeping, they come out of hiding. Because they tend to itch people’s faces, which is why they are also known as “kissing bugs.”

After they bite and ingest the blood, they defecate on the person. Without realizing it, the sleeping person can accidentally scratch or scrub the feces in the wound left by the bite, in the eyes or in the mouth. the bite of another harmless insect

Other forms of contagion

Eating uncooked food contaminated with infected insect feces .

Congenital transmission (from a pregnant woman to her baby). Blood transfusion .

Organ transplant and accidental exposure in a laboratory .

Form of transmission in Cuba

The Cuban medical cooperation missions have grown significantly in recent years, both the employees and the number of countries where Cuba tends helping hand; The different schools in the country where young people from Latin America study have also increased. In any case, these missions come into contact with diseases that do not exist today on this island, such as Chagas disease, which is endemic. from rural areas.

It is a parasitic disease widely distributed throughout the American continent, of which specimens have been found in the eastern provinces, in Camagüey , Villa Clara and Pinar del Río , although an infected person has never been reported. It has a broad clinical spectrum ranging from indeterminate forms of the disease, where the parasite is apparently absent, to severe forms that can lead to death.

Presence of the disease

The disease has a long incubation period and is difficult or impossible to cure, if it is not diagnosed early.

The disease causes inflammation of the tissues of the heart and esophagus . Some infected people develop hypertrophy of the heart or intestines .

Countries with cases of infested persons

It can be found anywhere in the world, but vector transmission is limited to Latin America , mainly to certain rural areas of Mexico , Central America , and South America . In some regions of Latin America, this form of propagation has been stopped through vector control programs. Transmission through this vector does not occur in the Caribbean area such as Puerto Rico or Cuba , rare cases of vector-borne Chagas disease have also been observed in the southeastern United States .

symptom

The disease has two phases, in any of the two the mortality of the disease can be reduced, if it is diagnosed in time.

Acute phase

It takes place in the first weeks or the first months of infection. It generally goes unnoticed because it shows no symptoms or exhibits only mild signs and symptoms that are not exclusive to Chagas disease. Symptoms noted by the patient may include fever , fatigue , body aches, headache, rash , loss of appetite, diarrhea, and vomiting . Signs found on physical examination may include mild enlargement of the liver or spleen , swollen glands, and local swelling at the site of the parasite. entered the body, inflammation of the eyelid may also appear on the side of the face near the wound left by the bite or where the insect’s feces were deposited, which may have accidentally entered the eye if the patient scrubbed the face .

Even if symptoms appear during the acute phase, they usually go away on their own, within a few weeks or months. Despite the fact that the symptoms disappear, the infection will persist if it is not treated. Very rarely, young children, less than 5% die from severe inflammation or infection of the heart muscle causing myocarditis or brain with meningoencephalitis .

Chronic phase

It can also remain asymptomatic for a long time. However, some people have heart complications, which may include an enlarged heart , heart failure, a change in heart rate or rhythm, and cardiac arrest , known as sudden death ; Intestinal complications also appear, which may include an enlarged esophagus causing a megaesophagus or the colon with the megacolon , which leads to difficulties in eating or defecating.

Prevention of disease

There are currently no medications or vaccines to prevent infection. People who sleep indoors and in well-built buildings have little risk of exposure to infected triatomine insects , as they infest lower-quality or older homes and are more active at night. Prevention measures include spraying insecticide- infested homesof residual action, the use of [mosquito nets]] treated with long-acting insecticides, the use of protective clothing and the application of insect repellent on exposed areas of the skin. In addition, travelers should be alert to other possible transmission routes, including transmission through blood and food.

Treatment of the disease

The measures can vary depending on the place, its characteristics, you must also take into account the age and the risk of presenting other chronic diseases that may be exacerbated by the infection of this insect .

Antiparasitic treatment

It is most effective in the early phase of infection, but is not limited to cases in the acute phase, this type of treatment is available through the Centers for Disease Control and Prevention . Your healthcare provider may consult the staff in charge to determine if you should be treated and what type of treatment is recommended. Most people do not need to be hospitalized during treatment

Symptomatic treatment

It can help people who have heart or intestinal problems caused by the disease. For example, pacemakers and medications to control irregular heartbeats can save some patients with chronic heart disease .

Impact of the disease on society

The social and economic impact of this infection is enormous. In some countries, those with a positive serology are not employed. Due to the numerous factors involved, to which are added those of political and economic power, this disease becomes not only a disease of poverty, but also an example of mechanisms of concealment and exclusion as a form of social and labor discrimination. .

In the last 10 years, knowledge about Chagas disease has increased, not only through research, but also among health authorities , during 2002 , the States of Mexico and other countries with present cases started a movement, with In order to draw the attention of institutional authorities to the lag of this disease in the country and its increase, due to the absence of interventions in most States, joint work was essential to eradicate the disease.

In support of this initiative, expert researchers from the Southern Cone , the Andean Pact and the European Community , as well as from the Pan American Health Organization and representatives of the Mexican health services, were present and promised to carry out an analysis of the problem. , but it was not given the importance that the situation required due to its severity and cases of infected people continue to appear.

In some states, vector control activities are occasional and partial, and are only carried out in the presence of a chronic case. These actions are based on the entomological study and home spraying as the program specifies, however, vector capture is poorly performed and the chemicals used are specific to others of other types of vectors, making the efficacy of their objective eradicating the insect was not always effective.

Regarding treatment, the health services of some countries of the so-called Third World do not have the supply of specific medicines necessary to treat acute cases, so it is necessary to request help from other countries, which proves that the program is weakened and requires strengthening.

 

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