Chagas: The Scary Disease Some Are Calling the New AIDS

Illustration for article titled Chagas: The Scary Disease Some Are Calling the New AIDS

Just when it seemed like all the super scary diseases had been discovered—flesh-eating bacteria, brain tapeworms, and, of course, HIV/AIDS, among many others—a new one comes along to bring fresh terror into our hearts. Introducing Chagas disease, which is caused by parasites that get into our bodies by way of blood-sucking insects. Ick. As for what it does, about one quarter of people who have it develop enlarged hearts or intestines which can eventually fail—or worse, burst—leading to death. Gaaah. Naturally, it's very difficult to treat and is normally only curable if caught early.

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Several tropical disease specialists recently published an editorial in PLoS Neglected Tropical Diseases (sounds like a fun read) in which they called Chagas, "the new AIDS of the Americas." They say the way it's spreading throughout this hemisphere is similar to the way that AIDS spread early on, and the disease itself shares some characteristics with HIV/AIDS. For one thing, it's got a very long incubation period, and there's also the difficultly involved in curing it. Besides being transmitted by bugs, infection can be passed from mother to child and also by blood transfusion. It's estimated that there about eight million people in this hemisphere with Chagas. It's concentrated mostly in Bolivia, Mexico, Colombia, and Central America. However there are more than 300,000 cases in the United States, and most of the people infected here are immigrants.

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The doctors who penned the editorial said that part of the reason Chagas has been so difficult to control is that being infected carries a stigma so people are reluctant to seek medical help. This, of course, leads to further spread of the disease. For those who do seek treatment, it involves months worth of very harsh drugs. Fortunately, they're not as pricey as AIDS drugs, but they still tend to be in short supply in the poorer countries where they're most needed. Right now this is thought of as "a disease of the poor," so there hasn't been much invested in finding new treatments. But perhaps it would be wise if we started paying attention, since blood-sucking insects don't seem to distinguish much between socio-economic classes and are probably more than happy to spread this horrible disease as far and wide as they can.

Stubborn Infection, Spread by Insects, Is Called ‘The New AIDS of the Americas' [New York Times]

Image via vetpathologist/Shutterstock.

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DISCUSSION

let's get some things straight, Jez, since you feel like playing doctor, but clearly never bought your copy of "Clinical Microbiology Made Ridiculously Simple":

1. you do not get infected with t. cruzi by blood sucking insects when they feed on you, only when they defecate on you

2. there are multiple vectors for this disease, but the only clinically important vector is the reduviid, or "kissing bug"

3. transmission can occur through blood transfusions, organ transplants, or even breast milk (other rare forms of transmission have been documented)

4. the reduviid feeds on human skin, but the trypomastigote (the 'fetal' form of the trypanosome in question, T. cruzi) is present in the bug's feces. they tunnel into the blood stream when the bug defecates on you, not when it bites you. the reduviid picks the parasite up into it's blood when it feeds on an infected animal. it then passes it to the next animal by pooping on it.

5. this is not a new disease. it's transmission and clinical sequelae are well documented, particularly in tropical regions.

6. the original article is an editorial that can be summed up by a sentence in the introduction: "There are a number of striking similarities between people living with Chagas disease and people living with HIV/AIDS, particularly for those with HIV/AIDS who contracted the disease in the first two decades of the HIV/AIDS epidemic." The reason for this distinction is that yes, it can be compared to HIV/AIDS in many respects, but calling it the new HIV/AIDS is awfully provocative, and will likely get your editorial noticed.

Calling this a new disease that might be the next great epi- or pandemic is beyond sensationalism. Some of my points above may need clarification or mild correction, but give your readers a break and consult a specialist before you throw down.