$Unique_ID{BRK03584} $Pretitle{} $Title{Chagas' Disease} $Subject{Chagas' Disease American Trypanosomiasis Brazilian Trypanosomiasis} $Volume{} $Log{} Copyright (C) 1986, 1987, 1989, 1991 National Organization for Rare Disorders, Inc. 147: Chagas' Disease ** IMPORTANT ** It is possible that the main title of the article (Chagas' Disease) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms American Trypanosomiasis Brazilian Trypanosomiasis General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section. Chagas' Disease is a parasitic infection involving practically all the organs in the body. It is potentially fatal when the heart muscle and gastrointestinal tract are severely affected, or it may have a mild, even asymptomatic, course. The disease occurs primarily in young children in South and Central America, and is transmitted by an insect inhabiting poorly constructed houses. Symptoms Chagas' Disease has an acute and a chronic stage. These stages represent different immunologic reactions against the parasite, which spreads to the various organs of the body. The parasite has a preference for skeletal and heart muscle, and the central nervous system. Early stages of acute Chagas' disease are characterized by fever, enlargement of lymph nodes, enlargement of the spleen and liver, and swelling (edema) of the trunk and especially the face. Painless swelling around the orbit of one eye, with mild inflammation of the conjunctiva (the thin membrane lining the eyelids and the surface of the eyeball), is typical and constitutes the Romana diagnostic sign. Lack of appetite, general malaise, and tearing from the eyes accompany these symptoms. Severe inflammation of the heart muscle often occurs, and may be fatal. Less commonly, meningoencephalitis (inflammation of the brain and its covering membranes) occurs causing seizures. Sometimes, this results in permanent brain damage, paralysis, or in death. In chronic Chagas' Disease, the heart muscle, esophagus, and large intestine may be involved. Evidence of heart involvement includes irregular or slow heart beat. There may be neurological symptoms such as tremor, muscle weakness, and mental disorders. Often, symptoms are very mild or nonexistent. Causes Chagas' Disease is caused by a protozoan microorganism known as a Trypanosoma cruzi. It is transmitted by a group of related insects belonging to the family reduviidae (e.g., Triatoma). The insect bites an infected individual, then bites an uninfected one, contaminating the bite wound, the corners of the lips, or eye with its infected feces. The parasite lives in man, and sometimes in dogs or cats, so that all of these can act as sources of infection. Affected Population Chagas' Disease affects mostly small children. It occurs only in South and Central America from Argentina and Chile to southern Mexico. However, persons coming into the United States from South America are presenting with heart problems related to Chagas Disease. The disease is probably underdiagnosed in the United States in both adults and children. Related Disorders Chagas' Disease is closely related to African forms of trypanosomiasis, which are transmitted by the tsetse fly and are popularly known as African sleeping sickness. Therapies: Standard Chagas' Disease should be treated early. Nifurtimox (a derivative of nitrofurazone) can destroy the parasite. No satisfactory drug to reverse chronic organ damage has been discovered thus far, however. Chagas' Disease can be prevented by eliminating the insect that transmits the disease. Various insecticides can be used to spray houses. Gamma- benzene hexachloride has been found effective. Therapies: Investigational The orphan drug allopurinol riboside for treatment of Chagas Disease is undergoing clinical trials. For more information, physicians can contact: Burroughs-Wellcome Co. 3030 Cornwallis Rd. Research Triangle Park, NC 27709 French pharmaceutical manufacturer, FOURNIER, is developing the drug LF1695, which may restore the immune system in children with Hodgkin's Disease, Schwachman Syndrome, and Chagas Disease. Physicians interested in obtaining LF1695 may contact: Fournier Labs BP90, Daix, 21121 Fontaine Les Dijon, France Cronassial is being tried on an experimental basis to treat the cardioneuropathy effects of Chagas Disease. It is also being studied in other countries to treat other peripheral neuropathies. The drug is under study in the United States, but is not commercially available here. Trials are sponsored in the U.S. by Rorer. It is available in other countries including Italy, Spain and Argentina. It is manufactured by Fidia in Italy. Fidia Farmaceutici Italiani Derivati Industriali e Affini Via Ponte della Fabbrica 3/A 35051 Abano Terme (Padova) Italy 049 810 444 This disease entry is based upon medical information available through October 1991. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Chagas' Disease, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 Centers for Disease Control (CDC) 1600 Clifton Road, N.E. Atlanta, GA 30333 (404) 639-3534 NIH/National Institute of Allergy and Infectious Diseases (NIAID) 9000 Rockville Pike Bethesda, MD 20892 (301) 496-5717 International Tremor Foundation 360 W. Superior St. Chicago, IL 60610 (312) 664-2344 References THE MERCK MANUAL 15th ed: R. Berkow, et al: eds; Merck, Sharp & Dohme Research Laboratories, 1987. P. 210. CECIL TEXTBOOK OF MEDICINE, 18th ed.: James B. Wyngaarden, and Lloyd H. Smith, Jr., Eds.: W. B. Saunders Co., 1988. Pp. 352-3, 1865-9, 1920.