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$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.