Materiały źródłowe

• #1 Chagas disease | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/chagas-disease

  Chagas disease can cause a sudden, brief illness. This type of illness is known as acute. Or it can become a long-lasting, chronic condition. Both stages can be free of symptoms. Or there can be life-threatening symptoms in either phase. […] The acute phase of Chagas disease lasts for weeks or months. It often has no symptoms. If there are symptoms, they’re mostly mild. They may include: Swelling at the infection site. Fever. Tiredness. Rash. Body aches. Eyelid swelling. Headache. Loss of appetite. Nausea, diarrhea or vomiting. Swollen glands. A larger liver or spleen. […] Symptoms that come on during the acute phase most often go away on their own. But if the infection isn’t treated, Chagas disease stays in the body. Sometimes it moves to the chronic phase. […] Symptoms of the chronic phase of Chagas disease may appear 10 to 20 years after the infection starts. Or there might be no symptoms. In severe cases, Chagas disease symptoms may include: Irregular heartbeat. Heart failure. Sudden cardiac arrest. Trouble swallowing. Stomach pain or trouble passing stool, called constipation.

• #2 Chagas Disease | What We Do | World Heart Federation

  https://world-heart-federation.org/what-we-do/chagas-disease/

  Chagas disease is found mainly in endemic areas of 21 continental Latin American countries. The most common way people are infected with Chagas is through the blood-sucking triatomine bugs, also known as kissing bugs (or vinchuca, barbeiro, pito, chinche, chipo in different Latin American countries). […] Around 12,000 people die every year due to complications from Chagas disease, with only 1 in 10 being diagnosed. Of these, only a small percentage receive treatment. […] There are two main stages of the disease: an acute phase and a chronic phase. In the acute phase, which lasts about two months, symptoms generally start to develop about one to two weeks following the bite. These are generally mild and unspecific, and may include fever, fatigue, body aches, headache, rash, loss of appetite, diarrhoea and vomiting. In people bitten by a triatomine bug, characteristic first visible signs of infection, such as a skin lesion or a purplish swelling of the lids of one eye (the so-called Romaa sign), can help in the diagnosis of new cases. […] In the chronic phase, about 70-80% of people may not show any symptoms at all. However, in about 20-30% of people, the disease progresses, mainly affecting the heart or gastro-intestinal organs. This occurs 10 to 20 years after the initial infection. In the heart, the disease can cause enlargement of the heart muscle, leading to heart failure. Other common problems are arrythmias and sudden cardiac arrest. In the gastro-intestinal system, there can be enlargement of the colon or the oesophagus, leading to digestive problems.

• #3 Chagas disease – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/1160

  Chagas disease is a chronic and neglected infectious disease associated with poverty, migration, and poor housing conditions with a high burden of morbidity and mortality. […] Patients with acute-phase disease are generally asymptomatic or present with mild symptoms, although these may be more severe in immunocompromised patients, or in disease due to oral transmission. Chronic-phase disease has cardiac, gastrointestinal, indeterminate, and mixed (cardiac and gastrointestinal) forms. Reactivation occurs in immunosuppressed patients and presents as myocarditis or severe meningoencephalitis. […] Clinically, there are acute and chronic phases. If the acute phase remains untreated, T. cruzi infection is lifelong. The chronic phase can manifest in various forms: indeterminate, cardiac, gastrointestinal, and mixed (cardiac and gastrointestinal). […] Reactivation of infection can occur in patients with induced or acquired immunosuppression (such as in advanced HIV infection or after organ transplantation), causing myocarditis or severe meningoencephalitis.

• #4 Untitled Document

  https://www.cdc.gov/parasites/cme/chagas/lesson_2/1.html

  The natural history of Chagas disease is divided into two phases, acute and chronic. The acute phase lasts approximately 8 weeks, and usually causes mild or no symptoms. […] Patients with chronic Chagas disease have lifelong infection in absence of treatment. Spontaneous cure is extremely rare. […] Most chronically infected persons remain asymptomatic for life. However, approximately 20% to 30% of T. cruzi-infected persons progress to clinical manifestations characteristic of Chagas disease (determinate forms) over the course of their lifetimes. […] The most common clinical manifestation is heart disease, often referred to as Chagas cardiomyopathy. […] Following the acute phase, 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. Many people may remain asymptomatic for life. However, approximately 20% to 30% of infected people will develop clinical disease over the course of their lives.

• #5 Chagas Disease in the U.S.: What We Do and Don’t Know

  https://asm.org/articles/2021/april/chagas-disease-in-the-u-s-what-we-know-about-the-k

  Chagas disease is tricky to manage medically because it is mostly asymptomatic or mild until it is too late for treatment. The acute phase, which begins several days after infection, is usually asymptomatic or with mild flu-like symptoms and lasts about 8-10 weeks. After the acute phase, the person enters into the chronic phase of the disease. There are 2 possible chronic disease phases, the indeterminant (or asymptomatic) phase and the determinant (or symptomatic) phase. About 70-80% of people will remain asymptomatic for life and never develop Chagas-related symptoms. However, an estimated 20-30% of infected people will develop health problems years to decades later that are often fatal. The most common symptoms in this late symptomatic stage are cardiac and include conduction abnormalities (arrhythmias), heart failure and sudden death. […] Most people with Chagas disease are unaware they are infected, yet once noticeable chronic symptoms develop, it is most likely too late for treatment. The challenge is to identify people with the infection as early as possible so they may receive proper care.

• #6

  https://kissingbug.tamu.edu/

  Chagas disease can occur in people, dogs, and other mammals. […] Chagas disease has two stages; the first stage is called the 'acute phase’ and the second stage is called the 'chronic phase’. After the T. cruzi parasite enters the body, the acute phase can last for a few weeks or months. During the acute phase, some people experience symptoms like fever, tiredness, body aches, headache, rash, diarrhea, loss of appetite, or vomiting. Some people do not notice any symptoms during the acute phase. This can make it difficult to diagnose for Chagas disease. […] After the T. cruzi parasite enters the body, about 1 out of 3 people develop the chronic phase of Chagas disease. The chronic phase can take many years to develop; some people have the chronic phase for decades after the parasite enters their body. In the chronic phase, people may experience heart problems or other symptoms.

• #7

  https://www.who.int/news-room/fact-sheets/detail/chagas-disease-(american-trypanosomiasis)

  Chagas disease presents in two phases. The initial acute phase lasts for about two months after infection. Although a high number of parasites can circulate in the blood, in most cases symptoms are absent or mild and non-specific (fever, headache, enlarged lymph glands, pallor, muscle pain, difficulty in breathing, swelling, and abdominal or chest pain). Much less frequently, people bitten by a triatomine bug show characteristic first visible signs, which can be either a skin lesion (chagoma) or a purplish swelling of the lids of one eye (Romaas sign). […] During the chronic phase, the parasites are hidden mainly in the heart and digestive muscles. One to three decades after infection, up to a third of patients suffer from cardiac disorders and up to 1 in 10 suffer from digestive (typically enlargement of the oesophagus or colon), neurological or mixed alterations. In later years these patients may experience the damage to the nervous system and muscles of the heart and digestive system, leading to cardiac arrhythmias, progressive heart failure, and sudden death, among other clinical manifestations and complications.

• #8 Chagas disease – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/chagas-disease

  Chagas disease has two clinical forms or phases: an acute phase and a chronic phase. Many people (70- 80% of the infected) are asymptomatic all of their lives, while a 20-30% of the ones infected evolve into the chronic phase, which includes symptoms that indicate damages to the tissue of the heart, digestive system and/ or nerves system. […] The acute phase, when it is symptomatic, lasts for about two months after infection. During the acute phase, a high number of parasites circulate in the blood. […] Signs and Symptoms for acute Chagas disease can be absent or mild and include the following: Signs of entry of the parasite, Rash and inflammatory nodules (Chagoma), Swelling of periorbital soft tissue (Romaa’s sign), Fever, Headache, Nausea, diarrhea or vomiting, Enlarged lymph glands, Difficulty breathing, Muscle, abdominal or chest pain.

• #8 Chagas disease – PAHO/WHO | Pan American Health Organization

  https://www.paho.org/en/topics/chagas-disease

  Although not typical, a first visible sign can be a skin chancre, called 'chagoma’, or a purplish swelling of the lids of one eye. If the infection is left untreated, it can advance into the chronic phase. […] Over several years or even decades, Chagas disease affects the central nervous system and the enteric nervous system, the digestion system and the heart. Specific medical treatments and surgery may be necessary. […] Signs and symptoms for chronic Chagas disease can include the following: About 30% of people will develop cardiac damage: Cardiomyopathy, Heart rhythm abnormalities, Apical aneurysm, Sudden death or heart failure caused by progressive destruction of the heart muscle. Less than 10% of patients will experience enlargement of the gastrointestinal tract and organs, and gastrointestinal motor disorders. Enlargement of the esophagus. Enlargement of the colon. Disturbances of gastric emptying. Colon and gallbladder motor disorders.

• #9 Chagas disease – UF Health

  https://ufhealth.org/conditions-and-treatments/chagas-disease

  A majority of people will not present symptoms. […] Symptoms that may develop are non-specific, such as fever, enlarged lymph nodes, fatigue. […] Chagoma: skin inflammation at the site where the parasite entered. […] Romaas sign: swelling around the eye of person who contracted the parasite through mucous membranes. […] A serious acute infection may occur if the person has a weakened immune system. […] No clinical evidence of Chagas disease-related illness. […] Positive screening and confirmatory testing for parasite exposure. […] Majority of people remain asymptomatic (parasite may be detected in blood). […] Parasite can reactivate if the person develops a condition that weakens immune system causing serious disease. […] Person should be monitored with a clinical provider for the potential development of the chronic phase.

• #9 Chagas disease – UF Health

  https://ufhealth.org/conditions-and-treatments/chagas-disease

  Heart disease (most common organ affected): Abnormality in electrical activity. […] Sudden cardiac arrest. […] Dilated cardiomyopathy and congestive heart failure. […] Gastrointestinal tract disease (abnormal enlargement of esophagus and/or colon): Trouble swallowing liquids and solids. […] Chronic constipation and abdominal pain. […] Colon enlargement can distend the abdomen. […] Thromboembolic disease: higher rates of pulmonary embolism and stroke. […] About one third of infected people likely develop chronic or symptomatic Chagas disease. […] It can take more than 20 years from the time of the original infection to develop chronic illness, typically heart or gastrointestinal dysfunction. […] Abnormal heart rhythms may cause cardiac arrest and sudden death. […] Those who develop heart failure without management or heart transplant, usually die within several years.

• #10 About Chagas Disease | Chagas Disease | CDC

  https://www.cdc.gov/chagas/about/index.html

  Chagas disease has two stages. The first stage, called the acute phase, happens shortly after infection. The second stage, known as the chronic phase, occurs over a long time. In both stages, some people might not feel sick at all, while others can have serious health problems. […] A symptom of Chagas disease is Romaa’s sign when the eyelid swells up. This happens when the Trypanosoma cruzi parasite gets into the eyelid, usually by accidentally rubbing the bug feces (poop) into your eye or into a bug bite near your eye. […] Acute phase: This early stage happens in the first weeks or months after getting infected. Symptoms are often mild or not there at all and can include: Fever, Feeling tired, Body aches, Headache, Rash, Loss of appetite, Diarrhea, Vomiting, Eyelid swelling (Romaa’s sign).

• #10 About Chagas Disease | Chagas Disease | CDC

  https://www.cdc.gov/chagas/about/index.html

  Chronic phase: This stage can last many years or even a lifetime. Most people have no symptoms during this time. However, about 20-30% of those infected develop serious problems. These include: Heart issues, such as an enlarged heart, heart failure, altered heart rate or rhythm, or sudden death. Digestive problems, such as an enlarged esophagus or colon, leading to trouble eating or going to the bathroom.

• #11 Chagas Disease

  https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/community_epidemiology/dc/chagasdisease.html

  Chagas disease, also known as American trypanosomiasis, is a vector-borne disease caused by the parasite Trypanosoma cruzi (T. cruzi). […] There are two phases of Chagas disease: acute and chronic. Most people with acute infection have no symptoms (asymptomatic) and if left untreated, they will progress to chronic infection. […] Acute phase: Lasts for the first few weeks or months of infection. A person may have no symptoms (asymptomatic) or mild ones that usually resolve on their own such as: Swelling at the infection site; Fever; Fatigue; Rash; Body aches; Eyelid swelling; Headache; Loss of appetite; Nausea, diarrhea, or vomiting; Swollen glands; and/or Enlargement of liver or spleen. […] Romaas sign, the swelling of the eyelid, is a marker of acute Chagas disease. Swelling is due to T. cruzi infecting the eyelid when bug feces are accidentally rubbed into the eye, or because the bite wound was on the same side of the face as the swelling.

• #12 Chagas Disease | Texas DSHS

  https://www.dshs.texas.gov/notifiable-conditions/zoonosis-control/zoonosis-control-diseases-and-conditions/chagas-disease

  Chagas disease is also known as American trypanosomiasis. It is caused by infection with Trypanosoma cruzi, a single-celled parasite. The parasite and its vector are present in the Americas. This includes most of South America to the southern half of the United States (U.S.), including all regions of Texas. Human infection is common in some parts of Latin America. It is relatively rare within the U.S. because of improved housing conditions. […] There are two phases of Chagas disease: acute and chronic. Both phases can be symptom-free or life-threatening. […] The acute phase of the disease occurs during approximately the first 8 weeks of infection. Symptoms, if present, may include: Fever, Malaise, Body aches, Rash, Headache, Loss of appetite, Vomiting, Diarrhea, Localized swelling (chagoma) where the parasite entered the body.

• #13 Chagas Disease: Symptoms, Causes and Treatment

  https://resources.healthgrades.com/right-care/infections-and-contagious-diseases/chagas-disease

  Chagas disease is a potentially life-threatening condition. It is caused by contact with the feces of the triatomine bug, which carries the parasite known as Trypanosoma cruzi. […] After initial infection, the acute phase can last around 2–8 weeks. You may experience symptoms such as: headaches, enlarged lymph glands, muscle pain, pale skin, breathing problems, swelling, stomach or chest pain, skin lesions, purplish swelling on one of your eyelids. […] The acute phase of CD can be life threatening for those with weakened immune systems. This can include those receiving chemotherapy and those with advanced HIV. […] In the first stage, you will have no symptoms. The parasite will live deep inside your organ tissue, especially in the heart. […] During the second stage, around 70–80% of people infected may not have any symptoms. In the remaining 20–30%, the disease progresses and may begin to exhibit symptoms.

• #14 Chagas Disease | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/chagas-disease.html

  Symptoms of Chagas disease vary from minimal to severe and life-threatening. They might be hard to tell apart from other illnesses. In some people, symptoms may be mild at first and then disappear for years or even decades, possibly never returning. But in the chronic phase of the disease, the parasite causes disease by long-term effects on your heart or intestinal muscles. This is why later symptoms often involve the heart or the digestive tract. […] Symptoms of Chagas disease in the acute phase (the first few weeks or months) are: Mild, flu-like symptoms, such as fever, fatigue, body aches, and headaches, Rash, Loss of appetite, Diarrhea, Vomiting, Swelling or a sore near the eye or on the side of the face where the bite or infection occurred (visible in fewer than half of infected people), Enlarged glands.

• #15 Chagas Disease: Signs and Symptoms and Treatments

  https://www.healthline.com/health/chagas-disease-symptoms

  Chagas disease symptoms can be divided into two phases: the acute phase (within the first few months) and the chronic phase (decades later). […] Acute phase symptoms may include swelling at the site of the insect bite, which is known as chagoma. People may also develop Romaas sign, which is swelling of the eyelid. This may happen if a person accidentally rubs infected poop from a kissing bug into their eye or if a person is bitten on their face (swelling will be on the same side as the bite). […] Other acute phase symptoms include: fever, fatigue, headache, body aches, rash, loss of appetite, stomach upset (vomiting and diarrhea), swollen lymph nodes, enlargement of the liver and spleen. […] In rare cases, people may also experience myocarditis (inflammation of the heart) or meningoencephalitis (inflammation of the meninges and the brain) in the weeks or months following infection.

• #15 Chagas Disease: Signs and Symptoms and Treatments

  https://www.healthline.com/health/chagas-disease-symptoms

  Chronic phase symptoms may take some time to recognize. […] According to the Centers for Disease Control and Prevention (CDC), people often first develop an asymptomatic form of Chagas disease, called chronic indeterminate disease. People in the chronic phase may or may not develop additional symptoms or health issues. […] The chronic phase can last indefinitely without treatment. However, about 60% to 70% of people with Chagas disease have an indeterminate form, meaning they test positive but do not experience symptoms. That said, people may transmit the infection through blood, organ donation, or the birth of a child no matter the severity of their symptoms. […] The most severe symptoms of Chagas disease affect the heart and gastrointestinal tract. […] People may experience: heart rhythm issues (arrhythmia), enlarged heart, heart failure, cardiac arrest, enlarged esophagus, enlarged colon, trouble eating or defecating, thromboembolism, chest pain. […] Without prompt treatment, these symptoms can become life threatening, particularly for people who are immunocompromised.

• #16 Symptoms, transmission, and current treatments for Chagas disease | DNDi

  https://dndi.org/diseases/chagas/facts/

  Up to a third of people with Chagas will suffer heart damage that becomes evident only many years later and can lead to progressive heart failure or sudden death. […] The disease has two clinical phases: […] Acute phase: […] Can occasionally cause severe symptoms or deaths, especially in infants. […] In most cases, symptoms are absent or mild and unspecific. […] Possible fever, headache, enlarged lymph glands, pallor, muscle pain, difficulty in breathing, swelling, and abdominal or chest pain. […] Chronic phase, which can be divided into two stages: […] The advanced chronic stage is when 30-40% of people with Chagas experience symptoms. This stage develops years after infection and most often results in damage to the heart, while others may experience abnormal enlargement of the colon or esophagus. […] People in both chronic stages are at risk for severe symptoms if their immune system is suppressed due to medical treatment or immune disorders such as HIV.

• #17 Foodborne Chagas disease causes severe symptoms and may be more common than we think » Emerging Pathogens Institute » University of Florida

  https://epi.ufl.edu/2024/06/07/foodborne-chagas-disease-causes-severe-symptoms-and-may-be-more-common-than-we-think/

  Foodborne Chagas disease is more severe. Doctors have a hard time identifying acute Chagas, a phase of the disease that happens immediately after infection, in patients bitten by a kissing bug since symptoms are either nonexistent or mild. People infected may not realize T. cruzi has entered their body, but they can still develop a chronic infection many years later. […] Meanwhile, those who ingest T. cruzi experience more severe symptoms and soon end up in the hospital. Without antiparasitic medicine, patients may die from the acute phase of infection and face a higher probability of chronic disease, resulting in cardiac or gastrointestinal dysfunction. […] It’s about the inoculum—how much parasite has entered your body. Through vector-borne inoculum, you’re going to have far less parasite transmission than you would with oral ingestion.

• #17 Foodborne Chagas disease causes severe symptoms and may be more common than we think » Emerging Pathogens Institute » University of Florida

  https://epi.ufl.edu/2024/06/07/foodborne-chagas-disease-causes-severe-symptoms-and-may-be-more-common-than-we-think/

  Havelaar, a consultant to the WHO, made his case with an estimate that foodborne Chagas disease is responsible for at least 137,000 disability adjusted life years per year. But because foodborne Chagas disease is understudied and often more severe than the vector-borne version, Havelaar suspects this is an underestimation.

• #18 Chagas Disease (American trypanosomiasis, kissing bug) Symptoms, Treatment, Diagnosis

  https://www.medicinenet.com/chagas_disease/article.htm

  Chagas disease is an infection caused by the T. cruzi parasite. Symptoms of Chagas disease include rash, swollen lymph nodes, fever, fatigue, nausea, vomiting, and the Romaa sign. […] The first symptoms and signs, when present in the acute phase, may include some of the following: Swelling and/or redness at the skin infection site (termed chagoma), Skin rash, Swollen lymph nodes, Fever, Headaches and body aches, Fatigue, Nausea, vomiting, and/or diarrhea, Abdominal discomfort or pain, Liver and/or spleen enlargement, Romaa sign (unilateral painless edema [swelling] of tissues around the eye), EKG changes suggestive of myocarditis and/or arrhythmias may occur, Muscle aches. […] Most individuals who get the above acute-phase symptoms have them resolve spontaneously in about three to eight weeks.

• #18 Chagas Disease (American trypanosomiasis, kissing bug) Symptoms, Treatment, Diagnosis

  https://www.medicinenet.com/chagas_disease/article.htm

  However, this symptom-free stage may only last about 10-20 years in some patients before the chronic symptoms develop in about 10%-30% of those infected. […] Symptoms of chronic Chagas disease vary according to the organs most affected; in most cases, the heart or the gastrointestinal tract (or both) show the most serious symptoms. Chronic Chagas disease symptoms may include the following: Irregular heartbeats, Palpitations (abnormal heartbeat sensations), Fainting (syncope), Cardiomyopathy (chronic disease of the heart muscle), Congestive heart failure (dilated heart), Shortness of breath (dyspnea), Emphysema, Stroke, Sudden death, Chronic abdominal pain, Chronic constipation, Dilated esophagus and/or colon, Difficulty swallowing. […] These symptoms are due to organ damage caused by the persistent presence of the parasites within the tissues of these organs. Chronic inflammation develops as the body reacts to the parasites; it affects the nerve cells or neurons in these tissues, causing electrical conduction changes in the heart (arrhythmias) and poor muscle tone in the intestines.

• #19 Chagas Disease Symptoms, Treatment, Cause & Pictures

  https://www.emedicinehealth.com/chagas_disease_american_trypanosomiasis/article_em.htm

  Chagas disease is incurable. Those who have Chagas disease are usually symptom-free. Some people who have been infected for a long time may develop symptoms of heart failure, trouble swallowing, or trouble moving the bowels. […] The symptoms and signs happen in an acute (early) phase and a chronic (later) phase. For about half of victims, the first symptom is the Romaa’s sign. Other than this, most people have no symptoms or signs. Those who do get early symptoms or signs may have fever, headache, swollen lymph glands, fatigue, muscle pain, or body aches. They may have swelling and difficulty breathing, and they may have chest or abdominal pain, which is due to swelling of the liver and spleen. Most of these symptoms and signs are a reaction to a large amount of parasites in the bloodstream. The acute phase is most serious in the young. Up to 8% of children die. This phase lasts about eight weeks, then the level of parasites in the blood drops to low levels.

• #19 Chagas Disease Symptoms, Treatment, Cause & Pictures

  https://www.emedicinehealth.com/chagas_disease_american_trypanosomiasis/article_em.htm

  The chronic phase of Chagas disease occurs when the parasites continue to multiply in the tissues of the nervous system and in the muscles of heart and digestive system. The parasites progressively destroy these tissues over years. The patient may remain without symptoms for 10 or more years, up to lifelong. This is called the „indeterminate form” of chronic Chagas. About one out of three patients go on to develop symptomatic disease with heart problems, such as congestive heart failure from a dilated heart or even sudden death. About one in 10 patients develop a dilated esophagus or dilated colon. This is called the „determinate” form of Chagas. The heart is the organ that is affected the most, and chronic heart failure is called Chagas cardiomyopathy. Worldwide, Chagas disease is the common infectious cause of heart failure. Any triatomine bug that feeds on a person with acute or chronic Chagas disease can pick up the infection and transmit it to others. People with chronic infection can reactivate the disease (develop high blood levels again) if they develop a condition that weakens their immune defenses.

• #20 Chagas Disease – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/extraintestinal-protozoa/chagas-disease

  Chagas disease is infection with Trypanosoma cruzi, transmitted by Triatominae bug bites or, less commonly, via ingestion of sugar cane juice or foods contaminated with infected Triatominae bugs or their feces, via blood transfusion or an organ transplant from an infected donor, or via maternal-fetal transmission. Symptoms after a Triatominae bite typically begin with a skin lesion or unilateral periorbital edema, then progress to fever, malaise, generalized lymphadenopathy, and hepatosplenomegaly; years later, 20 to 30% of infected patients develop arrhythmias, chronic cardiomyopathy, or, less commonly, megaesophagus or megacolon. […] Acute infection is followed by a latent (chronic indeterminate) period, which may remain asymptomatic or progress to chronic disease. […] Acute Chagas disease is fatal in a small percentage of patients; death results from acute myocarditis with heart failure or meningoencephalitis. In the remainder, symptoms subside without treatment.

• #20 Chagas Disease – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/extraintestinal-protozoa/chagas-disease

  Chronic Chagas disease develops in 20 to 30% of patients after the chronic indeterminate phase, which may last years or decades. The main effects are Cardiac and Gastrointestinal. […] Cardiac disease usually manifests with conduction abnormalities including right bundle branch block or left anterior fascicular block. Chronic cardiomyopathy often follows with flaccid enlargement of all chambers, apical aneurysms, and progression of lesions in the conduction system. Patients may present with heart failure, syncope, sudden death due to heart block or ventricular arrhythmia, or thromboembolism. […] Gastrointestinal disease manifests with symptoms resembling achalasia or Hirschsprung disease. Chagas megaesophagus manifests as dysphagia and may lead to pulmonary infections caused by aspiration or to severe undernutrition. Megacolon may result in long periods of obstipation and intestinal volvulus.

• #21 Chagas Disease

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/chagas.html

  Chagas disease has an acute and chronic phase. During the acute phase, most people have no symptoms or experience a non-specific, mild febrile illness. Other symptoms include eyelid swelling or swelling at the bite wound. Rarely during the acute phase, an infected individual can rapidly develop myocarditis (inflammation of the heart muscle), heart failure or meningo-encephalitis (inflammation of the brain and its lining). The acute phase lasts about two months after infection. […] During the chronic phase the parasite hides mainly in the heart and digestive muscles. Although most infected individuals never exhibit any symptoms, about 20 to 30 percent will develop more serious and life-threatening medical complications during the chronic phase. These can include heart failure, arrhythmias (irregular heart rhythm), and gastrointestinal complications such as megaesophagus (dilated esophagus).

• #22 Chagas Disease: Causes, Symptoms, Treatment, and More

  https://www.verywellhealth.com/chagas-disease-overview-4109239

  This infection can progress to the chronic phase, causing life-threatening complications later which is why treatment is important during the acute phase. […] Sometimes acute Chagas disease can affect your heart. People with cardiac (heart) involvement have symptoms of acute myocarditis (inflammation of the heart muscle), and may also have acute pericarditis (inflammation of the tissue around the heart). […] Symptoms and signs of cardiac involvement may include: Chest pain, Dyspnea (shortness of breath), Changes on your electrocardiogram (ECG), Evidence of a pericardial effusion (fluid collecting around the heart) on an echocardiogram. […] Most often, the heart problems that are seen with acute Chagas disease resolve completely after a few months. However, some people with acute cardiac Chagas disease will progress rapidly to a chronic form of heart failure, and around 5% die from cardiac disease during the acute phase of the illness.

• #23 Chagas Disease

  https://ph.health.mil/topics/entomology/vbd/Pages/Chagas.aspx

  Chagas disease has both acute and chronic effects. The acute phase occurs within the first 6 to 8 weeks after infection and is generally without symptoms or with mild flu-like illness. One sign unique to the acute phase of Chagas disease that may occur in some people is known as Romaa’s sign. This symptom is the peri-orbital swelling of the eyelid caused by a kissing bug taking a blood meal near the eye and the parasite entering through the conjunctiva. While some people may have no symptoms in the acute stage, it is common for infected people to experience swelling or inflammation at the bite site where the parasites enter their body. In less than 5% of cases, acute heart failure and inflammation of the brain or spinal cord (meningoencephalitis) leads to death. This acute reaction is rare but is more common in children under the age of 2 years old. After the acute phase, most people will enter a long chronic phase that is without any symptoms. This asymptomatic phase may last years to decades

• #24 Chagas Disease: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21876-chagas-disease

  If you treat Chagas early, you have a better chance of getting rid of the parasites before they can cause serious complications. […] Antiparasitics may be less effective at curing chronic infections, but they might reduce your risk of severe complications. […] Most people who arent treated develop a chronic infection. Many people can live for decades with a chronic infection without developing complications. Some people develop life-threatening or long-lasting complications.

• #24 Chagas Disease: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21876-chagas-disease

  Chagas can cause flu-like symptoms or no symptoms; complications can cause chest pain, palpitations, issues eating and more. […] Most people dont have symptoms of the initial infection, and when they do, the symptoms are often mild. […] Without treatment, most people go on to have a chronic infection. About 30% to 40% of people with Chagas develop serious complications. Symptoms of complications include: Chest pain, Heart palpitations, Shortness of breath, Dizziness, Fainting, Fatigue, Difficulty swallowing (dysphagia), Constipation, Heartburn, Bloating. […] Chronic Chagas disease may cause serious complications that affect your heart, brain and digestive tract. These can be life-threatening and may be something you may have to manage for the rest of your life. Chronic Chagas complications include: Arrhythmia (unusual heart rate or rhythm), Cardiac arrest (sudden death), Dilated cardiomyopathy (enlarged heart), Heart failure, Enlarged esophagus, Enlarged colon.

• #25 Chagas Disease: Causes, Symptoms, and Treatments

  https://www.webmd.com/a-to-z-guides/chagas-disease-overview

  Chagas disease has two phases. During the first (or acute) phase, symptoms are usually mild. They might include: […] These early symptoms — if they happen at all — usually fade on their own in a few weeks or months. The only people in real danger are young children or people with already weakened immune systems. […] While the symptoms may go away, the parasite remains in the body. It can stay dormant for years or even decades. […] If the disease enters its second (or chronic) phase, it can cause serious heart and intestinal problems, including:

• #26 Chagas disease in Florida: What to know » Emerging Pathogens Institute » University of Florida

  https://epi.ufl.edu/2024/07/10/chagas-disease-in-florida-what-to-know/

  Serological evidence of T. cruzi infection (antibodies can be detected in the blood) […] No clinical evidence of disease or organ-specific involvement […] Parasite can reactivate if the person develops a condition that weakens immune system, causing serious disease, such as brain abscesses, encephalitis, myocarditis and skin nodules or rashes […] Heart disease: […] Abnormal heart rhythm […] Sudden cardiac arrest […] Dilated cardiomyopathy and congestive heart failure […] Gastrointestinal tract disease: […] Abnormal enlargement of esophagus and/or colon […] Trouble eating and drinking […] Chronic constipation and abdominal pain […] Distended abdomen […] Thromboembolic disease, which can lead to higher rates of pulmonary embolism and stroke. […] Chagas disease can be a silent killer: Symptoms may take decades to appear and are often irreversible once they are recognized. Most people infected with T. cruzi do not know they carry the parasite, Beatty said. Without treatment, they can remain infected for life.

• #27 SciELO Brazil – Chagas disease: what is known and what is needed – A background article Chagas disease: what is known and what is needed – A background article

  https://www.scielo.br/j/mioc/a/J5P5DTw6G9QmDTDMZLv7jzB/

  Chagas disease is characterized by an acute phase with or without symptoms, and with entry point signs (inoculation chagoma or Romaa’s sign), fever, adenomegaly, hepatosplenomegaly, and evident parasitemia, and an indeterminate chronic phase (asymptomatic, with normal results from electrocardiogram and x-ray of the heart, esophagus, and colon) or with a cardiac, digestive or cardiac-digestive form. […] The vast majority of cases of the acute or initial form of Chagas disease in Brazil present few or no symptoms, possibly because of the small inoculum. Among 510 chronic cases in several Brazilian states that we followed up over the last 30 years, we found that less than 1% had a history of an acute phase. […] In the chronic phase, Chagas infection may present as an indeterminate form, in which approximately 40% of the infected individuals remain totally asymptomatic, with anatomically and physiologically normal x-ray results for the heart, esophagus, and colon and no changes seen on electrocardiograms.

• #28 Chagas disease: symptoms, treatment, prevention – Institut Pasteur

  https://www.pasteur.fr/en/medical-center/disease-sheets/chagas-disease

  Following an acute phase subsequent to infection, the disease becomes chronic in over a third of infected individuals. Patients enter the chronic phase after 10 to 20 years of „silent” infection. Irreversible lesions may occur in the heart, esophagus, colon, and peripheral nervous system: 30% of infected individuals suffer from cardiac symptoms (chronic heart disease), potentially leading to sudden death. Approximately 10% of individuals suffer from chronic lesions of the digestive tract and 3% of infected individuals experience peripheral nervous system impairments (neurological disorders). […] The resulting chronic infection is incurable, sometimes debilitating, and claims over 10,000 lives every year.

• #29 Clinical features of Chagas disease progression and severity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11519696/

  Chagas cardiomyopathy presents with a wide variety of ECG abnormalities, ranging from nonspecific ST- and T-wave abnormalities to advanced atrioventricular block and ventricular tachyarrhythmias. […] Chagas cardiomyopathy can present in a preclinical phase characterised by asymptomatic ECG abnormalities with preserved global left ventricular function. […] Chagas cardiomyopathy generally develops gradually and steadily, although in some cases, it may have a more sudden course. The clinical presentations of this condition span a range of severity, from cases without symptoms, known as silent cardiopathy, to thromboembolic events, heart failure, and arrhythmias, which are the three primary clinical syndromes. […] Chagas cardiomyopathy typically manifests with heart failure symptoms, including exertional dyspnoea leading to a gradual reduction in physical activity.

• #29 Clinical features of Chagas disease progression and severity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11519696/

  Cardiac arrhythmia is a common feature in Chagas cardiomyopathy, with ventricular ectopic activity being predominant from the early stages of its natural course. […] Thromboembolic events are commonly observed in Chagas cardiomyopathy, and they are a significant contributor to mortality, ranking as the third most common cause of death in this population. […] The clinical presentation and prognosis of Chagas cardiomyopathy have recently changed significantly due to increased life expectancy, improved access to healthcare, and advances in heart failure treatment. […] Over the years to decades, about 30-40% of these patients progress to the determinate phase of the disease, characterised by cardiac and/or gastrointestinal manifestations. […] There is increasing evidence on predisposing factors to organ damage in patients with chronic Chagas disease; especially a pivotal role of the host’s genetic background in regulating the innate and specific immune response against the parasite, which leads to tissue damage when it is improperly regulated.

• #29 Clinical features of Chagas disease progression and severity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11519696/

  The production of cytokines is under genetic control and is influenced by polymorphisms in several cytokine genes. […] Chagas disease is strongly associated with poor housing conditions in rural Latin American subsistence-level agricultural communities, providing the ideal domestic and peridomestic habitat for the triatomine vectors. […] Studies comparing quality of life indicators between groups of people with and without Chagas disease show worse scores for people with Chagas disease, particularly those who are living alone, obese, and with low educational attainment. […] While nutritional factors have not been extensively studied as potential factors in Chagas cardiomyopathy, diet and lipid metabolism may be important factors that influence progression from indeterminate form to Chagas cardiomyopathy.

• #29 Clinical features of Chagas disease progression and severity

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11519696/

  Hyperglycaemia appears to be more common in people with Chagas cardiomyopathy compared to age, sex, and BMI-matched groups with indeterminate chronic Chagas disease and people without Chagas disease. […] Physical exercise has been hypothesised to prevent progression to Chagas cardiomyopathy, and this hypothesis is supported by murine studies such as one comparing T. cruzi infected sedentary mice to mice undergoing an exercise program; while both groups showed similar cardiac parasite loads, the exercised mice developed less cardiac fibrosis. […] Chagas cardiomyopathy exhibits significant variability in its clinical course and prognosis. The classification, based on the severity of ventricular dysfunction and adapted from the American Heart Association (AHA), is employed to assess prognosis. […] In recent decades, the occurrence of cardiomyopathy linked to Chagas disease has been consistently decreasing due to successful vector control.

• #30 Chagas disease – Wikipedia

  https://en.wikipedia.org/wiki/Chagas_disease

  Unless treated with antiparasitic drugs, individuals remain infected with T. cruzi after recovering from the acute phase. Most chronic infections are asymptomatic, which is referred to as indeterminate chronic Chagas disease. However, over decades with the disease, approximately 30-40% of people develop organ dysfunction (determinate chronic Chagas disease), which most often affects the heart or digestive system. […] The most common long-term manifestation is heart disease, which occurs in 14-45% of people with chronic Chagas disease. People with Chagas heart disease often experience heart palpitations, and sometimes fainting, due to irregular heart function. By electrocardiogram, people with Chagas heart disease most frequently have arrhythmias. As the disease progresses, the heart’s ventricles become enlarged (dilated cardiomyopathy), which reduces its ability to pump blood. In many cases the first sign of Chagas heart disease is heart failure, thromboembolism, or chest pain associated with abnormalities in the microvasculature.

• #30 Chagas disease – Wikipedia

  https://en.wikipedia.org/wiki/Chagas_disease

  Also common in chronic Chagas disease is damage to the digestive system, which affects 10-21% of people. Enlargement of the esophagus or colon are the most common digestive issues. Those with enlarged esophagus often experience pain (odynophagia) or trouble swallowing (dysphagia), acid reflux, cough, and weight loss. Individuals with enlarged colon often experience constipation, and may develop severe blockage of the intestine or its blood supply. Up to 10% of chronically infected individuals develop nerve damage that can result in numbness and altered reflexes or movement. While chronic disease typically develops over decades, some individuals with Chagas disease (less than 10%) progress to heart damage directly after acute disease. […] Signs and symptoms differ for people infected with T. cruzi through less common routes. People infected through ingestion of parasites tend to develop severe disease within three weeks of consumption, with symptoms including fever, vomiting, shortness of breath, cough, and pain in the chest, abdomen, and muscles. Those infected congenitally typically have few to no symptoms, but can have mild non-specific symptoms, or severe symptoms such as jaundice, respiratory distress, and heart problems. People infected through organ transplant or blood transfusion tend to have symptoms similar to those of vector-borne disease, but the symptoms may not manifest for anywhere from a week to five months. Chronically infected individuals who become immunosuppressed due to HIV infection can have particularly severe and distinct disease, most commonly characterized by inflammation in the brain and surrounding tissue or brain abscesses. Symptoms vary widely based on the size and location of brain abscesses, but typically include fever, headaches, seizures, loss of sensation, or other neurological issues that indicate particular sites of nervous system damage. Occasionally, these individuals also experience acute heart inflammation, skin lesions, and disease of the stomach, intestine, or peritoneum.

• #31

  https://www.who.int/health-topics/chagas-disease

  After the infection is transmitted there is an initial, acute phase that lasts for about two months. In most cases, symptoms are absent or mild and unspecific. In people bitten by a triatomine bug, characteristic first visible signs of infection, such as a skin lesion or a purplish swelling of the lids of one eye (the so-called Romaa sign), can help in the diagnosis of new cases. […] With any transmission route, patients can present fever, headache, enlarged lymph glands, pallor, muscle pain, difficulty in breathing, swelling, and abdominal or chest pain. […] During the chronic phase that succeeds the acute phase, up to 30% of patients suffer from cardiac disorders and up to 10% experience digestive, neurological or mixed disorders. In later years, the infection can lead to sudden death principally due to heart arrhythmia or heart failure caused by the destruction of the heart muscle and its nervous system.

• #32 Chagas disease – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/1160

  Chagas disease is a chronic and neglected infectious disease associated with poverty, migration, and poor housing conditions with a high burden of morbidity and mortality. […] Patients with acute-phase disease are generally asymptomatic or present with mild symptoms, although these may be more severe in immunocompromised patients, or in disease due to oral transmission. Chronic-phase disease has cardiac, gastrointestinal, indeterminate, and mixed (cardiac and gastrointestinal) forms. Reactivation occurs in immunosuppressed patients and presents as myocarditis or severe meningoencephalitis. […] Clinically, there are acute and chronic phases. If the acute phase remains untreated, T. cruzi infection is lifelong. The chronic phase can manifest in various forms: indeterminate, cardiac, gastrointestinal, and mixed (cardiac and gastrointestinal).

• #33 New Chagas research unravels decades-long mystery of how the tropical disease progresses | Tulane University News

  https://news.tulane.edu/pr/new-chagas-research-unravels-decades-long-mystery-how-tropical-disease-progresses

  Chagas, a lesser-known and studied tropical disease, is caused by Trypanosoma cruzi parasites, which are transmitted by kissing bugs. […] While most infected patients remain asymptomatic, about 20-40 percent will develop chronic heart disease years or decades after infection, and about 5 percent will develop digestive disease. […] Treating Chagas patients is challenging because the disease progression is unpredictable, resulting in 14,000 deaths annually. […] Rhesus macaques naturally infected with T. cruzi were studied for two to three years, and researchers found that those infected with mixtures of multiple strains were able to better control the parasite and stop the progression of the disease, while those with a progressive form of the disease had fewer strains. […] In finding a clear association, these results provide a new framework for the development of more effective treatments and vaccines.

• #34 Chagas disease Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/chagas-disease

  Chagas disease has two phases: acute and chronic. The acute phase may have no symptoms or very mild symptoms, including: […] After the acute phase, the disease goes into remission. There may be no other symptoms for many years. When symptoms finally develop, they may include: […] About one third of infected people who are not treated will develop chronic or symptomatic Chagas disease. It may take more than 20 years from the time of the original infection to develop heart or digestive problems. […] Abnormal heart rhythms may cause sudden death. Once heart failure develops, death usually occurs within several years.

• #35 Chagas Disease – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/parasitic-infections-extraintestinal-protozoa/chagas-disease

  Chagas disease occurs in three stages. Symptoms can occur in the first and third stages. […] Chagas disease symptoms usually start 1 to 2 weeks after the protozoa enter the body, usually through the bite wound or tissues around an eye. A swollen, red bump may appear at the bite wound. If the protozoa entered through tissues around the eye, the area around the eye may swell (called Romaa’s sign). A fever may develop. Some people have no symptoms, but the protozoa can be identified in their blood. […] In most people, symptoms of the first stage of Chagas disease disappear without treatment. However, a few people, usually children, die during this stage. Death may result from a severe infection of the heart, which causes heart failure, or from infection of the brain and tissues covering the brain and spinal cord (meningoencephalitis).

• #36 People with Chagas or 'kissing bug’ disease are asymptomatic during the acute and chronic phases. – Infectious Diseases | UCLA Health

  https://www.uclahealth.org/news/article/chagas-disease-can-be-deadly-most-infected-people-dont-know

  Left untreated, Chagas disease kills the heart very slowly, Dr. Yang says. […] Patients with Chagas disease as cause of end stage heart failure generally do very well after heart transplantation, Dr. Schaenman says. And they can live a full and high-functioning life after the transplant. […] However, anti-parasite medications are only effective against Chagas during the acute phase or recurrence after a transplant. […] Unfortunately, if youre antibody positive, indicating a past exposure to Chagas disease, there’s no medication that’s effective to treat it at that point in time, Dr. Schaenman says. But I think it would be useful for that person to be aware so that they can monitor for the development of any symptoms and just realize that theyre at higher risk for developing heart failure because of that parasite exposure.

• #37 Chagas disease – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chagas-disease/diagnosis-treatment/drc-20356218

  Your healthcare professional does a physical exam, asking about your symptoms and anything that put you at risk of Chagas disease. If you have symptoms of Chagas disease, two or more blood tests can confirm the diagnosis. […] If you’re diagnosed with Chagas disease, you’re likely to have more tests. These tests can show whether the disease has become chronic and caused heart or digestive complications. […] Treatment for Chagas disease is to kill the parasite and ease symptoms. […] During the acute phase of Chagas disease, the medicines benznidazole and nifurtimox (Lampit) may help. […] Once Chagas disease becomes chronic, medicines won’t cure the disease. But the medicines may be offered to help slow the disease and its most serious complications. […] Other treatment depends on the symptoms.

• #37 Chagas disease – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/chagas-disease/diagnosis-treatment/drc-20356218

  Heart-related complications. Treatment may include medicines, a pacemaker or other devices to control heart rhythm. Surgery, or even a heart transplant, might be needed. […] Digestive complications. Treatment may include diet changes, medicines and corticosteroids. In severe cases, surgery might be needed.

• #38 Chagas Disease – Symptoms & Treatments | MedStar Health

  https://www.medstarhealth.org/Services/Chagas-Disease

  Chagas disease, also called American trypanosomiasis, is parasitic infection transmitted by kissing bugs who are native to Latin America which is why this condition is commonly called the kissing bug disease. […] The resulting infection can, if not effectively treated, cause cardiac and bowel disorders. During the acute phase of the disease, killing the parasite is the focus of treatment. Physicians manage the symptoms in people who have chronic Chagas disease where eliminating the parasite is no longer possible. […] Acute symptoms are: Swelling/redness at the bug bite, Muscle pain, Flu-like symptoms, Swollen gland, Abdominal pain. […] If Chagas disease is not treated in the first days or weeks, years may pass before serious cardiac and bowel symptoms become pronounced. These include symptoms of a heart attack, difficulty in eating, and difficulty in passing stool.

• #39 Chagas disease: Definition, locations, treatment, and prevention

  https://www.medicalnewstoday.com/articles/chagas-disease

  Some symptoms that a person may experience during the chronic phase include: difficulty eating, digestive problems, difficulty passing stool, abnormal heart rhythm, stroke, heart failure. […] Prompt treatment with benznidazole or nifurtimox can often completely cure Chagas disease. […] However, many people who have Chagas disease will not experience any symptoms until they enter the chronic stage of the condition. The longer it goes undetected, the higher the risk of complications. […] People who have Chagas disease have around a 30% chance of developing complications. These complications may include: enlarged esophagus, enlarged colon, enlarged heart, infection of the heart muscle, or myocarditis, heart arrhythmias, stroke, infection of the brain, or meningoencephalitis, death.

• #40 Chagas Disease – ECHO

  https://wp.uthscsa.edu/echo/echo-programs/chagas-disease/

  Chagas disease is not transmitted from person-to-person like a cold or the flu or through casual contact with infected people or animals. […] There are two phases of Chagas disease. The acute phase that may have flu-like symptoms (if any) and may only last about 8-10 weeks followed by the chronic phase that can be without symptoms for years to decades. […] Only about 20 to 30% of people with chronic Trypanosoma cruzi infection eventually develop clinical disease, predominantly cardiac. Cardiac disease usually begins with conduction abnormalities such as right bundle branch block and/or left anterior fascicular block, which may be followed years later by dilated cardiomyopathy. Later cardiac disease is sometimes accompanied by apical aneurysm and thrombus formation. […] Less frequently, patients with Chagas disease experience gastrointestinal disease (megasyndromes). Once the characteristic pathology is established (e.g., dilated cardiomyopathy, megaesophagus), antiparasitic treatment will not reverse it.

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