Chagas Heart Disease Essay

1504 words - 6 pages

History, Impact and EpidemiologyIn 1908, untold numbers of slaves and laborers working the railroads connecting Rio, Brazil to the heart of the Amazon succumbed to malaria, yellow fever and other mysterious, undiagnosed illnesses. Having been previously successful at reducing malarial disease transmission in the Santos shipping industry four years earlier, Carlos Chagas was appointed the challenge of alleviating the infectious disease burden being faced in the Brazilian interior. Upon relocating to the undeveloped, rural area of Lassance, he encountered droves of individuals complaining about irregular heartbeats, atypical arrythmias, cardiac insufficiencies and inexplicable cases of sudden death. Chagas had received training in fields of public health and parasitology from renowned physician, Oswaldo Cruz, and wisely deduced a link between the endemicity of myocardial failure and the triatomine bug. While unheard of along the more developed Brazilian coast, these large black insects would often emerge from cracked mud walls and thatch roofs to feed on the blood of inhabitants throughout the night. They were often referred to as “kissing bugs” for the trademark swollen bite sites often left near the eyelids and lips of their victims. Upon dissection of the triatomine bug, Chagas discovered a eukaryotic, flagellated protozoan similar to Trypanosoma brucei, earlier identified as the agent of African sleeping sickness. After finding this parasite in the bloodstream of young girl who had experienced fever, lymphadenopathy, hepatosplenomegaly and heart failure prior to death, after being been bitten by the reduvvid bug, Chagas confirmed the link between his novel trypanosome discovery and disease by infecting monkeys with triatomine droppings and observing identical clinical symptoms(Prata, 1994) Chagas named the protozoan after his mentor, Trypanosoma cruzi, and the associated disease eventually bore his own name. After nearly a century of its identification, Chagas disease remains a significant public health issue and a major cause of suffering and death in Latin America. The Centers for Disease Control estimates that 8 – 11 million people in Mexico, Central and South America have Chagas disease and many are unaware they are even infected (http://www.cdc.gov/chagas/factsheet.html). The large numbers of currently infected individuals, along with the estimated 100 million at risk in 21 countries and approximate 50,000 annual fatalities, make T. cruzi infection one of the leading causes of heart disease and cardiovascular-related deaths in endemic areas (1-3). Public health efforts geared toward limiting vectorborne transmission have significantly reduced the number of newly infected individuals, but the cases now being identified outside of the typical endemic regions from increasing incidences of blood transmission (4) and organ transplantation (5) still make Chagas one of the most important diseases to understand due to its history of...

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