Chagas disease,a disease spread through kissing bug.

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Speaking about Chagas disease, it is significant that we understand that it is a tropical parasitic infection, transmitted through crawling hosts like blood-sucking insects like kissing bugs. Chagas disease is also called American trypanosomiasis, the disease could be described as a regional one because the kissing bug is almost exclusive to central Latin America. The infection from the bite is from the parasite Trypanosoma cruzi(T.cruzi). The most common means of transmitting the disease is through a bite from an infected triatomine bug (kissing bug), but asides from the transmission through a bite, there are other methods of transmission that although may be rare they are possible they are;

• Through the sharing of needles.
• Infected blood transfusions.
• Consumption of food/beverages that are already contaminated by the insect.
• Through organ transplants or any form of a laboratory accident.

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Having mentioned that Chagas disease is more commonly spread through the bite of an infected triatominae bug on a human or an animal, during the process of the bite, the infected bug deposits feces that contains metacyclic trypomastigotes on the skin, and the infective forms go through the wound bite or penetrate through the conjunctivae or mucous membranes. The parasites process to invade the macrophages found at the site of entry, then proceed to transform them into amastigotes that get multiplied through binary fission; the amastigotes grow into trypomastigotes and enter into the bloodstream and tissue spaces, infecting other cells. The cells that are most commonly involved are; the reticuloendothelial system, myocardium, muscles, and nervous system are the most involved.

There are 3 stages of infection T.cruzi, the stages are; acute, chronic, and chronic indeterminate.

Acute infection is followed by a more chronic interminate(latent) period, which may remain asymptomatic to chronic disease. Immunosuppression has the ability to reactivate infection, resulting in high parasitemia, in some people it could be skin or brain lesions.
Acute T. cruzi infection in regions that are endemic, often happens in children and could b asymptomatic, when present, the symptoms could begin about 1-2 weeks after exposure.

Amongst the group of people with Acute Chagas disease, a little percentage of the patients often experience acute myocarditis with heart failure or meningoencephalitis often leading to death, in other percentages of patients however, symptoms would subside sometimes without even treatment. The disease is immunocompromised in patients who have AIDS, which may be severe and atypical.

The symptoms at this stage may be mild and they include; Fatigue, fever, swelling at the site of infection, body aches, rashes, headache, loss of appetite, swollen glands, nausea, and liver or spleen enlargement.

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Chronic Indeterminate: Patients who have the chronic indeterminate phase of the infection have parasitologic or/and sociological evidence of *T.cruzi *infection, but with the stage, there are no symptoms, there is no form of abnormal physical findings, neither is there any evidence of cardiac or gastrointestinal involvement.

Chronic with cardiac or intestinal tract involvement.
The chronic indeterminate phase of infection may last for several years or several decades, it is after this phase that up to 20% of patients develop Chronic Chagas disease. The chance that the parasites are present in chronic disease, which is an autoimmune reaction that could contribute to organ damage, but the main effects they cause are;

• Cardiac and Gastrointestinal.

Cardiac disease comes on with condition abnormalities, which include right bundle branch block or left anterior fascicular block. Patients with this condition may have issues relating to heart failure, syncope, sudden death as a result of heart block, ventricular arrhythmia, or even thromboembolism.

The gastrointestinal disease shows off with symptoms that bear the form of achalasia or Hirschsprung disease.

Chagas disease is diagnosed in hospitals with any of these procedures;

• Screening serological test which would be confirmed by a second test.
• Light microscopy of blood smear or tissue.
• Polymerase chain reaction-based tests.

There is a greater chance of getting Chagas disease if;
You reside in poor rural regions of Central America, South America, and even Mexico.

Residing in regions that contain triatomine bugs.

The transfer of blood or organ from someone who is a carrier of the infection.

The complication of Chagas disease would prolong to a long-lasting phase of problems including;

• Colon enlargement(megacolon), which occurs when the colon becomes highly dilated leading to stomach pain, stomach swelling and serious constipation.

• Heart failure, which occurs when the heart becomes very stiff or weak, to the extent that it does not have the capacity to pump sufficient blood to meet the needs of the body.

• Esophagus enlargement, which is a rare condition caused by dilation (abnormal widening) of the esophagus, leading to difficulty with digestion and swallowing.

How to prevent Chagas Disease.

If you stay in regions exposed to Chagas disease, these steps would help you prevent them from happening;

• Avoid sleeping in the mud, catch,, or adobe houses as these type of residents is more likely to harbor triatomine bugs.

• Use insecticides to take off insects from your residence.

• Make use of insecticide-soaked netting over your bed.

• Ensure to make use of insect repellant on the exposed part of your skin.

Conclusion.

Chagas disease is a serious disease whose implication may be death in some cases, and in other situations, the carrier may recover without any treatment. However, the moment you begin to notice any symptom, check into the hospital for treatment. If you plan to visit rural areas especially in Central or south America, choose to stay in a clean and well-built building all through your stay there, you may also consider taking along with you bed nets, as well as put on long sleeves and pants to cover every part of the body.

References.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/chagas-disease

https://medlineplus.gov/chagasdisease.html

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

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

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

https://www.mayoclinic.org/diseases-conditions/chagas-disease/symptoms-causes/syc-20356212

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

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