Chagas disease in the Americas--2013
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Chagas disease in the Americas--2013

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      Chagas disease, caused by the parasite Trypanosoma cruzi, is spread by infected insects called triatomine bugs and can be life threatening during both the early and late stages of infection. Those with the acute form of the disease, which lasts 4–8 weeks, typically either have no symptoms or experience mild illness. Some patients with acute disease develop swelling at the site of infection, known as Romaña’s sign. Chagas disease then progresses to the chronic phase, which can last for years to decades. Infected persons usually don’t have overt symptoms nor know they are infected. Twenty to 30 percent of these persons eventually develop chronic disease, which can cause death. Signs and symptoms can include cardiac (such as heart failure) and/or gastrointestinal problems (such as dilated esophagus or colon), in addition to an increased risk of stroke. Historically, transmission has been concentrated in rural areas of Latin America where poor housing conditions promoted contact with infected bugs. However, in the last several decades, successful control programs targeting the bugs have substantially decreased transmission rates in rural areas, and large-scale migration has brought infected persons to cities both within and outside Latin America.

      The impact of Chagas disease, once thought to be limited to Latin America (where an estimated 8 million people are infected), has moved to the United States, through immigration of persons from Chagas–endemic areas of Mexico, Central America, and South America. The estimated number of infected persons living in the United States is 300,000 or more, based on estimated disease rates by country of origin. The parasite has long been recognized also to occur in local bugs and mammals in the southern regions of the United States, and there have been a few reported cases of local transmission in humans.

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