Aaron Manning

Overview Also called American trypanosomiasis and the Kiss of Death A tropical parasitic disease caused by the flagellate protozoan Trypanosoma cruzi. Spread to humans through the bite of an insect vector

Signs and Symptoms Acute Stage Nonspecific symptoms i.e. fever, diarrhea, vomiting Swelling and inflammation Romaña's sign

Signs and Symptoms Chronic Stage About 30% develop medical problems Cardiac damage Digestive system damage Neurological disorders Potentially fatal if untreated

Diagnosis T. cruzi in blood smears PCR to ID strains

Discovery Brazilian physician Carlos Chagas Chagas’ work unique Darwin

Epidemiology 1960s 16–18 million people affected as of 2008 ~100 million at risk Kills around 20,000 annually

18 countries from US to Argentina Occurs almost exclusively in rural areas Why?

The Vector Blood-sucking insects of the subfamily Triatominae vinchuca, barbeiro, chinche, the kissing bug

Transmission A triatomine becomes infected Hides during day Emerges at night Bites, feeds, then defecates

Transmission Scratching Blood transfusions, organ transplants, or breast milk Congenital Transmission 13% of stillborn deaths in parts of Brazil

T. Cruzi Life Cycle

Clinical Manifestations Cell death in target tissues Inflammatory response

Treatment and Prevention

Prevention Most effective approach Insecticides Improving housing conditions Testing of blood donors No vaccine

Treatment and Management Two approaches Antiparasitic treatment Symptomatic treatment

Antiparasitic Treatment Most effective early Drugs include azole or nitro derivatives Resistance

Symptomatic Treatment Disease cannot be cured in chronic phase Managing the clinical manifestations Pacemakers and anti-arrhythmia drugs Surgery for megaintestine. Heart transplantation surgery

On the Horizon New Drugs New vaccines being tested Stem cell therapy

Resources Antonio RL Teixeira; Nascimento; Sturm. Evolution and pathology in Chagas disease - a review. Mem. Inst. Oswaldo Cruz vol.101 no.5 Rio de Janeiro Aug Centers for Disease Control. Prata A. Clinical and epidemiological aspects of Chagas disease. Lancet Infect Dis Sep;1(2): Vanessa Leiria Campo, Carvalho, Allman, Davis and Robert A. Field. Chemical and chemoenzymatic synthesis of glycosyl-amino acids and glycopeptides related to Trypanosoma cruzi mucins Org. Biomol. Chem., 2007, 5, 2645 Wikipedia. World Health Organization.