Signs and Symptoms of Chagas Disease

The symptoms of Chagas' disease vary over the course of the infection. In the early, acute stage symptoms are mild and are usually no more than local swelling at the site of infection. As the disease progresses, over as much as twenty years, the serious chronic symptoms appear, such as heart disease and malformation of the intestines. If untreated, the chronic disease is often fatal. Current drug treatments for this disease are generally unsatisfactory, with the available drugs being highly toxic and often ineffective, particularly in the chronic stage of the disease.

Much of the clinical information about Chagas disease comes from experience with people who became infected as children through vectorborne transmission. The severity and course of infection might be different in people infected at other times of life, in other ways, or with different strains of the T. cruzi parasite.

Usually a small sore develops at the bite where the parasite enters the body. If this is near the eye, the eyelid becomes swollen (known as the Romana sign). Within a few days, fever and swollen lymph nodes may develop. This initial acute phase may cause illness and death, especially in young children. More commonly, patients enter a symptomless phase lasting several months or years, during which time parasites are invading most organs of the body, often causing heart, intestinal and esophageal damage and progressive weakness.

Chronic infection: Some people develop serious, irreversible damage to the heart or intestinal tract that appears 10 to 20 years after infection. Heart-related problems include an enlarged heart, altered heart rate or rhythm, heart failure, or cardiac arrest. Enlargement of parts of the digestive tract can result in severe constipation or problems with swallowing.

The most recognized symptom of acute Chagas infection is the Romaña’s sign, or swelling of the eye on one side of the face, usually at the bite wound or where feces were rubbed into the eye. Other symptoms are usually not specific for Chagas infection. These symptoms may include fatigue, fever, enlarged liver or spleen, and swollen lymph glands. Sometimes, a rash, loss of appetite, diarrhea, and vomiting occur. In infants and in very young children with acute Chagas disease, swelling of the brain can develop in acute Chagas disease, and this can cause death. In general, symptoms last for 4-8 weeks and then they go away, even without treatment.

Acute infection is followed by a latent (indeterminate) period, which may remain asymptomatic or progress to chronic disease. Immunosuppression may reactivate latent infection, with high parasitemia and a 2nd acute stage, skin lesions, or brain abscesses. Congenital transmission occurs in 1 to 5% of pregnancies and results in abortion, stillbirth, or chronic neonatal disease with high mortality.

Infectious diseases not necessarily common in Canada can occur and may even be widespread in other countries. Standards of hygiene and medical care may differ from those at home. Before departure, you should learn about the health conditions in the country or countries you plan to visit, your own risk of disease and the steps you can take to prevent illness.

Chagas disease can also lead to enlargement of parts of the digestive tract, which result in severe constipation or problems with swallowing. In persons who are immune compromised, including persons with HIV/AIDS, Chagas disease can be severe. Not everyone that is infected with T. cruzi will develop the chronic symptoms of Chagas disease.

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