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Chagas' Disease (American Trypanosomiasis): a Tropical Disease Now Emerging in the United States
Book chapter

Chagas' Disease (American Trypanosomiasis): a Tropical Disease Now Emerging in the United States

Louis V Kirchhoff
Emerging Infections 3, pp.111-134
ASM Press
09/01/1999
DOI: 10.1128/9781555818418.ch8

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Abstract

In the United States it is important to keep in mind that imported cases among tourists returning from countries where acute Chagas' disease is endemic have not been reported and that autochthonous Trypanosoma cruzi infections are extremely rare. Even though T. cruzi‐infected triatomine insects are present in many parts of the western and southern United States, only four autochthonous cases of acute Chagas' disease have been reported. Importantly, none of the imported cases occurred in tourists returning to the United States, but two such instances have been reported in Europe. Although the number of imported and autochthonous cases of acute Chagas' disease that go unrecognized may be several times the number described, the fact is that acute T. cruzi infection is rare in the United States, and there is no reason to expect that this situation will change. The courses of acute Chagas' disease in the transfusion recipients were particularly severe because of immunosuppressive treatments that they were receiving, and no doubt this contributed to the specific diagnosis. Finally, an antifungal agent, bis‐triazole (00807), was recently reported to cure acute T. cruzi infections in mice, but it is still in the early stages of development. Management of the occasional severely ill patient with chagasic meningoencephalitis or myocarditis is for the most part supportive. Cardiac transplantation is an option for patients with end‐stage chagasic heart disease.
 Immunosuppression acute Chagas' disease American Trypanosomiasis antiparasitic drugs chronic Chagas' disease heart transplantation tropical disease Trypanosoma cruzi

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