The new HIV/AIDS

herman6292003

By Debra Black9 y) w: a% S2 |0 j  N

' N  n& L+ |: q& t: UToronto Star, May 31, 20127 c& X, p5 x6 h. O) X; ~0 _# C
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Chagas disease, which is caused by parasites transmitted to humans by a tiny insect called the “kissing bug”, is “the New HIV/AIDS of the Americas”, according to a leading expert in tropical diseases.! O: ]- I# y" I! i2 {

6 n; j9 ^1 C# `0 b! t5 d  }In an editorial in the PloS Neglected Tropical Diseases journal, Dr. Peter Hotez warns of the serious consequences of the disease which is already widespread amongst the poor and indigenous groups in Latin America and parts of the United States, specifically Texas and the Gulf coast.! J- H; R9 S! u2 s3 ?5 i) O) s
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The disease — named after Carlos Chagas, a Brazilian doctor who first discovered it in the early 20th century — is caused by a parasite known as a trypanosome. The parasite is carried by the “kissing bug” which has been described as a cockroach with a long proboscis (snout) that allows it to feed on blood.
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But the parasite itself is transmitted through the bug’s feces. When the bug bites someone it also defecates on them and the parasite enters the body, Hotez explained.% a2 e2 W8 h- O
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The kissing bug is found throughout the poorer regions of the Americas in Brazil, Bolivia, the Amazon regions, Central America, Mexico and southern Texas.
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Once infected, it can take up to 10 to 15 years for the damage from the disease to manifest itself.
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Reports suggest there are some 10 million cases in the Western hemisphere, predominantly in Latin America.3 J6 a, C8 C! _7 f  a) X8 c

5 b, L9 [; h  V: aAbout 30 per cent of people with Chagas will develop heart disease — about 3 million of the 10 million infected with trypanosomes in the Western hemisphere.
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3 V! B+ \6 S: q' f. }6 ~Of those 3 million the majority will ultimately die from the disease, Hotez said. Some estimates suggest 20,000 die annually from the disease, he added.8 n8 x! j6 L' [% k2 Y7 y" S6 `

7 x, q7 @4 ~" e1 e( H1 W8 {The disease can cause fatal heart disease — including cardiomyopathy and arrhythmias — as well as damage to the intestines and esophagus.7 [, {% z6 Q! l6 _' e; \8 }
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Treatment for Chagas , officially known as American trypanosomiasis, involves taking the drug Benznidazole for three months., k+ K- e" e( C. f. x3 b* ^
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But the treatment often doesn’t provide any relief and only works if the disease is caught early.6 W' C/ T  K' ~
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If global action isn’t taken, Hotez fears conditions may be ripe for what he describes as a “perfect storm” for infection and transmission amongst the poor.
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4 G  I$ S( ], Y% ~Hotez and his co-authors believe there are striking similarities between the people living with Chagas and those living with HIV/AIDS, especially those who contracted the disease in the first 20 years of the epidemic.
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Both diseases are chronic and can remain undetected for years, he explains. Transmission can occur through blood transfusions or organ transplants and as well as through mother-to-child during pregnancy just like HIV/AIDS.
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5 m$ y. O. g! C: v0 r+ Z3 DThe American Red Cross universally tests for Chagas, said Hotez. A spokesman for Canada Blood Services said that it only screens for the disease based on a donor’s ancestry, place of birth or recent travels and if the potential donor has been to a place where Chagas is common.
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Both diseases also share a stigma that prevents care. In the case of HIV/AIDS sexual orientation had been a barrier to care. With Chagas, immigration status may prove to be a deterrent to care and prevention, said Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston.4 q3 T# M$ ?' ?* ]4 O( t/ ?

9 r1 S7 P4 V% }' N“It occurred to me one day how similar it is now with Chagas to the early years of the AIDS epidemic when they didn’t have good drugs or an understanding of the disease,” said Hotez.
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6 e2 E5 {: g$ J% PThe U.S. Centre for Disease Control estimates there are 300,000 cases in the U.S. But Hotez believes it’s closer to one million cases in the U.S. overall.! B; q; l/ x1 u, j
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There are also cases in Canada, but a much smaller number of people have been exposed to the disease. A 2010 study in Journal Actatropica reports that 3.5 per cent of the 156,960 immigrants to Canada from Latin America in 2006 were infected with Chagas.' c6 m# s2 M1 m- A5 V$ s! e' Y

4 z$ e- ~9 L6 V! o) D“It’s a forgotten disease among forgotten people,” Hotez said. “Can you imagine having 300,000 people in the suburbs with a serious case of heart disease caused by a bug? We wouldn’t tolerate it as a society, but because it’s happening to an indigenous people we’re silent.”
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0 Q0 Q. b  m' t; y' m6 ]( @" f/ MHotez and his lab are working on developing a prototype vaccine that would be given after exposure to Chagas, like a rabies vaccine.