Large-scale population migrations have carried Chagas disease to new regions, which now include the United States and many European countries. The disease was first described in 1909 by Brazilian physician Carlos Chagas, after whom it is named.
Langgaard (1842). The formal description of Chagas disease was made by Carlos Chagas in 1909 after examining a two-year-old girl with fever, swollen lymph nodes, and an enlarged spleen and liver.
However, locally acquired infection is very rare: only 28 cases were documented from 1955 to 2015.
This was originally done with organochlorine, organophosphate, and carbamate insecticides, which were supplanted in the 1980s with pyrethroids.
In endemic areas, due largely to vector control efforts and screening of blood donations, annual infections and deaths have fallen by 67% and more than 73% respectively from their peaks in the 1980s to 2010.
Widespread screening is also common in non-endemic nations with significant populations of immigrants from endemic areas including the United Kingdom (implemented in 1999), Spain (2005), the United States (2007), France and Sweden (2009), Switzerland (2012), and Belgium (2013).
Orally transmitted Chagas disease is of particular concern in Venezuela, where 16 outbreaks have been recorded between 2007 and 2018. Chagas exists in two different ecological zones: In the Southern Cone region, the main vector lives in and around human homes.
In endemic areas, due largely to vector control efforts and screening of blood donations, annual infections and deaths have fallen by 67% and more than 73% respectively from their peaks in the 1980s to 2010.
As of 2013, the cost of treatment in the United States was estimated to be US$900 million annually (global cost $7 billion), which included hospitalization and medical devices such as pacemakers. Chagas disease affects approximately 68,000 to 123,000 people in Europe as of 2019.
However, locally acquired infection is very rare: only 28 cases were documented from 1955 to 2015.
Several experimental vaccines have been tested in animals infected with and were able to reduce parasite numbers in the blood and heart, but no vaccine candidates had undergone clinical trials in humans as of 2016. ==Management== Chagas disease is managed using antiparasitic drugs to eliminate T.
, new drugs for Chagas disease are under development, and experimental vaccines have been studied in animal models. It is estimated that 6.2 million people, mostly in Mexico, Central America and South America, have Chagas disease as of 2017, resulting in an estimated 7,900 deaths.
Surgery to sever the muscles of the lower esophageal sphincter (cardiomyotomy) is indicated in more severe cases of esophageal disease, and surgical removal of the affected part of the organ may be required for advanced megacolon and megaesophagus. ==Epidemiology== In 2017, an estimated 6.2 million people worldwide had Chagas disease, with approximately 162,000 new infections and 7,900 deaths each year.
As of 2018, benznidazole and nifurtimox were the antiparasitic drugs of choice for treating Chagas disease, though benznidazole is the only drug available in most of Latin America.
Orally transmitted Chagas disease is of particular concern in Venezuela, where 16 outbreaks have been recorded between 2007 and 2018. Chagas exists in two different ecological zones: In the Southern Cone region, the main vector lives in and around human homes.
As of 2019, 22.5% of new infections occurred through congenital transmission. ==Pathophysiology== In the acute phase of the disease, signs and symptoms are caused directly by the replication of and the immune system's response to it.
As of 2019, resistance to these drugs has been reported. ===Complications=== In the chronic stage, treatment involves managing the clinical manifestations of the disease.
As of 2013, the cost of treatment in the United States was estimated to be US$900 million annually (global cost $7 billion), which included hospitalization and medical devices such as pacemakers. Chagas disease affects approximately 68,000 to 123,000 people in Europe as of 2019.
As of 2020, approximately 300,000 infected people are living in the United States, about 30,000 to 40,000 of whom have Chagas cardiomyopathy.
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Page generated on 2021-08-05