Costa Rica
Chagas Disease

Costa Rica: General Health Risks

Chagas Disease

Chagas Disease is transmitted by the Triatoma insect in rural and suburban areas of Mexico, Central America, South America, and the southern United States.

Description

Chagas Disease, also known as American Trypanosomiasis, is a protozoan infection transmitted by the Triatoma insect (known as 'vinchuca' in Spanish or 'barbeiro' in Portuguese) which bites humans most commonly on the face at night. The Triatoma insect sheds feces containing the Trypanosoma cruzi protozoa at the site of the bite which are rubbed or crushed into the bite wound to alleviate itching. The parasite then enters the bloodstream and affects organ tissues, typically the heart and the intestines. The disease largely spreads with the rise of migration from rural areas to urban and suburban areas as well as increasing deforestation. Chagas Disease affects between 6 and 7 million people and is a Neglected Tropical Disease (NTD)*. Many countries affected by the disease have active health education and eradication programs.

* Neglected Tropical Diseases are chronic infections that are typically endemic in low income countries. They prevent affected adults and children from going to school, working, or fully participating in community life, contributing to stigma and the cycle of poverty.

Risk

Travellers undertaking outdoor activities such as hiking, camping, and ecotourism in endemic countries in Central and South America are at higher risk. Triatoma insects are found in forest ecosystems and poorly built homes, including huts and cabins. Chagas Disease can also be acquired via unscreened blood products, transmitted from mother to child during pregnancy, or by eating contaminated food and drinking unpasteurized fruit juices.

Symptoms

There are two phases of the illness. The majority of cases in the acute phase are asymptomatic (persons do not exhibit symptoms). For those that have symptoms, they usually appear 1 to 2 weeks after being infected and may include fever, swelling of the lymph nodes, enlarged liver, and in some cases swelling at the site of the bite usually on the face, hands, or feet. For most people, however, Chagas Disease is a silent infection showing up many years later often mimicking chronic heart conditions or as gastro-intestinal complications. Treatment includes taking anti-parasitic medications.

Prevention

One of the most effective ways to prevent Chagas Disease is to sleep under a permethrin-treated bed net. Also, avoid drinking unpasteurized juices and only eat well cooked foods or fruits that can be peeled. Other important prevention tips include: 

• When travelling in endemic areas, do not sleep in huts since the Triatoma insects shelter in the palm-front roofs and in the wall cracks.
• When choosing a campsite, stay away from palm trees; do not set your tent close to stone or wood piles where the insects may be hiding.
• When checking into modest or older hotels (alojamientos), search for hidden insects under the mattress, behind picture frames, in drawers, or dark corners of the room. Carry insect and insecticides repellents with you.
• Before sleeping, apply insect repellent to exposed parts of your body (available in sprays, lotions, and towelettes), which may help to keep the insects away. Any commercially available preparation containing DEET (N, N-diethyl-meta-toluamide) is suitable.
• Use bed nets to prevent contact with insects. Put a cloth over the bed net to prevent the feces of infected insect from falling on you.
• Protect your hands with a cloth, paper, or gloves, if it is necessary to handle the insects.

For complete information on prevention methods as well as transmission patterns and geographical distribution of Chagas Disease, see IAMAT's: Be Alert to Chagas Disease.

Information last updated: February 23, 2021.