Trypanosoma Cruzi

1. Trypanosoma Cruzi By: Kevin Malone

2. Early History • American Trypanosomiasis was first described by Carlos Chagas in Brazil in 1909 • It is a flagellate protozoan parasite • It causes Chagas Disease

3. Location • It’s main locations are in Southern Mexico, Central South America and Northern South America

4. Life Cycle

5. Transmission • Trypanosoma Cruzi is transmitted by the Reduvidae bugs • The transmission by the vector is faecal. • T.cruzi infective metacyclic trypomastigotes are shed in the feces of the bug and are inoculated into the human host by scratching infected feces into skin abrasions usually caused by the bug in the process of feeding (blood-sucking)

6. Continued • It is also transmitted through the mucosa of the mouth and, in humans, through the conjunctiva of the eye.

7. The Infection • Trypomastigotes infect most of the vertebrate cells, PMNL’s and macrophages are among the first vertebrate host cells that T.cruzi attacks first.

8. Stages of the Infection • Three stages of the infection • Acute phase • Intermediate phase • Chronic phase

9. Acute • The acute phase usually passes unnoticed but there may be an inflamed swelling at the site of entry of the trypanosomes • Romanas'sign is when this swelling involves the eyelids but it occurs only in about 1-2% of the cases • In the acute phase, the death rate is only about 5% • Death may be caused by acute heart failure or meningoencephalitis in children less than two years old • Symptoms may include fever, hepatosplenomegaly, adenopathies and myocarditis

10. Intermediate • The intermediate phase is clinically asymptomatic and is detected by the presence of specific antibodies • No parasites are found in bloostream smears but xenodiagnosis could be positive in some cases

11. Chronic • The chronic phase of Chagas'disease develops 10 - 20 years after infection and affects internal organs such as the heart, oesophagus and colon as well as the peripheral nervous system • The lesions of Chagas’ disease are incurable and in severe cases patients may die as result of heart failure • In other severe cases, the infection may cause megacolon disease

12. Prevention • The drugs of choice for prevention are Nifurtimox with Benznidazole as an alternative • Nifurtimox (discontinued in 1991) kills the protozoa that causes infection and side effects may include skin rash, Chills or sore throat; clumsiness or unsteadiness; confusion; convulsions (seizures); decreased sexual drive or ability; fever; forgetfulness; irritability; mood or mental changes; muscle weakness; numbness tingling, pain, or weakness in hands or feet; trembling; trouble in sleeping; uncontrolled back-and-forth and/or rolling eye movements; unusual excitement, nervousness, or restlessness Abdominal or stomach pain; dizziness; headache; loss of appetite; nausea; vomiting; weight loss

13. Continued • Benznidazole kills the protozoa that cause the infection and side effects may include Convulsions (seizures); numbness, tingling pain, or weakness in hands or feet; reddish discoloration of skin Fever or chills; pinpoint red spots on skin; skin rash; sore throat; unusual bleeding or bruising Abdominal or stomach pain; diarrhea; nausea; vomiting Confusion; dizziness; headache; restlessness; temporary loss of memory; trouble in sleeping; difficulty concentrating; unusual tiredness or weakness • Neither of the two medicines have proven very effective

14. Further Prevention • Insecticide spraying with modern pyrethroids • To prevent blood transfusion infection, blood donor screening is necessary or kill the T. Cruzi by mixing the blood with gentian violet (0,25 gr./L for 24 hours)

15. Works Cited • www.cdc.gov • www.drugs.com • www.google.com