As a child, Emiliana Rodriguez witnessed a friend collapse during a nighttime soccer game, an event that would haunt her for years. Growing up in Bolivia, she developed a fear of the dark and a deep-seated anxiety about Chagas disease—a condition transmitted by nocturnal insects often referred to as the “silent killer.” Each year, Chagas disease affects up to 8 million people globally, resulting in approximately 12,000 deaths.
Now 42 and living in Barcelona after moving from Bolivia 27 years ago, Rodriguez reflects on how her fear of the night influenced her sleep. “I was often anxious, worrying that I wouldn’t wake up,” she shared. After undergoing specific tests at eight, while pregnant with her first child, she learned that she carried the Chagas gene. The memory of her friend’s tragic death resurfaced, triggering panic about her own child’s future. Fortunately, she received medication to prevent the transmission of the parasite to her unborn daughter, who ultimately tested negative.
In another case, Elvira Idalia Hernández Cuevas, an 18-year-old blood donor from near Veracruz, Mexico, learned about the dangers of Chagas disease only after her son was diagnosed. When her blood sample tested positive for the disease, caused by triatomine bugs—often called vampire or kissing bugs—Hernández began researching Chagas online. “Reading about it being a silent killer filled me with fear. I felt lost and didn’t know where to seek help,” she said in an interview with The Guardian.
Emiliana Rodriguez is not alone; many people are unaware of the diseases that these troubling insects can transmit. The term “Chagas” comes from Carlos Ribeiro Justiniano Chagas, a Brazilian physician who identified the first human case of the disease in 1909. In recent decades, cases of Chagas disease have been reported across Europe, Japan, Australia, Latin America, and North America. Kissing bugs, which are primarily found in rural and suburban low-income areas, tend to be most active at night when people are asleep. They bite an animal or human and then excrete feces on the victim’s skin. The victim may unknowingly scratch the bite, breaking the skin, or they might inadvertently transfer the feces into their mouth or eyes, leading to a T. cruzi infection.
The World Health Organization (WHO) estimates that between 6 and 7 million people worldwide, including about 8 million in Mexico, Central America, and South America, are affected by Chagas disease, with most individuals unaware of their condition. According to the Centers for Disease Control and Prevention (CDC), untreated infections can be fatal. Chagas disease causes over 12,000 deaths each year, making it the deadliest parasitic disease in Latin America, surpassing even malaria. Although nearly 300,000 people in the United States are infected with Chagas disease, it is not considered endemic to the region. While some individuals may never show symptoms, the CDC reports that 20 to 30 percent of those infected can experience gastrointestinal or heart complications, leading to severe pain and health issues decades later.
Globally, only about 10% of Chagas disease cases are detected, making prevention and treatment extremely difficult. Hernández and her daughter, Idalia, sought help from numerous doctors, yet many were unaware of Chagas disease and its management. “I was shocked, terrified, and depressed, believing my child was going to die. Most concerning was my inability to find reliable information,” Hernández expressed. Fortunately, with assistance from a family member in the medical field, Idalia finally received the care she needed.
“The Mexican government claims that Chagas disease is under control and that few people are affected, but that is not true,” Hernández stated. Medical professionals often misdiagnose Chagas as other heart conditions due to a lack of knowledge. Most people in Mexico are unaware of the disease’s presence. The World Health Organization (WHO) categorizes Chagas as a neglected tropical disease, indicating it is often overlooked in global health policies.
Colin Forsyth, a research manager at the Drugs for Neglected Diseases Initiative (DNDi), explains that Chagas is frequently ignored because it is a “silent disease that remains hidden in the body for so long,” mainly due to the asymptomatic nature of the early infection stages. He noted, “Those affected lack the power to influence healthcare policies,” referring to the impoverished communities most impacted. A combination of social and biological factors keeps Chagas hidden. However, awareness is growing as the disease spreads to other continents and can be transmitted from mother to child during pregnancy or childbirth, as well as through organ and blood transfusions.
The Chagas Hub, established in the UK by Professor David Moore of the Hospital for Tropical Diseases in London, aims to increase testing and treatment for Chagas disease while managing transmission risks, particularly from mother to child. Professor Moore commented on the WHO’s goal to eradicate the disease by 2030, describing progress as “glacial” and expressing skepticism about achieving this target, stating, “I can’t imagine that we’ll be remotely close by 2030.”
Two medications, benznidazole and nifurtimox, have been used for over 50 years to treat Chagas disease. According to Moore, these drugs are “toxic, unpleasant, and not particularly effective.” While they can cure infants, there’s no assurance that they will stop or slow the disease’s progression in adults. Rodriguez recounted experiencing dizziness, nausea, and hives as severe side effects during her treatment. Although she completed her therapy, she continues to undergo annual check-ups.
Moore emphasized the need for the development of more effective anti-Chagas medications to control the disease’s spread. However, he noted that pharmaceutical companies currently lack financial incentives to invest in this research.
As president of the International Federation of Associations of People Affected by Chagas (FINDECHAGAS), Hernández is dedicated to raising awareness about Chagas disease until there is a greater demand for innovative treatments. In Spain, Rodriguez is confronting the “monster” through a public awareness campaign led by the Barcelona Institute for Global Health. “I’m tired of hearing nothing at all,” Rodriguez asserts. “I want Chagas to be talked about and made public. I advocate for testing and treatment for those affected. They deserve to be heard, too.”
World Chagas Disease Day, established by the WHO on April 14, commemorates the date in 1909 when Carlos Chagas discovered the first human case of the disease. The WHO outlines global targets for 2030 aimed at preventing, controlling, eliminating, and eradicating a diverse range of 20 diseases, including Chagas disease.
To help prevent potential infestations, the CDC recommends several measures: seal any gaps and cracks around doors, windows, walls, and roofs; remove rock, wood, and brush piles near your home; install screens on windows and doors, and repair any tears or holes; close gaps leading to the outside, as well as in crawl spaces and attics; keep pets indoors, especially at night; maintain cleanliness in your home and outdoor pet areas, and regularly check for bugs.
If you suspect you’ve encountered a kissing bug, the CDC advises against crushing it. Instead, gently place the insect in a jar, fill it with rubbing alcohol, and freeze it. Afterward, it’s recommended to take the container to a local health authority or an academic laboratory for identification. Sharing this information can help raise awareness about this often-overlooked disease!
