Chagas

by Leighton Gage

Many years ago, I used to spend idyllic weekends on the beach at Trindade. (The spelling is correct, without a second "i".)

 It was beautiful and unspoiled.

Not like today, when it has morphed into a popular tourist destination.

The transformation has taken place not only because it’s one of the most beautiful beaches between Rio de Janeiro and Santos, but also because access has become simple.

But back then, before the highway connecting the two cities was complete, it was anything but easy to get to.

Adventurous souls would sometimes attempt a descent of the encircling mountain range in four-wheel vehicles, but the road was unpaved, muddy and rutted, and many of them would get stuck, so most of us walked.

And it was a long walk, so the little fishing village got few visitors.

There was no running water, but there was a river with a waterfall, from which you could draw drinking water and bathe.

There was no electricity. Light was provided by kerosene lamps, so the locals tended to go to bed early and rise with the sun.

There were no hotels, or pousadas, so we’d rent the hut of some local family, who’d happily move-in with their neighbors for the sake of a few Cruzeiros, the currency of the time.

There were no beds, at least no beds that we townsfolk would be willing to sleep in, so we’d spend the nights on packed earthen floors.

We’d bring cachaça and guitars.

We’d sing, solve the problems of the world, and swim in the pristine, boulder-strewn sea.

We thought the place was paradise.

Little did we know that a killer was living in the walls.

Those walls were of daub and wattle construction, sometimes whitewashed, but mostly not.

And they were infested with triatomine bugs.

Brazilians call these little creatures barbeiros. They have a habit of creeping out at night to feed on human blood, and their favorite grazing ground is the human face, hence the name.

Barba, in Portuguese, means beard, barbeiro, barber, meaning, in this case, that they like to hang out in beards. (And, yes, barbeirois also the word we use for the guy who cuts your hair. Same origin, different meaning.)

What makes barbeiros particularly objectionable, other than the thought that they’re sucking your blood, and the fact that their bites itch, like those of a mosquito, is the fact that they transmit a nasty disease called the mal de chagas.

And Chagas disease, as it’s referred to in English, can kill you.

I’ve been bitten by barbeiros, and I recognize, now, that I was a lucky man never to have caught it.

The disease is named after Carlos Chagas, the Brazilian physician who first described it in 1909.

Chagas’ work is unique in the history of medicine because he was the first researcher to describe solely and completely a new infectious disease: its pathogen, vector, host, clinical manifestations, and epidemiology.

But he carried-on his work with marmoset monkeys, and the significance of his findings for humans went largely ignored until the 1960’s, when Chagas disease came to be recognized as serious threat to humans.

Why did it take so long?

Because decades generally pass between infection and death.

In humans, it presents itself in two stages: an acute stage, which occurs shortly after an initial infection, and a chronic stage that develops over many years. The acute phase only lasts for the first few weeks or months, and it usually passes unnoticed, because it’s either symptom-free or exhibits only mild, non-unique symptoms like fever, fatigue and vomiting.

And then, for the next twenty or thirty years, there don’t seem to be any symptoms at all.

Meanwhile, tiny parasites, called trypomastigotes, are  busily eating away internal organs.

Eventually arrhythmias, weight loss, digestive problems and neuritis begin to appear.  

But, by that time, it’s usually too late.

The heart muscle has been damaged beyond repair.

Chagas disease can be found as far north as Mexico.

In Bolivia, up to 70% of the children in some rural areas have become infected.

Across Latin America, it kills more people than any other parasite, about 20,000 last year alone.

Since the 1970’s there have been some drugs that can effect a cure.

But the longer you’ve been infected, the less likely they are to work.

And there is no vaccine that can prevent it.

The illness is most commonly associated with the rural, and the poor, but it is hypothesized that at least one famous man may have died of it.

Charles Darwin, in the last years of his life, presented symptoms typical of Chagas disease.

Attempts to test his remains were met with a refusal by the curator of Westminster Abbey, but it’s thought, by many experts, that Darwin contracted mal de chagas while in South America.

And that it might have killed him.