L.A. Clinic the Nation’s First to Treat Chagas Disease

Mary Engel, Los Angeles Times, November 6, 2007

A Los Angeles County hospital has opened the first clinic in the country devoted to studying and treating Chagas disease, a deadly parasitic illness that has long been the leading cause of heart failure in Latin America and is now being seen in immigrant communities in the United States.

Unless Chagas is treated early, little can be done to halt its advance. Yet because 10 to 20 years can pass before heart or gastrointestinal complications develop, many people don’t realize they’re infected with what has been called a silent killer.

“We really, really need to become more aware of the potential of this disease in our Latin American population because the long-term outcome is pretty horrific,” said Dr. Sheba Meymandi, director of the new center at Olive View-UCLA Medical Center in Sylmar. “If we can block the progression to full-blown Chagas disease and heart failure, we’d be doing a huge service.”

Like Lyme disease or malaria, Chagas is a vector-borne illness, meaning that it is transmitted by insects, not person-to-person contact. For Chagas, the insect is a winged, blood-sucking creature commonly called a conenose, or kissing bug, because it feeds at night, often on uncovered faces.

An estimated 8 million to 11 million people in Central and South America and Mexico are infected, according to the U.S. Centers for Disease Control and Prevention. Chagas is most common in poor, rural areas, where adobe houses with cracked walls, thatched roofs or dirt floors allow the bugs easy entry.

The parasitic illness can also pass from mother to child at birth and through blood or organ transfusions, which have become the main source of infection in Latin American cities. In December, the U.S. Food and Drug Administration approved a test for screening the blood supply by testing for antibodies to the parasite. The American Red Cross and Phoenix-based Blood Systems, which collect about 65% of the U.S. blood supply, have been using the test since January.

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Most donors who tested positive since screening began this year emigrated from high-risk areas, sometimes years ago, or were the children of such immigrants, said the Red Cross’ Stramer in an e-mail. But in nine cases still under investigation, Stramer said, infection may have been transmitted by insects in the United States.

According to the CDC, several species of conenose bugs carry the parasite. They are found in 27 states and as far north as Northern California and Maryland. But insect transmission in the U.S. has been extremely rare—or at least not often documented—because of better housing conditions, Stramer said. The infected donors reported spending time outdoors camping and hunting.

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As the numbers grow, Meymandi knows that some people will complain about the cost of treating immigrants.

“We take care of those who are in need as long as they are L.A. County residents,” she said. “If I can prevent someone from developing heart failure, which if they do will tax the system even more, that’s my job.”

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