A Century After Chagas Disease Discovery

A Century After Chagas Disease Discovery, Hurdles to Tackling the Infection Remain

Rebecca Voelker

JAMA. 2009;302(10):1045-1047.

Early in the 20th century, the State of Minas Gerais in southeastern Brazil was rife with malaria. So severe was the epidemic that it sickened hundreds of railroad workers, threatening government efforts to expand Brazil's railway system from the mouth of the Amazon River south to Rio de Janeiro. The government needed a malaria mastermind, someone who could halt the spread of disease and help railway construction resume.

2009 marks the centennial of the discovery of Chagas disease, named for Carlos Chagas, MD (left), a Brazilian physician who linked clinical symptoms, an insect vector, and an infectious parasite to the syndrome. Triatomine bugs (right), also called kissing bugs because they bite near the lips and eyes, carry the parasite that causes Chagas disease. (Photo credit: Photo credit: Casa De Oswaldo Cruz/Fiocruz)

Government officials contacted Oswaldo Cruz, MD, Brazil's famed infectious disease fighter and director of the Manguinhos Institute (now the Oswaldo Cruz Institute), a vaccine and sera production center in Rio de Janeiro. Cruz sent a young researcher from the institute, Carlos Chagas, MD. By age 28 years, Chagas already had 2 successful antimalaria campaigns under his belt, and he prevailed once again in Minas Gerais. But it was not his fight against malaria that eventually placed his name in the history books of infectious disease, epidemiology, and tropical medicine.

One hundred years ago, in the spring of 1909, Chagas reported on one of the most remarkable feats in public health and tropical medicine of the 20th century. In Minas Gerais, he came across nocturnal blood-sucking triatomine insects, also known as kissing bugs, that bite human victims on the face near the lips and eyes. Chagas wanted to know more about the bugs' biology and whether they were capable of transmitting disease. He suspected that triatomines might be associated with unexplained cardiac abnormalities he found in many railroad workers, regardless of their malaria status./.../