Chagas: Opportunity for Testing Companies as US Army, CDC Get Involved

In Kalorama Information’s Emerging Infections Testing report ( , we discussed Chagas.  Chagas disease is named after the Brazilian physician Carlos Ribeiro Justiniano Chagas, who discovered the disease in 1909. Chagas disease (Trypanosoma cruzi, known as kissing bugs) is also referred to as American trypanosomiasis. It is endemic throughout Mexico, and Central and South America, and is caused by the protozoan parasite T cruzi, which is transmitted to humans by blood-sucking insects of the family Reduviidae (Triatominae).  Now there is word  that the Defense Department is concerned enough to embark on a study, which is just the latest indication of the disease threat in the United States.

Chagas disease is part of the trypanosomal group of diseases that includes human African trypanosomiasis (also known as African sleeping sickness), and leishmaniasis. These diseases are grouped together because they share a common family of vectors: African trypanosomiasis (Sleeping Sickness, caused by Trypanosoma brucei), South American trypanosomiasis (Chagas Disease, caused by Trypanosoma cruzi), and leishmaniasis (a set of trypanosomal diseases caused by various species of Leishmania).

Chagas represents one of the greatest and least publicized public health problems in Latin America. Transmission occurs through insects that spread in low-income rural and peri-urban housing and through uncontrolled blood transfusions.

Although mainly a vector-borne disease, Chagas disease can be acquired by humans through blood transfusions and organ transplantation, congenitally (from a pregnant woman to her baby), and through oral contamination (foodborne).

Chembio, Bioconcept and Altona Diagnostics are among the companies that produce tests for Chagas.   Last year, a study found that a combination of marketed rapid point-of-care (POC) diagnostics was useful in screening for Chagas disease in a study conducted in Bolivia. The results compared well with the gold standard enzyme-linked immunosorbent assay (ELISA) approach, which is a challenge in low-resource settings, researchers reported on December 19 in PLOS Neglected Tropical Diseases.  Molecular testing is the most effective technique, however it is not widely available for screening programs. There is some expectation that current advancements in miniaturization may lead to cost-effective molecular devices. In the meantime major health organizations have been motivated to take action.

Doctors in the United States that treat people with Chagas disease, a parasitic illness transmitted by the “kissing bug” in the Americas, are increasingly worried about the estimated 30,000 to 45,000 people that are at increased risk of complications from COVID-19 because they have Chagas-related heart problems. As an indication of that concern, the U.S. Department of Defense has granted 700,000 to Texas State University to conduct a study assessing the threat of Chagas disease to military bases.