Infection With Trypanosoma cruzi and Progression to Cardiomyopathy

Chagas disease, also known as American trypanosomiasis, has been haunting the American continent for centuries. Evidence of Trypanosoma cruzi has been traced back to mummified tissues from the Chinchorro Indians from the Atacama Desert almost 9000 years ago.1 However, the clinical description of the disease did not appear in the scientific literature until 1909, when Carlos Chagas brilliantly made the connection between the acute parasitic infection and the clinical manifestations.2 It seems perplexing that, after more than a century, we are just starting to pay attention to this devastating disorder, to the extent of identifying Chagas as the “most neglected of neglected diseases.”3 Some researchers have even gone so far as to suggest that Chagas disease may be the “new HIV/AIDS of the Americas,”4 opening a vivid debate among researchers.5,6 Regardless of the media attention spurred by these contentious views, there is one undeniable truth: Chagas disease remains a largely neglected disorder that in the 21st century has migrated to nonendemic areas, triggering a resurgence in research of this fascinating disorder.Article see p 1105What do we really know about the incidence and natural history of Chagas disease once the host is infected by T cruzi ? Let us begin by estimating the burden of the disease. Approximately 8 million people in Latin America are affected,7 and the Pan American Health Organization calculates that 109 million individuals were at risk and nearly 7.7 million individuals were infected in 2005.8 In the United States, >300 000 individuals are reportedly infected with T cruzi , and in Spain, between 47 738 and 67 423 individuals are infected.9,10 Although the mortality related to Chagas has been decreasing, this disease was responsible for 12 500 deaths in 2006.7One of …