As a child in Bolivia, Emiliana Rodríguez vividly recalls a night she will never forget. She was watching a group of friends play soccer when one of the players suddenly collapsed and died. At the time, she didn’t understand the cause, but later she learned about a silent killer called Chagas disease, a parasite transmitted by nocturnal bugs that can strike without warning. That friend was among the estimated 12,000 people who die each year from Chagas disease, an illness often called the “silent and silenced disease.” Globally, up to 8 million people are infected annually, many unaware of their condition.
Though Rodríguez moved from Bolivia to Barcelona 27 years ago, she lives with Chagas disease, which she refers to as a “monster.” She remembers the fear that gripped her at night. “Sometimes I couldn’t sleep. I was afraid of going to sleep and not waking up,” she said. Eight years ago, while expecting her first child, Rodríguez discovered she was a carrier of the disease. The memories of her friend’s sudden death came flooding back. “I was paralyzed with shock,” she recalled. “I remembered all the stories my family told me about people suddenly dying, and I thought, ‘What will happen to my baby?’”
Thankfully, medical treatment prevented the parasite from passing through the placenta to her unborn child. Her daughter tested negative for Chagas disease, a relief that highlights both the danger and the hope surrounding this illness.
A Mother’s Unexpected Diagnosis
Rodríguez’s story is not unique. In Mexico, Elvira Idalia Hernández Cuevas had never heard of Chagas disease until her 18-year-old daughter received a diagnosis. While donating blood near Veracruz, her daughter was found to be infected with the parasite Trypanosoma cruzi, which is transmitted by triatomine bugs—commonly known as kissing or vampire bugs. Hernández recalled her terror: “I had never heard of Chagas before, so I started researching it online. I was terrified when I read it described as a silent killer. I didn’t know where to turn or what to do.”
Many people remain unaware that these bugs, which feed on human blood at night, can transmit a life-threatening disease.
A Discovery Over a Century Ago
Chagas disease was first identified in 1909 by Brazilian doctor Carlos Ribeiro Justiniano Chagas, who documented the first human case. Over the last century, the geographic range of Chagas has expanded beyond Latin America to parts of Europe, Asia, and Oceania. The nocturnal triatomine bugs, which emerge while people sleep, can hide in cracks in walls, floors, and roofs of low-income rural or suburban homes.
The disease spreads when an infected bug bites a person or animal and defecates near the wound. Scratching allows the parasite to enter the body through skin or mucous membranes—a seemingly innocuous act with potentially serious consequences.
A Hidden Epidemic
The World Health Organization estimates that 6 to 7 million people worldwide live with Chagas disease, many of them unaware of their infection. The disease primarily affects Mexico, Central America, and South America, though cases have been reported elsewhere. Approximately 12,000 people die each year from Chagas, a toll that surpasses some other parasitic diseases like malaria in Latin America. In the United States, nearly 300,000 people are infected, though the disease is not considered endemic.
Even without symptoms, 20–30% of infected individuals may develop severe heart or gastrointestinal complications decades after infection, according to the Centers for Disease Control and Prevention (CDC).
Challenges in Diagnosis and Treatment
One of the most concerning aspects of Chagas disease is how few people receive a diagnosis. Globally, only about 10% of infected individuals are aware of their status. Limited awareness among medical professionals compounds the problem. Hernández and her daughter faced difficulty finding doctors familiar with Chagas. “I was scared and sad, thinking my daughter might die. The lack of reliable information only increased my anxiety,” Hernández said. In Mexico, Chagas is often misdiagnosed as other heart conditions due to insufficient training among healthcare providers.
The World Health Organization classifies Chagas as a neglected tropical disease, reflecting both the biological and social neglect that surrounds it.
Current Treatments and Research
Chagas remains challenging to treat. Current medications—benznidazole and nifurtimox—have been in use for over 50 years. These drugs can be toxic, unpleasant, and less effective in adults. Newborns can be cured if treated early, but in adults, treatment usually only slows disease progression rather than guaranteeing a cure.
Rodríguez endured side effects such as allergic rashes, dizziness, and nausea during her treatment but has now completed it and undergoes annual checkups. Unfortunately, pharmaceutical companies have little incentive to develop new therapies due to the limited commercial market for this disease.
Researchers like Colin Forsyth of the Drugs for Neglected Diseases Initiative (DNDi) emphasize that Chagas is overlooked in part because it remains silent for so long, making early detection difficult. Transmission can occur not only from insect bites but also from mother to child, blood transfusions, and organ transplants, expanding the disease beyond traditional geographic boundaries. Dr. David Moore, leading the Chagas Hub at London’s Hospital for Tropical Diseases, highlights efforts to increase testing and treatment, particularly to prevent mother-to-child transmission. Yet progress is slow. “The target to eliminate Chagas by 2030 seems highly unlikely,” Moore said.
Raising Awareness
Advocacy plays a critical role. Hernández, president of the International Federation of Associations of People Affected by Chagas Disease (FINDECHAGAS), works to amplify the voices of those impacted and push for better treatments. In Spain, Rodríguez collaborates with the Barcelona Institute for Global Health to raise public awareness. “I’m tired of the silence,” she said. “I want people to talk about Chagas, get tested, and receive treatment.”
In recognition of Dr. Carlos Chagas’ work, the World Health Organization declared April 14 as World Chagas Disease Day, promoting awareness and global action to combat the disease. WHO’s 2030 global health targets include Chagas alongside other neglected tropical diseases.
Preventing Kissing Bug Infestations
Preventing infection starts at home. The CDC recommends practical steps to reduce kissing bug infestations:
- Seal gaps between floors, ceilings, walls, and doors.
- Remove debris around your home.
- Repair and use window and door screens.
- Block access points to basements, attics, and other parts of the house.
- Keep pets indoors at night and maintain cleanliness around pet areas.
- Regularly inspect your home for pests.
If you find a kissing bug, avoid squashing it. Instead, place it carefully into a jar and either fill it with rubbing alcohol or freeze it in water.
Chagas disease may be silent, but the consequences can be life-altering. Awareness, early diagnosis, and preventive measures are crucial to controlling this hidden epidemic. For individuals like Emiliana Rodríguez and families like Hernández’s, advocacy and education offer hope—not only to prevent new infections but to break the decades-long silence surrounding this deadly disease.