As a child, Emiliana Rodríguez, originally from Bolivia, watched a group of friends playing soccer at night when one of the players suddenly collapsed and died. At the time, she did not understand what had happened but soon learned about the silent killer called Chagas disease—a “monster” she was told only comes out at night. Rodríguez’s friend was one of the 12,000 people who die each year from Chagas disease, a “silent and silenced illness” transmitted by nocturnal bugs that infect up to 8 million people annually.
Although Emiliana moved from Bolivia to Barcelona 27 years ago, she still lives with Chagas disease, which she refers to as a “monster.” “The fear usually came at night. Sometimes I couldn’t sleep,” she said. “I was afraid of going to sleep and not waking up.” She discovered she was a carrier of Chagas disease eight years ago while expecting her first child. The memories of her friend’s sudden death flooded 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, Rodríguez received treatment to prevent passing the parasite to her unborn child through the placenta. Her newborn daughter tested negative for the disease. A Mother’s Unexpected Diagnosis. In Mexico, Elvira Idalia Hernández Cuevas had never heard of Chagas disease until her 18-year-old daughter was diagnosed. Idalia’s daughter gave blood in her hometown near Veracruz, and during testing, doctors discovered she had contracted the disease, which is spread by triatomine bugs—commonly known as kissing or vampire bugs—that feed on human blood. “I had never heard of Chagas before, so I started researching it online,” Hernández said in an interview. “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 can transmit serious disease.
A Discovery Over a Century Ago
Chagas disease was first identified by Brazilian doctor and researcher Carlos Ribeiro Justiniano Chagas in 1909, when he documented the first human case. Over the years, the geographic range of Chagas has expanded beyond Latin America to include parts of Europe, Asia, and Oceania. At night, while people sleep, kissing bugs emerge from cracks and walls in low-income rural or suburban homes.
The parasite Trypanosoma cruzi spreads when an infected bug bites a person or animal, then defecates near the bite. Scratching allows the parasite to enter the body through the skin or mucous membranes.
A Hidden Epidemic
The World Health Organization (WHO) estimates that 6 to 7 million people worldwide live with Chagas disease, many of whom are unaware of their infection. The disease mainly affects people in Mexico, Central America, and South America, and can remain untreated for life. Approximately 12,000 people die annually from Chagas, a toll that surpasses other parasitic diseases like malaria in Latin America. Although nearly 300,000 people in the United States are infected, Chagas is not considered endemic there. Even without symptoms, 20-30% of those infected may develop serious heart or gastrointestinal complications decades after infection, according to the Centers for Disease Control and Prevention (CDC).
Challenges in Diagnosis and Treatment
Only about 10% of infected individuals worldwide receive a diagnosis. This low detection rate, along with a lack of awareness among medical professionals, complicates efforts to treat and prevent the disease. Hernández and her daughter saw multiple doctors but struggled to find knowledgeable care. “I was scared and sad, thinking my daughter might die,” Hernández said. “The lack of reliable information only increased my anxiety.” She explained that in Mexico, many doctors confuse Chagas with other heart diseases due to lack of training. “The authorities say it’s under control, but that’s not the reality,” she added. The WHO classifies Chagas as a neglected tropical disease, one that suffers from both biological and social neglect.
Current Treatments and Research
Colin Forsyth, research manager at the Drugs for Neglected Diseases Initiative (DNDi), said Chagas is overlooked partly because it stays silent for so long in the body, making it hard to detect early. Transmission can also occur from mother to child during pregnancy or childbirth, as well as through blood transfusions and organ transplants, spreading the disease beyond traditional regions. The Chagas Hub, led by Dr. David Moore at London’s Hospital for Tropical Diseases, aims to increase testing and treatment, especially to prevent mother-to-child transmission. Moore admits progress is slow. “The target to eliminate Chagas by 2030 seems highly unlikely,” he said. Current drugs—benznidazole and nifurtimox—have been in use for over 50 years. These medications can be toxic, unpleasant, and not always effective, especially in adults.
Newborns can be cured if treated early, but treatment in adults only slows disease progression without guaranteed success. Rodríguez experienced side effects like allergic rash, dizziness, and nausea during her treatment but has now completed it and undergoes yearly checkups. Pharmaceutical companies have little incentive to develop new treatments because of the limited commercial market.
Raising Awareness
As president of the International Federation of Associations of People Affected by Chagas Disease (FINDECHAGAS), Hernández works to amplify the voices of those affected and push for better treatments. In Spain, Rodríguez is collaborating with the Barcelona Institute for Global Health to raise public awareness about Chagas disease. “I’m tired of the silence,” she said. “I want people to talk about Chagas, get tested, and receive treatment.”
Global Efforts
In recognition of Dr. Carlos Chagas’ discovery, the World Health Organization declared April 14 as World Chagas Disease Day to promote awareness and action. The WHO’s global health targets for 2030 include efforts to prevent, control, and eliminate a variety of diseases, including Chagas.
Preventing Kissing Bug Infestations
The CDC recommends the following steps to reduce the risk of 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, especially at night.
- Maintain cleanliness in and around pet areas and inspect regularly for pests.
If you find a kissing bug, avoid squashing it. Instead, place it carefully into a jar and either fill the jar with rubbing alcohol or freeze it in water.
