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Venezuela: the hidden Chagas disease

A little-known illness is on the rise in Venezuela.

A public health official holds up three Triatoma dimidiatas, a type of bloodsucking insect that spreads Chagas disease, in San Pedro Sula, Honduras, March 18, 2008. (Edgard Garrido/Reuters)

CARACAS, Venezuela — It was just a glass of guava juice. But now Emily Cordova is undergoing treatment with such harsh side effects that many compare it to cancer chemotherapy.

Three years ago, Cordova and some 100 other children and teachers at a school in the middle-class Caracas neighborhood of Chacao were infected with Chagas disease after drinking juice at the school canteen.

“It’s difficult because you are used to living a different life,” said Cordova, now 16, while waiting to take treatment at the Institute for Tropical Medicine in Caracas. “When I was small my grandmother used to take me to the beach every weekend but now I can’t go because when taking the treatment the sun stains your skin.”

The outbreak of Chagas at the Andres Bello college in Chacao in 2007 is one of three major incidents to have occurred in Venezuela in the past three years. The latest was in Antimano, western Caracas, affecting at least 19 people and killing one.

Such outbreaks are strong indicators that this much-neglected disease is on the rise in Venezuela. The Venezuelan Parasitological Society calculates that cases of Chagas have tripled in the past two decades, from affecting 0.5 percent of the population to 1.6 percent.

It’s a worrying trend for a little-known illness that nonetheless affects more than 8 million people in the Americas and kills more people in the region than malaria. Chagas is now spreading to the United States and Europe, carried by unsuspecting immigrants in their blood.

The Chagas parasite is carried by a forest-dwelling insect known as the kissing bug, which bites victims and transmits the parasite by defecating on the wound. It typically manifests itself in two stages, acute and chronic, and its symptoms can lie dormant for years before it is diagnosed.

Some 30 percent of those infected die from heart attacks caused by the blood-borne virus, while in some cases it can cause an acute form of meningitis or swelling of the brain.

Chagas is increasing steadily in Venezuela, said Dr. Oscar Noya of the Institute of Tropical Medicine, who blamed human encroachment on the kissing bug’s environment. More worrying still is that the kissing bug appears to be adapting to human habitats, he said.

“What has happened in Caracas?” he said. “The kissing bug, which used to live by feeding off animals, has started to adapt itself to homes now that the number of animals has diminished through forest fires, deforestation and through land grabs.”

For critics of the government, the increase in cases of Chagas is not only a sign of neglect of a previously successful program of control through fumigation, but also an indicator that President Hugo Chavez’s socialist government’s assertion that it has dramatically reduced poverty is not as watertight as it claims.