Chagas disease historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

History

The disease was named after the Brazilian physician and infectologist Carlos Chagas, who first described it in 1909[1][2][3] but, the disease was not seen as a major public health problem in humans until the 1960s (the outbreak of Chagas' disease in Brazil in the 1920s went widely ignored[4]). He discovered that the intestines of Triatomidae harbored a flagellate protozoan, a new species of the Trypanosoma genus, and was able to prove experimentally that it could be transmitted to marmoset monkeys that were bitten by the infected bug. Later studies showed that squirrel monkeys were also vulnerable to infection.[5]

Chagas named the pathogenic parasite that causes the disease Trypanosoma cruzi [1] and later that year as Schizotrypanum cruzi,[6] both honoring Oswaldo Cruz, the noted Brazilian physician and epidemiologist who fought successfully epidemics of yellow fever, smallpox, and bubonic plague in Rio de Janeiro and other cities in the beginning of the 20th century. Chagas’ work is unique in the history of medicine because he was the only researcher so far to describe completely a new infectious disease: its pathogen, vector, host, clinical manifestations, and epidemiology. Nevertheless, he at least believed falsely until 1925, that the main infection route is by the bite of the insect - and not by its feces, as was proposed by his colleague Emile Brumpt 1915 and assured by Silveira Dias 1932, Cardoso 1938 and Brumpt himself 1939. Chagas was also the first to unknowingly discover and illustrate the parasitic fungal genus Pneumocystis, later to infamously be linked to PCP (Pneumocystis pneumonia in AIDS victims).[2] Confusion between the two pathogens' life-cycles led him to briefly recognize his genus Schizotrypanum, but following the description of Pneumocystis by others as an independent genus, Chagas returned to the use of the name Trypanosoma cruzi.

On another historical point of view, it has been hypothesized that Charles Darwin might have suffered from this disease as a result of a bite of the so-called Great Black Bug of the Pampas (vinchuca) (see Charles Darwin's illness). The episode was reported by Darwin in his diaries of the Voyage of the Beagle as occurring in March 1835 to the east of the Andes near Mendoza. Darwin was young and in general good health though six months previously he had been ill for a month near Valparaiso, but in 1837, almost a year after he returned to England, he began to suffer intermittently from a strange group of symptoms, becoming incapacitated for much of the rest of his life. Attempts to test Darwin's remains at the Westminster Abbey by using modern PCR techniques were met with a refusal by the Abbey's curator.[7]

References

  1. 1.0 1.1 Chagas C (1909). "Neue Trypanosomen". Vorläufige Mitteilung. Arch. Schiff. Tropenhyg. 13: 120–122.
  2. 2.0 2.1 Redhead SA, Cushion MT, Frenkel JK, Stringer JR (2006). "Pneumocystis and Trypanosoma cruzi: nomenclature and typifications". J Eukaryot Microbiol. 53 (1): 2–11. PMID 16441572.
  3. WHO. Chagas. Accessed 24 September 2006.
  4. "Historical Aspects of American Trypanosomiasis (Chagas' Disease)".
  5. Hulsebos LH (1989). "The effect of interleukin-2 on parasitemia and myocarditis in experimental Chagas' disease". Journal of Protozoology. 36 (3): 293–298.
  6. Chagas C (1909). "Nova tripanozomiase humana: Estudos sobre a morfolojia e o ciclo evolutivo do Schizotrypanum cruzi n. gen., n. sp., ajente etiolojico de nova entidade morbida do homem". Mem Inst Oswaldo Cruz. 1 (2): 159-218 (New human trypanosomiasis. Studies about the morphology and life-cycle of Schizotripanum cruzi, etiological agent of a new morbid entity of man.
  7. Adler D (1989). "Darwin's Illness". Isr J Med Sci. 25 (4): 218–21. PMID 2496051.