Shedding Light On A Silent Killer: World Chagas Disease Day

Every year on April 14, the world pauses to observe World Chagas Disease Day, a crucial date in the calendar of global public health. Far from the spotlight that shines on more prominent illnesses, Chagas disease—also known as American trypanosomiasis—remains a neglected tropical disease that silently affects millions. Named after Brazilian physician Carlos Ribeiro Justiniano Chagas, who discovered the disease in 1909, it continues to claim lives, disrupt families, and strain fragile healthcare systems.

World Chagas Disease Day is about remembering a century-old discovery and confronting a modern-day global health challenge that remains largely in the shadows. With over six million people infected, primarily in Latin America but increasingly worldwide due to globalization and migration, the need for attention, advocacy, and action has never been greater.

What is Chagas Disease?

Chagas disease is caused by the parasite Trypanosoma cruzi, which is primarily transmitted through the bite of infected triatomine insects, commonly known as “kissing bugs.” These bugs are found in rural, impoverished areas of Latin America, where they hide in cracks in walls and roofs and emerge at night to feed on human blood. After biting, the bug defecates near the wound, allowing the parasite to enter the body.

Although vector-borne transmission is the most common route, Chagas disease can also be spread through:

-Blood transfusion or organ transplantation
-Congenital transmission (from mother to baby during pregnancy)
-Consumption of contaminated food or drink
-Laboratory accidents

Once inside the human body, the parasite can remain undetected for years. The disease progresses in two phases:

1.Acute Phase—This lasts weeks or months. It may present mild symptoms like fever, fatigue, rash, or swelling at the site of infection. In many cases, however, it goes unnoticed or is misdiagnosed.
2.Chronic Phase – Without treatment, the disease may lie dormant for 10–30 years before manifesting serious complications.

These include:

-Chronic heart disease (cardiomyopathy, arrhythmias, heart failure)
-Digestive complications (megacolon, megaesophagus)
-Neurological disorders
-Sudden cardiac death

It is estimated that 30–40% of people infected with T. cruzi will develop life-threatening complications later in life.

Once inside the human body, the Chagas parasite can remain undetected for years (Image:Freepik)

A Neglected Disease in a Globalized World

While the World Health Organization (WHO) classifies Chagas disease as a neglected tropical disease (NTD), it is no longer confined to tropical or subtropical regions. Migration, urbanization, and international travel have brought Chagas into non-endemic countries like the United States, Spain, Italy, Japan, and Australia. It is estimated that more than 300,000 people are living with Chagas in the U.S. alone, most of whom are unaware of their condition.

The disease is now a global health issue, yet it remains underdiagnosed and undertreated—even in countries with the capacity to respond. Less than 10% of those infected are diagnosed, and fewer than 1% receive adequate treatment. For many, it is a disease not just of the heart but of inequality, invisibility, and neglect.

Why April 14 Matters

World Chagas Disease Day was officially recognized by the WHO in 2019, with the first global observance held in 2020. The date—April 14—marks the day in 1909 when Carlos Chagas diagnosed the first human case of the disease in a Brazilian child named Berenice. The discovery was unprecedented in medical history: Chagas identified the pathogen, the vector, the host, and the clinical symptoms—all at once.

But over 100 years later, the disease he named and fought remains underfunded, under-researched, and underreported. World Chagas Disease Day aims to:

-Raise awareness of the disease among the public, healthcare workers, and policymakers
-Promote early screening and diagnosis
-Encourage national programs to monitor, prevent, and treat the disease
-Combat the stigma and social discrimination associated with Chagas
-Advance research and innovation to develop better diagnostics, treatments, and vaccines

The 2025 campaign theme, “Finding and Reporting Every Case to Defeat Chagas Disease,” emphasizes the importance of visibility. Chagas has been a disease of the unseen and unheard for too long. To defeat it, we must first recognize it.

The Human Cost

Beyond statistics, Chagas disease is a deeply human tragedy. It affects people in rural farming communities, urban migrants, and undocumented workers—those who often lack access to regular health care. Many learn of their infection only after experiencing debilitating heart symptoms. By then, the disease may be irreversible.

In endemic areas, Chagas is a disease of poverty, thriving in communities with substandard housing and limited health infrastructure. In non-endemic countries, it becomes a disease of exclusion, where migrants and marginalized populations fall through the cracks of the healthcare system.

Women of childbearing age face additional challenges. Without proper screening, congenital transmission can occur, passing the disease silently to the next generation. In some regions, up to 5% of babies born to infected mothers are also infected, perpetuating a cycle of transmission and suffering.

Barriers to Progress

Despite the pressing need, efforts to eliminate Chagas disease face numerous barriers:

-Low awareness among healthcare professionals: In many countries, medical training does not adequately cover Chagas, leading to misdiagnosis or missed diagnoses.
-Stigma and discrimination: Fear of deportation or job loss can prevent migrants from seeking testing or care.
-Limited treatment options: The two primary drugs—benznidazole and nifurtimox—are most effective in the acute phase. However, they are often poorly tolerated by adults and unavailable in some regions.
-Lack of investment in research: Chagas receives a fraction of the funding allocated to other diseases with similar health burdens.
-No vaccine: While promising efforts are underway, no vaccine for Chagas disease exists.

Making Strides: Progress and Hope

Despite these challenges, there have been meaningful strides in recent years:

-Vector control programs in Latin America have dramatically reduced transmission in countries like Brazil, Chile, and Uruguay.
-Screening programs for blood donors and pregnant women are reducing transmission in several regions.
-International organizations such as the Drugs for Neglected Diseases initiative (DNDi), PAHO, and Médecins Sans Frontières are actively working to improve access to care and develop new treatments.
-Mobile health clinics and telemedicine are being used to reach underserved communities in remote and urban areas.
-Innovative diagnostics using molecular and serological testing are in development, offering the hope of faster, more accurate, and more accessible testing.

In 2020, the WHO also launched its roadmap for neglected tropical diseases (2021–2030), which sets ambitious targets for the control and elimination of Chagas, including:

-Interrupting transmission in all endemic countries
-Ensuring access to diagnosis and treatment for at least 75% of infected people
-Eliminating congenital Chagas disease through systematic screening and maternal care

These goals are achievable—but only with sustained political will, funding, and public awareness.

What Needs to Happen Now

To defeat Chagas disease, a coordinated, global effort is essential. This means:
1.Expanding screening programs in both endemic and non-endemic countries, particularly among at-risk populations.
2.Training healthcare providers to recognize, diagnose, and treat Chagas disease effectively.
3.Ensuring access to safe, effective, and affordable medication, especially in low-income and migrant communities.
4.Investing in research for new drugs, vaccines, and rapid diagnostics.
5.Raising public awareness to reduce stigma and encourage proactive health-seeking behavior.

Importantly, affected communities must be at the center of the response. Empowering people with knowledge about the disease and access to care is the only way to break the cycle of invisibility.

A Call to Action

On this World Chagas Disease Day, let us remember that diseases do not discriminate—but health systems often do. Chagas disease, though silent and slow-moving, exacts a devastating toll on individuals, families, and societies. Yet it is both preventable and treatable.

We have the tools to change the story. We need a commitment to research, equity, and every person affected.

Let April 14 be more than a date on the calendar. Let it be a call to action for policymakers, scientists, healthcare providers, and ordinary citizens. Awareness is the first step in the fight against Chagas disease, but action is what will make the difference. Together, we can ensure that no more lives are lost in silence.

(Note: Dr (Prof) Sadhana Kala is a USA-trained robotic & laparoscopic surgeon, Uppsala University, Sweden, trained fertility specialist, Icon Endoscopic Surgeon of North India, and National Icon Endoscopic Surgeon of India. She is rated as India's Best Gynecologist by Google.)

(Disclaimer: The views expressed in this article are the personal opinions of the author.)