Infectious Diseases More Infectious Diseases Chagas Disease Guide Chagas Disease Guide Overview Symptoms Causes Diagnosis Treatment How Chagas Disease Is Diagnosed By Richard N. Fogoros, MD Richard N. Fogoros, MD Facebook LinkedIn Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. Learn about our editorial process Updated on September 17, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Ronald Lubelchek, MD Medically reviewed by Ronald Lubelchek, MD LinkedIn Ronald Lubelchek, MD, is a board-certified infectious disease specialist in Chicago, Illinois. He previously served as the Medical Director for Cook County’s ambulatory HIV clinic, one of the largest HIV clinics in the U.S. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Acute Chagas Disease Chronic Chagas Congenital Chagas Frequently Asked Questions Next in Chagas Disease Guide How Chagas Disease Is Treated The diagnosis of Chagas disease depends on whether the infection is acute, chronic, or congenital. © Verywell, 2018 Acute Chagas Disease The optimal time to diagnose Chagas disease is during the acute phase of the illness, when the chance of eradicating the Trypanosoma cruzi (T. cruzi) infection with antitrypanosomal drugs is the highest. Unfortunately, this opportunity is all too often missed. This is because the symptoms caused by acute Chagas disease are usually mild and not particularly alarming, so people with acute Chagas typically do not seek medical help. Watch for Outbreaks People who live in endemic areas should pay attention to potential symptoms of acute Chagas disease, especially if they have noticed insect bites that are particularly prominent or long-lasting, or if they are aware of an outbreak of Chagas disease in their area. If they are suspicious they should see a doctor. As for the doctors, it is important that they too remain suspicious that Chagas disease might be present and then do the necessary diagnostic testing. In actual practice, this generally occurs only during recognized local outbreaks, when community-wide screening is instituted. Chagas Disease Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Email the Guide Send to yourself or a loved one. Sign Up This Doctor Discussion Guide has been sent to {{form.email}}. There was an error. Please try again. Making the Diagnosis During the acute phase of Chagas disease, the number of T. cruzi parasites in the bloodstream is usually quite high. This allows the diagnosis of Chagas to be made by examining specially prepared blood samples under a microscope. However, the number of T. cruzi in the bloodstream falls off rapidly after the first 90 days, even if no treatment is given. The microscopic examination of blood is no longer a reliable means of diagnosing Chagas disease after that time. The microscope test is almost never useful during the chronic phase of Chagas. In addition to the microscopic exam, laboratory blood testing also can be very accurate in diagnosing acute Chagas disease. This is done with a polymerase chain reaction (PCR) test, which detects the DNA of T. cruzi in the blood sample. A positive PCR test, like the microscope test, indicates that T. cruzi organisms are present in the bloodstream. The symptoms associated with acute Chagas disease—such as weakness, fever, sore throat, rash, and muscle pains—can be easily confused with those of other illnesses, such as symptoms of infectious mononucleosis, or of acute HIV infection. So when a person living in an area endemic for Chagas disease is being tested for either of these conditions, it is usually a good idea to test for T. cruzi infection as well. Chronic Chagas In chronic Chagas disease, the T. cruzi organism is usually no longer present in the bloodstream, so microscopic testing of a blood sample is almost always negative, as is the PCR test. Diagnosing chronic Chagas disease usually relies on detecting antibodies made by the body to fight off the infection. A number of tests have been developed to look for antibodies to T. cruzi, including an enzyme-linked immunosorbent assay (ELISA) and an immunofluorescent antibody assay (IFA). None of these antibody tests is accurate enough to be used by itself, so to diagnose chronic Chagas disease, at least two different antibody tests are usually done—and if the results are different between them, a third test is then done to serve as a tie-breaker. At the same time, testing should also be performed to look for any of the other potential causes for the kinds of cardiac and gastrointestinal problems associated with chronic Chagas disease. The list of conditions that can do this is unfortunately quite long, and doctors have to use a lot of clinical judgment in deciding what testing to do, and in what order. Congenital Chagas Up to 10 percent of babies born to mothers infected with T. cruzi will develop acute Chagas disease—a condition called congenital Chagas disease. It is important for a baby with congenital Chagas disease to be treated with antitrypanosomal therapy to prevent chronic complications. The possibility of congenital Chagas disease should be considered in any newborn whose mother is from an area where the disease is endemic. Prenatal testing is often done in pregnant women living in such areas, and babies of the mothers who test positive can then be screened for the disease. Screening of the babies themselves for congenital Chagas disease is usually done at birth with PCR testing of the cord blood, or on a blood sample obtained during the first few days after birth. If the mother is known to be positive for Chagas disease and the initial screening of the infant is negative, repeat testing of the baby should be done after a month or two. Frequently Asked Questions How accurate is the blood test for Chagas disease? In the first 90 days of contracting the disease, examining a blood sample under a microscope is an accurate way to establish a T. Cruzi infection. At this stage, a polymerase chain reaction (PCR) test, which examines DNA, is also highly reliable. In the chronic phase of the disease, neither of these methods are reliable, and antibody testing must be used. How many people get Chagas disease? An estimated 6 to 7 million people worldwide are infected with T. cruzi. The CDC estimates that 300,000 people in the United States carry the infection. However, only a handful of cases of contracting Chagas disease inside the U.S. have been reported. How can I get tested for Chagas disease? If you’ve given blood in the United States since 2010 (and in some cases since 2007), you’ve already been tested for Chagas disease. If you’ve recently been exposed, ask your health care provider for a test. In the early stages of the disease, a simple blood test can establish a diagnosis. How Chagas Disease Is Treated Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. Parasites. American Trypanosomiasis (also known as Chagas Disease). Diagnosis Centers for Disease Control and Prevention. Parasites. American Trypanosomiasis (also known as Chagas Disease). Detailed FAQs Carlier Y, Sosa-estani S, Luquetti AO, Buekens P. Congenital Chagas disease: an update. Mem Inst Oswaldo Cruz. 2015;110(3):363-8. doi:10.1590/0074-02760140405 Klotz JH, Dorn PL, Logan JL, et al. “Kissing bugs”: Potential disease vectors and cause of anaphylaxis. Clin Infect Dis. 2010 Jun 15;50(12):1629-34. doi:10.1086/652769 World Health Organization. Chagas disease (American trypanosomiasis). Epidemiology & Risk Factors. Centers for Disease Control and Prevention, Global Health, Division of Parasitic Diseases and Malaria. Centers for Disease Control and Prevention, Global Health, Division of Parasitic Diseases and Malaria. Parasites—American trypanosomiasis (also known as Chagas disease). Diagnosis. Additional Reading Bern C, Martin DL, Gilman RH. Acute and Congenital Chagas Disease. Adv Parasitol 75:19. Messenger LA, Gilman RH, Verastegui M, et al. Toward Improving Early Diagnosis of Congenital Chagas Disease in an Endemic Setting. Clin Infect Dis 65:268.