The appearance of The Chagas disease in the medical world is somehow recent however there are descriptions related to this disease since the arrival of Spanish to America.

In the XVI century, Friar Ferdinando de Lizarraga discovered the presence and the life habits of the "Chince Besucona" (Kissing Bedbug), in the Cochabamba Valley, Bolivia. Other descriptions were made by Charles Darwin during the XIX century in the city of Lujan de Cuyo, Argentina, and by Guillermo E. Hudson in Uruguay.

This illness was discovered and described in 1909 by Dr. Carlos Ribeiro Justiniano Dos Chagas (1879-1934) who early in this century was working in the Bacteriological Institute of Manguinhas ( nowadays Oswaldo Cruz Institute) in Rio de Janeiro , Brazil.

During a antimalarial campaign before the building of the railway line of the Central Railroad Of Brazil to the Northeast of Minas Gerais State, Chagas become aware of the existence of a kissing bug, insect called by locals "barbeiro" that pullulated in that attacked men during the night.

Working in Lassance, near Bicudo river, he captured and analyzed these "barbeiros", identify them as Conorrhinus megistusnow called Panstrongylus megistus ( Burmeister, 1835), and found that the rare intestine was populated by parasites "with morphological characters of Crithidias" witch supossed intermediate forms of a trypanosome. So, he sent some samples of the insect to Dr. Oswaldo Cruz, who made the insect bit a monkey Callitrix penicillata 30 or 30 days after the bite-says Chagas- A big number of Trypanosomes with different morphology to any other specie known of the Trypanosoma Gender were found in the blood of that monkey.

So, we began the study of the flagellate, getting a fast infection by inoculating different lab animals like dogs, rabbits and other monkeys.

In this way he met all the necessary principles to characterize an infectious disease.

• The isolation of the germ
• Its association with manifestations and injuries that are repeated.
• The reproduction of the disease by inoculating the germ in an animal.

Chagas called this flagellate microorganisms Trypanosoma cruzi in honor to this master Oswaldo Cruz. During the early months of 1907 to April 22nd, 1909, day in which he presented his discovery to the National Academy of Medicine; Chagas, Cruz an some other who worked with them, investigated the epidemiology of the infection in the area, they also described the chronic disease and studied the biological cycle of the trypanosome in the transmitting insect and in lab animals.

First Studies

Some studies in The Manguinhos Institute, began to be carried out with the following results: Gaspar Vianna continues the parasitological studies and discovers the fundamental injuries of its pathological anatomy; Guerreiro y Machado successfully rehearse the reaction to fixing the complement to the diagnosis of the disease in chronic cases; Arturo Neiva the biology of the transmitting insect and Eurico Villela the clinical aspects. The Manguinhos group studies are enriched by other scientists: Brumpt discovers the mechanisms that transmits the parasitosis while Mayer and Rocha Lima first, and then Cronwell and Mangarinos Torres, make clear some aspects of the pathological anatomy and evolution of the flagellate in the tissues.

Since the very beginning of the investigations Chagas foresaw that he was dealing with an very important endemic disease because of the extension of the area that it takes and because of the pathogenic action of Trypasonoma cruzi, its etiological agent. Since almost half of all the patients with T. cruzi suffered at the same time of endemic goiter or cretinism, it was attempted to attribute such chronic thyroidal diseases to the parasite, almost going to the extreme to propose the name "parasitical thyroditis" for this disease. This aspect was very controversial specially in Argentina and Brazil, where this resulted with the losing of the doctor s interest and put off for many year, the interest in this disease; however, the discovery of Chagas was slowly progressing in many countries in America: in El Salvador, Segovia discovers the first case of serious Chagas disease in 1914, in 1919 Tejera discovers the first serious sick human beings and trypanosomes in blood, in Venezuela, pointing at Rhodnius Prolixus as the vector , and Escomel in Perú finds as well, a patient with parasites in his blood. In the same year, a similar discovery is made in Paraguay, Lutz, Souza, Araujo, De Fonseca y Migone find the first infected kissing bug, and in 1924 Gaminara in Uruguay, carries out studies about the "Vinchucas" infection in the country by T. Cruzi, in 1931, it is reported 19 human cases of Chagas disease found during a anti swamp fever campaign in the zone of the Panama Channel.

Difficulties during the investigations.

Carlos Chagas wouldn't enjoy the success of his discovery during lifetime. He suffered indifference and slanders.

In his sorrow he wrote the next paragraph "… there is a tragic signal in the study of Trypanosomiasis. Each work, each study, points out towards a not very well nourished population that lives under very bad conditions. It also points out towards an economic and social problem that makes governors feel uneasy because it shows the incompetence to resolve such a problem. It is not like malaria that is all about bugs in the nature, a mosquito related to the environment or like esquitosomiasis which is related to an ecological factor almost inalterable and incorrigible. It is a problem of vinchucas that invade and live in hovels with dirty rooms and with inhabitants that have been ignored , bad nourished and poor. Without any hope or social horizon and not willing to collaborate. Speak about this disease and you will have the governments against you."

In 1912, Chagas traveled to Buenos Aires and presented the disease that he discovered and the result of his studies to the scientific community. It was a very tough visit that caused great disappointment. He was criticized because he included as specific manifestation of the new Trypanosomiasis sick people with alterations in the thyroid gland that corresponded to other entities and states of the region. It was proposed to him that the Trypanosomiasis was a casual discovery and that it does not necessarily represent a disease. In 1914 Maggio and Rosenbusch showed for the first time that T. cruzi infected the Triatoma infestans which would result in the most common vectorial insect in the country; even though they suggested that "the infected kissing bug with T. cruzi in Argentina probably does not produce the Chagas disease. The cause could be the trypanosomes attenuation because of the climate…" In 1915 and 1916, the same authors and Kraus pointed out that the lack of epidemiological relationship among infected vinchucas endemic cretinism and goiter gave space to doubt about the Chagas pathogenic conceptions. In 1924 Muhlens (researcher from Hamburg's Tropical Disease Institute), Dios, Petroechi and Zuccarim found the first human being infected by T. Cruzi while they were doing some blood testing in order to look for Malaria parasites in Tucuman and Salta.

The role of Salvador Mazza

The relations between Salvador Mazza (1886-1946) and the Chagas disease was began during the 1920 decade, marking a big event in the history of the disease.Mazza, who had met Chagas in Germany and was very impressed by the clear and solid arguments about the disease, supported many studies that soon confirmed the importance of this disease in Argentina. In 1926, Mazza found a natural infected dog by T. cruzi and in 1927, it was diagnosed the first case know in Argentina. In 1929. In 1935 Cecilio Romaña described the ocular chagoma or Romana sign.

During the 30 s, heading the Mision de Estudios de Patologia Regional Argentina (MEPRA), Mazza supported the study of this illness showing many aspects about the vectorial insects, host mammals, epidemiology and pathogeny. This work allow to diagnose hundreds of cases parasitically proven. On the other hand, the verification of the human infection in zones free of endemic goiter allowed to overcome some obstacles that hod stopped Chagas. As a consequence of these works the American Trypanosomiasis became the main topic of the VI National Congress of Medice in 1939. In 1940 Mazza and Miguel E Jorg defined the 3 anatomic and Clinical periods of the disease, definition that still valid and it s accepted in our days.

In 1946, Mazza. who had traveled to Mexico as special guest to some updating meetings about Chagas, had a heart attack and died. The MEPRA; that had became in a very good interdisciplinary team of assistance, teaching and researching that resulted in more than 300 publications made about the Chagas disease, leishmaniasis, brucelosis, uncinariasis, zootoxicosis and bacterological infections, was temporally in change of Jörg. But he couldn't overcome the political and institutional attacks that ended up with the transfer to Capital Federal, a slow agony and the resolution about the definite closing that would come in 1958.

Source of Information

• Historia de la Enfermedad de Chagas
  Federacion Argentina de Cardiologia
  Foro de Educación Continua en Cardiologia
  http://www.fac.org.ar/fec/chagas/fatala/historia.htm

More Information

• The Chagas Disease
• Historical Review
      • Dr. Carlos Justiniano Riveiro Chagas (1879-1934)
      • Dr. Salvador Mazza (1886 -1946)
      • Dr. Mario Fatala Chabén (1936-1962)
      • Dr. Oswaldo Cruz (1872-1917)
• Medical Information
      • Epidemiology
      • Mortality
      • Race, sex and age.
      • Modes of Transmission
      • Pathophysiology
      • Clinical Information
      • Diagnosis
      • Other Medical Information
• Prevention and Control
• Frequently Asked Questions