The Kiss of Death: Chagas' Disease in the Americas


Dr. Carlos Chagas

Carlos Justiniano Ribeiro Chagas was born on July 9, 1879, in the town of Oliveira, Brazil, of farmers whose descendents came to Brazil in the seventeenth century. Prior to his father's death when Carlos was four, his upper-class parents owned a small coffee plantation. Carlos resisted his mother's persuasion for him the become an mining engineer and instead chose medical school, being swayed by a physician uncle who convinced him that for Brazil to develop Dr. Carlos Chagas industrially it was necessary to rid the country of endemic diseases. Many European ships refused to dock in Brazilian ports because of the risk of contracting yellow fever, smallpox, bubonic plague, and syphilis.

Carlos studied at the Oswaldo Cruz Institute in 1902 where he wrote his M.D. thesis on the "Hematological Aspects of Malaria" under the leading Brazilian parasitologist Oswaldo Cruz. Dr. Cruz's work was critical in the fight against yellow fever in Rio de Janeiro. He provided vaccinations against the plague and smallpox when eradication of vectors and mass vaccinations were considered revolutionary measures. Carlos Chagas refused Dr. Cruz's invitation to work on malaria research, wanting instead to practice family medicine. Later, Chagas introduced antipest serotherapy while working in a Jurujuba hospital. Dr. Cruz modified serotherapy introduced by Pasteur in 1890, and Chagas followed Pasteur's and Cruz's assumptions that negative organic elements fermented positive organic elements. Dr. Chagas was a very innovative and experimental doctor who looked for answers in practice rather in the laboratory.

Chagas succeeded against malaria priamrily because he did fieldwork, observed the disease in its environment, and addressed the problem in a scientific and therapeutic way. He also worked with patients, parasites, and insects in epidemic settings to get an enlarged perspective of the disease. Chagas contributed to malariology and in 1906 became an associate of the Oswaldo Cruz Institute in Rio de Janeiro. In 1908, the Central Railroad of Brasil invited Chagas to go to Lassance, a boisterous railroad-worker town at the end of the new railroad line across Brazil, where immigrant railroad workers were dying from what was thought to be malaria. Chagas set up a simple lab. Chagas found that some symptoms were not from malaria, and later was given an insect, a vinchuca, that sucked blood from the workers at night. He discovered flagellates in the bug's hindgut. He found that these were protozoa that resembled those known to cause African sleeping sickness. Subsequent research proved the infection cycle of the trypanosome, later named T. Cruz (after Chagas' mentor) was directly related to poverty, such as that existed in Lassance. An amazing rate of discovery led to the isolation of the disease's cause in 1909. Research relating to Chagas' disease has slowed since Chagas' death in 1933.

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