On a humid Bolivian night, beneath the dim glow of a crescent moon, whispers of an unseen menace stirred among the villagers.
They spoke of a phantom creeping through the darkness, a predator that left no sound, no trace, only lifeless bodies in its wake. For many, this was no mere bedtime tale; it was the chilling reality of Chagas disease, a silent killer lurking in the shadows.
For Emiliana Rodríguez, who grew up hearing such stories, the fear of this “monster” became an unshakable part of her childhood—a terror that would follow her far beyond the borders of her home.
As a young child, Emiliana Rodríguez recalls watching friends play a nighttime game of soccer, where one of the players suddenly dropped dead on the field. Not knowing what had happened, the Bolivian-born Rodríguez grew fearful of the night, afraid of the silent killer called Chagas, the “monster” she was told only comes out at night.
Chagas is a different kind of monster, a “silent and silenced disease,” transmitted by nocturnal bugs that infect up to 8 million people each year, and Rodríguez’s friend was one of 12,000 people killed each year.
As a young girl, Emiliana Rodríguez vividly remembers watching her friends play soccer under the night sky when tragedy struck—a player suddenly collapsed and died on the field. Confused and scared, Rodríguez grew terrified of the dark, haunted by tales of a silent killer called Chagas, a “monster” that lurks only at night.
Chagas disease is a different kind of monster—what experts call a “silent and silenced disease.” Transmitted by nocturnal bugs, it infects up to 8 million people annually and claims the lives of 12,000 people each year. Rodríguez’s childhood friend was one such victim.
Now 42, Rodríguez moved from Bolivia to Barcelona 27 years ago, but Chagas, the “monster,” followed her in a way she couldn’t escape. “The fear was always there, especially at night. Sometimes I couldn’t sleep,” she shared. “I was afraid of going to sleep and not waking up.”
Eight years ago, while pregnant with her first child, Rodríguez underwent tests that revealed she was carrying the parasite responsible for Chagas. The diagnosis brought back memories of her friend’s sudden death and the grim stories told by her relatives. “I was frozen with fear,” she said. “I kept wondering, ‘What will happen to my baby?’”
Fortunately, Rodríguez received treatment to prevent vertical transmission of the parasite to her unborn child. When her daughter was born, tests confirmed the baby was Chagas-free.
Chagas Strikes in Mexico
In Mexico, Elvira Idalia Hernández Cuevas’s encounter with Chagas was just as unexpected. Hernández’s 18-year-old daughter, Idalia, was donating blood near their hometown in Veracruz when routine screening revealed she had Chagas. The news was shocking.
“I had never heard of Chagas before,” Hernández admitted. “When I researched it online and saw it described as a silent killer, I was terrified. I didn’t know what to do or where to turn.”
Her experience mirrors that of countless others who remain unaware of Chagas, a vector-borne illness caused by triatomine bugs, also known as kissing or vampire bugs.
The Disease and Its Spread
Chagas disease was first identified in 1909 by Brazilian physician Carlos Ribeiro Justiniano Chagas, and over the decades, it has become a significant health concern in Latin America, North America, Europe, Japan, and Australia.
Kissing bugs thrive in the walls of poorly constructed homes in rural and suburban areas. These nocturnal pests are most active at night, biting their victims and then defecating on their skin. The infection occurs when a person unknowingly scratches the bite, allowing the parasite to enter through broken skin or spread to the eyes or mouth.
According to the Centers for Disease Control and Prevention (CDC), about 6 to 7 million people worldwide—primarily in Mexico, Central America, and South America—are infected with Chagas. The World Health Organization (WHO) estimates that most cases go undiagnosed, and untreated infections can lead to severe complications. Chagas is responsible for 12,000 deaths annually, claiming more lives in Latin America than any other parasitic disease, including malaria.
In the U.S., approximately 300,000 people are infected, though Chagas is not considered endemic.
While many infected individuals remain asymptomatic, the CDC warns that decades later, 20 to 30% may develop life-threatening cardiac or gastrointestinal complications. Yet, only about 10% of cases worldwide are detected, making effective treatment and prevention a significant challenge.
Lack of Awareness and Resources
In Mexico, Hernández faced difficulties finding adequate medical care for her daughter. Doctors often misdiagnosed Chagas as other heart conditions or knew little about the disease. “I was scared and sad because I thought my daughter would die,” Hernández said. “Not having reliable information only made my anxiety worse.”
With help from a family member in the healthcare field, Idalia eventually received the necessary treatment. However, Hernández believes the Mexican healthcare system underestimates the prevalence of Chagas. “Authorities say the disease is under control, but that’s not true. Most medical professionals don’t recognize Chagas, and the affected population has no voice.”
A Neglected Tropical Disease
The WHO classifies Chagas as a neglected tropical disease, meaning it lacks attention in global health policies. Colin Forsyth, a researcher with the Drugs for Neglected Diseases Initiative (DNDi), explains that Chagas remains hidden because of its asymptomatic early stages and the socioeconomic status of those affected.
“Chagas disproportionately impacts poor communities, who lack the power to influence healthcare policy,” Forsyth said.
However, as Chagas spreads globally, awareness is growing. It can also be transmitted through blood transfusions, organ transplants, and from mother to child during childbirth.
Professor David Moore, a consultant at London’s Hospital for Tropical Diseases, has established the Chagas Hub to increase testing and treatment and prevent transmission. Still, Moore describes progress in combating the disease as “glacial.”
The WHO’s target to eliminate Chagas by 2030 seems far-fetched, he says. Current treatments—benznidazole and nifurtimox—are decades old, have unpleasant side effects, and are not guaranteed to halt disease progression in adults.
For Rodríguez, the medication caused hives, dizziness, and nausea, but she completed the treatment and underwent annual check-ups. Moore stresses the need for more effective drugs but notes the lack of financial incentives for pharmaceutical companies.
Advocacy and Prevention
Despite these challenges, Hernández is determined to make the silent disease louder. As president of the International Federation of Associations of People Affected by Chagas Disease (FINDECHAGAS), she campaigns for awareness and action.
Rodríguez, now in Spain, is also working to fight the “monster” through a campaign by the Barcelona Institute for Global Health. “I’m tired of the silence,” she said. “I want people to know about Chagas, to get tested and treated.” The silence must end.”
We are taking action.
In response to the growing need for awareness, WHO established World Chagas Disease Day, which is commemorated annually on April 14, the day the first human case of the disease was identified in 1909.
To prevent infestations, the CDC recommends sealing cracks in homes, using screens on windows and doors, keeping pets indoors at night, and regularly inspecting living spaces for bugs. If you come across a triatomine bug, don’t crush it. Instead, capture it in an alcohol container or freeze it and take it to the health department for identification.
It’s disturbing to think of these bugs hiding in the walls, but Chagas is no longer just a distant horror story – it’s a global challenge that needs immediate attention.
Reports by Emiliana Rodríguez and Elvira Idalia Hernández Cuevas highlight the pervasive threat and profound neglect surrounding Chagas disease, often referred to as the “silent killer”.
Despite its lethality and widespread prevalence, particularly in Latin America, the disease remains underdiagnosed, underreported, d and overshadowed by other global health problems. This silence not only perpetuates misinformation but also denies affected populations the resources and care they desperately need.
While organizations like the World Health Organization (WHO) and initiatives like the Chagas Hub have taken steps to raise awareness and address this neglected tropical disease, progress is still slow. Treatment, even when available, is outdated, unpleasant, and often ineffective for adults, leaving millions with few options for relief or hope. The stories of Rodríguez and Hernández serve as a poignant reminder of the urgency to prioritize Chagas on the global health agenda, not only to provide better treatment options but also to break the silence surrounding the disease.
Meanwhile, prevention and awareness remain key tools in the fight against Chagas. Measures such as sealing homes, reducing exposure to bed bugs, and encouraging testing are essential to protect vulnerable communities. Advocacy efforts by individuals like Rodríguez and Hernández aim to amplify the voices of those affected and ensure that Chagas is no longer a hidden monster but a recognized challenge requiring global attention.
Solving Chagas ultimately requires a collaborative effort—governments, health organizations, researchers, and affected communities must come together to eradicate the disease. Only then can we hope to turn the fear and silence that defined Chagas into a story of resilience, action, and ultimate triumph.