What if a deadly epidemic was burgeoning and almost nobody noticed?

In the latest issue of PLoS Neglected Tropical Diseases, a distinguished group of virologists, epidemiologists and infectious-disease specialists say that’s not a hypothetical question. They argue that Chagas disease, a parasitic infection transmitted by blood-sucking insects, has become so widespread and serious — while remaining largely unrecognized — that it deserves to be considered a public health emergency. Extending the metaphor, they liken Chagas’ stealth spread to the early days of AIDS:

Both diseases are health disparities, disproportionately affecting people living in poverty. Both are chronic conditions requiring prolonged treatment courses…  As with patients in the first two decades of the HIV/AIDS epidemic, most patients with Chagas disease do not have access to health care facilities. Both diseases are also highly stigmatizing, a feature that for Chagas disease further complicates access to … essential medicines, as well as access to serodiagnosis and medical counseling.

That sounds like rhetoric — after all, what disease expert doesn’t think his or her disease is vitally important — but the numbers the experts bring to the argument are stunning. Overall, there are believed to be 10 million people living with Chagas infection; most of them are in Central and South America, but there are an estimated 1 million in the United States. Up to one-third of those infected, 3 million, are at risk of Chagas’ worst complications, enlarged heart and heart failure. And wherever blood donations are not tested for the protozoan, the blood supply — as well as organ transplants — are at risk.

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