Her name is Mayerlín. She is seven years old and she should not be one of the 39,000 people in the world who will contract Chagas disease this year
Her name is Mayerlín. She is seven years old and she should not be one of the 39,000 people in the world who will contract Chagas disease this year, and every year. She was most likely bitten at night by the vinchuca or kissing bug—the insect vector that transmits the Trypanosoma cruzi parasite. And that bug should not have been in her house.
Vector control programmes have achieved huge reductions in the number of acute cases of Chagas disease by reducing the presence of kissing bugs in homes throughout the areas in Latin America where the disease is endemic. The estimated number of deaths per year worldwide went from 45,000 in the 1980s to 23,000 in 1990 and to 7,000 today. The estimated number of people infected with the T. cruzi parasite has declined from 30 million in 1990 to between 6 and 7 million in 2015.
The estimated number of people infected with the 'T. cruzi' parasite has declined from 30 million in 1990 to between 6 and 7 million in 2015
Although these statistics may not be very accurate due to the lack of epidemiological data for some regions, they do reflect the efforts made to control the insect vector. And today, there are even areas completely free of the kissing bug responsible for the transmission of this disease. However, the problem in Mayerlín's community is not that the houses were never sprayed, but rather that there was no follow up on the initial treatment. After two years without seeing a vector control technician in the area, Mayerlín's mother found kissing bugs in their home.
The bad news is that, even today, less than 1% of patients with Chagas disease are receiving treatment
The good news for Mayerlín—as you can see in the photographic account of her story created by the Uruguayan photographer Ana Ferreira—is that she was diagnosed and treated in time. And, because of the early diagnosis and her age, the treatment was highly effective. The bad news is that, even today, less than 1% of patients with Chagas disease are receiving treatment. Mayerlín is one of the lucky ones.
Still, there is not much point in having access to one of only two drugs that can treat Chagas disease if there is no follow-up in the control of the insect vector. The fight against Chagas can only make headway on two legs—vector control and access to diagnosis and treatment—and both must be strong. One is not enough. If both legs are not moving forward at a steady pace, the struggle will falter, and the advances made will be lost.
Mayerlín's story puts a face and a name on the problem, describing a real experience that will stand out among all those thousands of people
Of the 39,000 new cases that occur every year, in the vast majority (30,000) infection occurs via the insect that transmits the disease. Mayerlín's story puts a face and a name on the problem, describing a real experience that will stand out among all those thousands of people and remain with us. Her story leaves us with a mixed aftertaste that reflects both the good and the bad news. And we are left wondering whether we are actually making progress. What we do know is that the only way to advance along the road is by walking.
For this reason, as we mark the 108th anniversary of the discovery of Chagas disease this week, Mayerlín’s story illustrates the light and the dark sides of the response to this global public health challenge. She is just one of the 39,000 people who have been threatened by this neglected disease this year; and she is our one. Chagas disease is the most deadly parasitic disease in Latin America and there are now tens of thousands of cases in other countries around the world, including the United States, Spain and Japan. We must not forget her.