Carlos Chagas

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Lore & Background

After a brief stint as a medical practitioner in the hinterlands, Chagas accepted a position in anti-malarial campaigns. In 1905, he worked under the Docas de Santos company at the port of Santos, São Paulo, fighting a malaria epidemic affecting workers. He introduced an innovation using pyrethrum insecticide to treat households, with surprising success. In 1906, he returned to Rio de Janeiro and joined the Oswaldo Cruz Institute. In 1907, an outbreak of malaria among railroad workers in Minas Gerais led the Brazilian government to ask Cruz for help. Cruz assigned Chagas and an assistant, Belisario Penna, to investigate. Camping at Lassance, a small town near the São Francisco River, Chagas stayed there for two years. During his investigation, he observed the peculiar infestation of rural houses with a large hematophagous insect of the genus Triatoma, called barbeiro ("barber") in Portuguese. He discovered that the intestines of these insects harbored flagellate protozoans, a new species of Trypanosoma. He proved experimentally that it could be transmitted to marmoset monkeys bitten by the infected bug. He soon found the parasites in the blood of a cat, then looked for a two-year-old girl, Berenice Soares de Moura, whom he had seen in the same hut. On 14 April 1909, he discovered the same Trypanosoma parasite in her blood. He described 27 cases of the acute form and performed more than 100 autopsies on patients with the chronic form. He suggested the armadillo could be the natural reservoir.

Reader's Guide

Chagas's work holds a unique place in the history of medicine because he described in detail a previously unknown infectious disease, its pathogen, vector (Triatominae), host, clinical manifestations, and epidemiology. He was also the first to discover and illustrate the parasitic fungal genus Pneumocystis, which later became infamous for being linked to pneumocystis pneumonia in AIDS patients. In 1908, he reported in Brazil Médico the blood sample of marmosets had protozoan parasites he named Trypanosoma minasense, and described an associated parasite he could not identify. He initially believed the fungus was part of the life cycle of the protozoan, describing both as Schizotrypanum cruzi. In 1912, French researchers Pierre Delanoë and Marie Delanoë identified the other parasite in rats, creating the new genus Pneumocystis. Chagas followed the literature closely and confirmed the distinction, again adopting the name Trypanosoma cruzi for the protozoan. His discovery of Chagas disease brought him domestic and international distinction. He persuaded Argentine physician Salvador Mazza to research the epidemic, leading to confirmation of Trypanosoma cruzi in Argentina in 1927. His published work on using pyrethrum for malaria prevention served as the basis for prevention worldwide and was adopted by a service of the Ministry of Health in Brazil established expressly for that purpose.

Did You Know?

• Chagas was nicknamed 'two-candle student' in medical school because he used up two candles every evening for reading, as there was no electricity in Rio de Janeiro at the time.
• He discovered Trypanosoma cruzi in the blood of a two-year-old girl named Berenice Soares de Moura on 14 April 1909.
• Chagas initially mistook the Pneumocystis fungus for a life cycle stage of Trypanosoma cruzi, describing both as Schizotrypanum cruzi.
• His son Carlos Chagas Filho became an internationally recognized scientist in neurophysiology and president of the Pontifical Academy of Sciences.
• Chagas persuaded Argentine physician Salvador Mazza to research the epidemic, leading to confirmation of Trypanosoma cruzi in Argentina in 1927.