[Sword of Damocles or Russian roulette ... what everyone knows or ought to know about Chagas disease]

In 2006 the Pan American Health Organisation (PAHO) roughly estimated the prevalence of Chagas disease or American Human Trypanosomiasis, due to Trypanosoma cruzi, still to be eight million cases. The migration of people from the country into towns has resulted, in recent decades, in the urbanisation of this rural disease. Up to the mid-20th century, the epidemiology of the disease was closely linked to the extreme poverty of the peasant population and to their housing, the rancho, which offers a suitable habitat for the vectors and encourages their proliferation. A further barrier has recently been crossed with the arrival in non-endemic areas of numerous seropositive individuals. We shall draw attention in this article to the main clinical signs and to the manner of progression of the disease as well as to the problems posed by treatment of the different phases of this unique condition. It is not fanciful to describe it as resembling an adventure story, because of the place and manner of its discovery and of how the disease unfolds.