On the front lines of Chagas disease
UF medical student Rodrigo Alcala-Arana tackles a silent killer across two continents
Photo courtesy of Rodrigo Alacala-Arana
Sept. 18, 2024 — Growing up in the small, coastal town of Puerto La Cruz, Venezuela, first-year University of Florida College of Medicine student Rodrigo Alcala-Arana was surrounded by kind neighbors, delicious fried fish, and lots of dancing.
He enjoyed spending time outdoors, learning to spearfish and playing on his family’s farm, where el chipo – a triatomine insect often referred to as a “kissing bug” in English – was common.
But the vibrant city was also home to a deadly and neglected tropical disease, caused by the parasite Trypanosoma cruzi and spread through the feces of these kissing bugs. Chagas disease, named after the Brazilian Dr. Carlos Chagas who identified the ailment in 1909, could often go unnoticed for years.
A photo of a Triatoma sanguisuga insect, a species of kissing bug common throughout the southeastern U.S. that can vector Chagas disease.
Photo courtesy of Norman Beatty, M.D.
Roughly 6 to 7 million people are now estimated to have Chagas disease worldwide, according to the World Health Organization, and increasing numbers of Floridians are experiencing its effects. By the time serious complications appear from the disease, like congestive heart failure and chronic inflammation, the odds of survival are diminished.
“Growing up, it was this random bug that bit you, your heart got big, and you just died,” Alcala-Arana said.
After witnessing the lack of awareness about Chagas disease abroad and watching people needlessly die from it, Alcala-Arana was moved to make a change. He has dedicated much of his time at UF to conducting research with his mentors and helping educate the public about the disease – a path that could potentially save lives all over the world.
Raising awareness
The Alcala-Arana family.
Photo courtesy of Rodrigo Alacala-Arana
In Puerto La Cruz, access to health care was limited and the nearest major hospital was hours away, Alcala-Arana said. People there recognized el chipo, but they did not have the scientific knowledge or access to timely medical intervention to treat Chagas disease. And often, people with the fewest resources were most at risk.
“Because of their socioeconomic situation, a lot of people face circumstances that are really difficult,” Alcala-Arana said.
Kissing bugs can more easily enter households with thatched roofs or adobe architecture – frequent features of lower-income homes. Standard bug spray does not repel el chipo. The insects can be blocked by mosquito nets, but only if people can afford to buy them.
Alcala-Arana’s family faced these challenges, and he lost a beloved relative to Chagas disease before moving to Florida in 2013 with his parents and two younger siblings to escape the political instability in Venezuela.
He soon learned that Chagas disease is as much of a threat to South America as it is to Florida. It is estimated that more than 18,000 Floridians already have chronic Chagas disease.
And the nocturnal bugs that spread Chagas disease aren’t just waiting for unlucky campers in the woods. UF researchers like Norman L. Beatty, M.D., an assistant professor in the College of Medicine’s Division of Infectious Diseases and Global Medicine, have found el chipo in foliage and wood piles at the edge of residential properties in Florida.
The insects venture inside homes at night to bite occupants on the arms, legs, and face for quick blood meals. The bugs leave behind feces that can spread parasites when people either ingest contaminated food and drinks or accidentally smear the matter into bite sites or open wounds.
Serving the community
For the past five years, Alcala-Arana has worked alongside Beatty and his team at the UF Chagas Disease Program to combat these critters. In addition to tracking kissing bugs throughout Florida, Beatty and Alcala-Arana have been collaborating with multidisciplinary researchers at UF to educate and routinely screen Floridians for Chagas disease.
Through free community health care services like the Mobile Outreach Clinic, the Equal Access Clinic Network, the Emerging Pathogens Institute, and extension events with the UF Institute of Food and Agricultural Sciences, the researchers have been able to reach people all around the state. They have connected closely with Florida’s large population of Latin American immigrants, as these individuals have a higher prevalence of Chagas disease.
Norman L. Beatty, M.D.
Alcala-Arana first crossed paths with Beatty while he was an undergraduate volunteer with the Equal Access Clinic Network, helping to translate medical information for Spanish-speaking patients while Beatty worked as the attending clinic physician. At the time, Alcala-Arana was already researching Chagas disease treatments with Simon Lopez D’Sola, Ph.D., an assistant professor of chemistry in the UF College of Liberal Arts and Sciences.
“I really found his enthusiasm to care for others and his passion for his community palpable, and I immediately invited him to join our new research project,” Beatty said about Alcala-Arana. “We have continued to work together since that day. Rodrigo is forward-thinking, which allows us to make significant changes in health care and to help all populations with diseases we are tackling. It’s been a pleasure to mentor him through undergrad and now as a new medical student here at the University of Florida.”
Norman Beatty, M.D., FACP, left, and Rodrigo Alcala-Arana, center, on a research trip in Boyacá, Colombia, with Bernardo Peniche, right, a doctoral student from the University of California, Berkeley. They studied Chagas disease in rural populations affected by “kissing bugs” that had invaded their homes.
For Alcala-Arana, who always dreamed of becoming a doctor, putting in more than 2,000 hours of work as a clinical research coordinator for the UF Chagas Disease Program has been a gratifying opportunity.
He has been able to help others who have gone through experiences similar to that of himself and his family, such as immigrating to another country, learning English, and working multiple jobs to support loved ones while still struggling to afford health care.
Through this research, he has also been able to return to South America and aid communities affected by Chagas disease in Colombia. The research team hopes to establish a medical student exchange program between UF and the University of Antioquia in Medellín, Colombia, for future collaboration.
Photo courtesy of Rodrigo Alacala-Arana
Making an impact
Thanks to the work of individuals like Alcala-Arana and Beatty, the UF Chagas Disease Program continues to grow, helping to save lives around Florida and the world.
The researchers have found the parasite that causes Chagas throughout most of the state and in about 30% of the kissing bugs they have surveyed, Beatty said. Florida wildlife also has a high prevalence of infection, and the team recently isolated the first canine case of Chagas in the state.
With the support of a 2024 UF Research Opportunity Seed Fund award, the team will move into another phase of research and continue to screen patients from Latin America for possible chronic Chagas disease.
Beatty and Alcala-Arana were recently featured alongside Jessica Portillo Romero, M.D., an assistant professor in the UF College of Medicine’s Division of General Internal Medicine, in the short film “The Kissing Bug Doctors of Florida.” The film was part of the Drugs for Neglected Diseases initiative – an international nonprofit founded by Doctors Without Borders, the World Health Organization Special Programme for Research and Training in Tropical Diseases, and other global health organizations.
“One of the biggest things is putting Chagas disease out there and raising awareness so we can continue to help,” Alcala-Arana said. “With more people, more resources, more time, more skills, and more services that can be provided, you can make a bigger impact.”
Photo courtesy of Rodrigo Alcala-Arana
Outside of Chagas research, Alcala-Arana is devoting time in his first year of medical school to exploring different specialties, and he hopes to become a student officer with the Equal Access Clinic Network. He has also worked as a tutor and as a pediatric phlebotomist at UF Health Shands Hospital.
“UF does a good job of picking not only very bright and intelligent people, but also very kind people,” Alcala-Arana said. “It has been such a blessing to be with people from different backgrounds and different skills. Everybody wants to support each other and take care of each other. UF is my home. This is definitely an institution where people like me can make it and follow their dreams.”
