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A road trip in Latin America and a lifelong interest in a debilitating endemic disease

Yale Medicine Magazine, 2007 - Winter


In 1966 a young Harvard graduate with a B.A. in Romance languages and literature set out on a three-month drive through Mexico and Central America. The part-time interpreter for the U.S. Department of State never imagined that his road trip would lead to a career in medical science.

“The culture was fascinating, the poverty oppressive, and I got hooked on Latin America,” recalled Louis V. Kirchhoff, M.D. ’77, M.P.H. ’77. In 1967, determined to use his fluency in Spanish and Portuguese to improve lives, Kirchhoff, the son of a Chicago insurance agent, became the lone Peace Corps volunteer in drought-prone Apodi, a Brazilian town without running water, electricity or paved streets.

Kirchhoff set out to demonstrate that vegetables could be grown out of season—a project that would require irrigation. He rented 2.5 acres of land, then organized sharecropper families to build an irrigation system. That led to year-round crops—and income. By the early 1970s, Apodi, in the northeastern state of Rio Grande do Norte, was nicknamed the “Tomato Capital” of the westernmost region.

Despite the agricultural improvements, Kirchhoff recognized that the sharecroppers of Apodi had few options. “They had no access to education, better jobs or even birth control information,” he said. Health care consisted of two pharmacists dispensing informal diagnoses and prescription drugs.

“Everyone had parasites, so I got a book on them,” recalled Kirchhoff. That’s when he learned about Chagas disease, a major cause of morbidity and death in Latin America that is associated with poverty and a semi-arid climate. The Chagas parasite (Trypanosoma cruzi) is transmitted when infected reduviid bugs (also known as triatomine or kissing bugs for their habit of attacking the face) gorge themselves on blood drawn from sleeping people and deposit parasite-laden feces near the site of the bite wound. The parasites enter the wound when the victim scratches the bite. Chagas causes debilitating, sometimes fatal, cardiac and gastrointestinal manifestations in 10 to 30 percent of those who have it, even decades after transmission.

Convinced that infectious diseases were the biggest health problem in poor tropical regions, Kirchhoff left Brazil with a reawakened childhood career goal. His Russian-born mother had always urged him to become a doctor, one of her own criteria for success in America. He returned to school and took undergraduate as well as graduate science and epidemiology courses only to discover—at 26—rampant age discrimination at most medical schools. Fortunately, Yale admitted Kirchhoff to its M.D./M.P.H. program.

In 1976 he found himself back in Brazil because his thesis advisor, Alfred Evans, M.D., was studying links between Epstein-Barr virus (EBV) and tumors in Brazil. After a lengthy initial interview, Evans asked, “You don’t happen to speak Portuguese, do you?”

Kirchhoff spent four months in São Paulo studying a possible Hodgkin lymphoma-EBV link. Collecting and organizing data solidified Kirchhoff’s love of research and earned him Yale’s Harold Lamport Biomedical Research Prize at graduation.

After a residency in internal medicine at Michigan and a four-year fellowship at the National Institutes of Health’s National Institute of Allergy and Infectious Diseases, in 1985 he became an assistant professor at the University of Iowa College of Medicine and began studying Chagas genetics and diagnostics. Between 12 and 14 million people (including about 100,000 residents of the United States) harbor the Chagas parasite; about 25,000 die annually, typically of premature heart disease. Asymptomatic in 70 to 90 percent of cases, Chagas is easily transmitted by blood transfusion. Kirchhoff wanted to develop an accurate seriodiagnostic tool to avoid transmission of the parasite by transfusion.

His appointment in 1990 as associate professor of internal medicine, infectious diseases and epidemiology at the University of Iowa brought him nearer to his goal. “Getting tenure brought more freedom to explore less traditional avenues of academic research, in technology transfer and commercialization,” said Kirchhoff. He had already developed a radioimmune precipitation assay, still the gold standard for confirmatory testing, yet slow and complicated to use. With co-inventor Keiko Otsu, he employed recombinant DNA technology to develop chimeric antigens as the basis of a test that is accurate and easy to use.

Last year the company he founded in 1998, Goldfinch Diagnostics, signed a licensing agreement with Abbott Laboratories to use the chimeric antigens as the basis of an automated assay for screening the United States blood supply for Chagas. The assay may eventually be marketed in Latin America as well. And in September Kirchhoff received a national Tibbetts Award for the development of the chimeric antigens.

Settled in Iowa City, Kirchhoff, who is divorced, continues to attend on internal medicine and infectious disease services. His children, Alicia, 29, and Aaron, 26, are both artists. Kirchhoff’s favorite pursuits include foreign films, National Public Radio and jogging. (In June, he ran his sixth marathon—in Argentina.)

“I get an enormous sense of accomplishment thinking about what my technology may do,” Kirchhoff reflected. “When the automated assay comes to market, it will be very satisfying that I could have an original idea, bang away at it in my lab for 10 years and finally be able to more effectively protect transfusion recipients. I will be delighted.”

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