Should You Be Concerned About Chagas Disease

The name “kissing bug” conjures up some scary images. And the reality is, the bug should be scary. Triatomine insects are widespread throughout Latin American and the southern half of the United States and they like to bite around the eyes and mouth – hence the name. Not only do they steal a bit of blood when they bite, they may also leave behind a parasite called “Trypanosoma cruzi,” which can lead to Chagas disease, causing serious heart and digestive problems.

Recent reports confirm new sightings of kissing bugs in Delaware, leading to public concern about the risks and generating many questions. In this blog article, I answer the many questions around Chagas. But most importantly, I want to stress two points. First, there is no current cause for panic. A kissing bug bite that leads to Chagas is rare in this country. Nevertheless, there is growing research suggesting that particularly in Texas, there may be a small but important risk of getting Chagas disease in the U.S.

Second, there is a group of individuals in the U.S. who are at much higher risk of having Chagas disease: those who emigrated from Latin America, or who spent extended periods of time there, particularly in rural environments. Screening for Chagas is very important, particularly among women of childbearing age, because the disease can pass through the placenta. Let’s get to the details.

What is the Kissing Bug, and Who Should Be Concerned about It?

The kissing bug is a large, beetle-like critter that thrives in the mud and corrugated metal housing common in rural Latin America. While the bug has been reported in 28 states in the U.S., mostly in the southern half, it is not common. The warmer temperatures of climate change may increase the bug’s numbers, but they are relatively low at this time.

However, people in this country who have lived in Latin America should be aware of the long-term impact of a kissing bug bite. The parasite it passes along can cause Chagas disease, which affects 5.7 million people across the globe, according to the World Health Organization.

The Centers for Disease Control (CDC) estimates there are now 300,000 people living with Chagas in the U.S., with almost all of these cases contracted in other countries.

What Does the Kissing Bug Look Like, and What Do I Do if I See One?

These bugs look like beetles, are about ¾ to 1 ¼” in length, and have orange or red stripes around the body. If you see one or think you see one, do not touch it. Rather, the CDC recommends placing a jar over the bug, sliding it into the jar, and filling it with rubbing alcohol. Use bleach to clean any surface the bug touched, and contact your local health department, university or the CDC to show experts the captured bug.

How Do I Know if I’ve Been Bitten?

There is no consistent reaction to such a bug bite, and it is very possible to be bitten and not know it.

Signs and Symptoms of Chagas Disease. Is Early Diagnosis Possible and is It Important?

There are two stages of Chagas disease – the initial, acute phase and the chronic phase. In the acute phase, which may last a few weeks to a few months, people may experience mild flu-like symptoms such as fever, fatigue, body aches, headache, rash, loss of appetite, diarrhea, and vomiting, according to the CDC. Because these symptoms are similar to many other illnesses, though, most people don’t realize they have been infected with the parasite.

However, a doctor may be able to identify other signs of infection, including mild enlargement of the liver or spleen, swollen lymph nodes, or swelling at the site of the bug bite. If treated with antiparasitic medication, the Chagas infection can be eradicated. Otherwise, the parasite remains in the body for life.

That is why screening is so very important if there is a possibility of Chagas, particularly among women of childbearing age. The disease can be passed through the placenta, so a pregnant woman who has lived in or visited Latin America for more than a few months should be tested immediately.

Two recent developments have improved both the chances for early diagnosis and the treatment of Chagas disease. In 2017, the Food and Drug Administration (FDA) approved the first rapid test for Chagas and has also recently approved the use of the anti-parasitic drug, benznidazole, to treat children between the ages of two and 12. Early treatment in children can cure the disease, and treatment of women of childbearing age is associated with a dramatic reduction in the passage of the infection through the placenta.

What is the Chronic Phase of Chagas?

Decades after being infected, about 30 percent of those who have Chagas develop serious health effects, including cardiomyopathy (disease of the heart muscle), heart failure, heart rhythm problems, and strokes. Less common are disorders that affect the digestive system. Research has shown that Chagas patients who develop heart issues tend to have higher rates of arrhythmia (irregular heart rhythms) and higher death rates overall.

Cardiologists with experience in advanced heart failure and serious arrhythmias can provide treatment, but currently, there is no cure for Chagas in the chronic phase.

What’s Most Important Now?

Studies are now underway to try to better understand the link between the parasite and Chagas, and to improve treatment for patients who develop long-term health problems. The key right now is education. Our goal is to reach people from Latin America with information about their risks and to encourage them to talk with their doctors early if they develop symptoms. We are also reaching out to our physician colleagues to encourage screening when appropriate.

Public education campaigns about Chagas are common in Latin America. With our country’s growing Latin American population, my colleagues and I want to see public education and awareness increase here as well.