It’s estimated that millions worldwide suffer from Chagas disease, a potentially lethal parasitic illness that can remain undetected for years after the initial infection.
Among these individuals are approximately 280,000 people in the United States, according to the Centers for Disease Control and Prevention (CDC). However, unlike 21 other countries in the Americas, the disease is not officially classified as endemic to the U.S. In a report published in this month’s issue of the CDC’s Emerging Infectious Diseases journal, public health experts argued for this designation to change.
The experts stated that “increasing evidence” of the parasites responsible for Chagas disease “challenges that nonendemic label.” They noted that “kissing bugs,” capable of transmitting the parasite to humans, have been identified across 32 states. While the report acknowledged that current data were “inadequate” to confirm an increase in kissing bug populations in the U.S., it indicated that these insects are “increasingly recognized because of frequent encounters with humans” and “increased research attention.”
The experts concluded, “Labeling the United States as non–Chagas disease–endemic perpetuates low awareness and underreporting.”
If you’re unfamiliar with Chagas disease, here’s a comprehensive overview.
How is Chagas disease acquired?
The parasite Trypanosoma cruzi is the cause of Chagas disease. This parasite can be transmitted to humans by an insect known as the triatomine bug, commonly called the “kissing bug,” as per the CDC. If a kissing bug consumes blood from an animal carrying the parasite, the bug itself can become infected.
Kissing bugs typically bite people during sleep, then defecate. Their droppings deposit parasites onto a person’s skin, which can then enter the body through the eyes, mouth, or an open wound.
Chagas disease is not spread directly from person to person. Other transmission routes include consuming uncooked food contaminated with feces from infected bugs, receiving donor blood or organs from an infected individual, or being in areas with infected wild animals.
What are the symptoms?
Many individuals infected with Chagas disease exhibit no symptoms.
Those with acute Chagas disease might experience relatively mild symptoms, such as swelling at the bite site, fever, rash, and body aches, among others, which can persist for weeks or months, according to the Mayo Clinic. These symptoms usually subside over time, but without treatment, the infection can persist in the body and advance to a chronic phase.
Some individuals may develop chronic symptoms 10 to 20 years after infection, as stated by the Mayo Clinic, although the CDC indicates that many remain asymptomatic even in this chronic stage. Nevertheless, approximately 20-30% of infected individuals develop severe symptoms, including various heart problems—such as heart failure, irregular heartbeat, or even death—and digestive issues—like an enlarged esophagus or colon, which can lead to difficulties with eating or bowel movements.
Where have “kissing bugs” been found in the U.S.?
Different species of kissing bugs are most frequently found in the southern U.S. states, but they have also been identified in several Midwestern states.
According to the report in the Emerging Infectious Diseases journal, autochthonous human cases of Chagas disease—meaning infections acquired within the reporting region—have been confirmed in at least 8 states: California, Arizona, Texas, Tennessee, Louisiana, Missouri, Mississippi, and Arkansas.
How can you safeguard yourself?
Presently, there are no vaccines or medications available to prevent Chagas disease, according to the CDC.
However, the Mayo Clinic advises people in high-risk areas to take several preventative measures, including using insecticide-treated bed netting, applying insecticides to eliminate insects inside their homes, and using insect repellent on their bodies. The Mayo Clinic also recommends avoiding sleep in mud or thatch houses, as these environments are conducive to kissing bug populations.
