Kissing Bug Disease Chagas, Which Can Cause Sudden Heart Attack, Is Spreading In U.S.

Kissing bug disease, which causes everything from a furious, excruciating itch to a sudden stroke or deadly heart attack, is endemic in the United States, a new report said.

In other words, Chagas disease, as the parasitic illness is formally known, is here to stay, according to the report published earlier this month by the U.S. Centers for Disease Control and Prevention journal Emerging Infectious Diseases.

The findings mean that Chagas, which the World Health Organization calls “a neglected tropical disease,” could finally get surveillance, prevention and testing efforts, and research funding that U.S. experts have been calling for since the mid-20th century. Chagas disease has been reported in almost two-thirds of the country.

“We’ve all been waiting forever, all of us Chagas people have been waiting for people to recognize this disease is in our communities,” Dr. Norman Beatty, coauthor of the report, told CNN. Beatty, a clinical associate professor at the University of Florida College of Medicine’s Division of Infectious Diseases and Global Medicine, has studied Chagas for the past decade.

The Pan American Health Organization has said Chagas is endemic in 21 countries in the Americas, excluding the United States. Research has shown Chagas disease to be a leading cause of heart disease in Latin America, where it is responsible for more disability than other insect-borne infections, including malaria and Zika.

The American Heart Association said in its journal that the parasite is “responsible for the highest disease burden of any parasitic disease in the Western Hemisphere.”

According to the CDC, 20 percent to 30 percent of people infected with the kissing bug disease develop serious complications, including long-term digestive and nervous system conditions, heart failure, stroke, or death.

Here are seven things to know about kissing bugs and Chagas:

What Are Kissing Bugs?

Triatomine bugs, as they are scientifically called, are bloodsucking insects in the Reduviidae family, whose members notoriously include assassin bugs and ambush bugs. They are mostly black or dark brown, and some may have small orange or red markings. Adults can fly, and measure about an inch long.

According to citizen science research coordinated by Texas A&M University, 50 percent of kissing bugs tested were infected with the Chagas parasite, Trypanosoma cruzi.

Once infected, kissing bugs carry the T. cruzi parasite in their guts, then pass it on in their feces. Some types of kissing bug — at least 11 types of kissing bugs have been identified in the United States — defecate while they are feeding, typically while a person is sleeping.

Why Are They Called Kissing Bugs?

Triatomine and other conenose bugs can’t bite through clothing, so their blood meals primarily take place on the tender areas of the face, which is why they’re called kissing bugs.

Other sites of attack, in order of decreasing frequency, are the hands, arms, feet, head and trunk, according to the Texas A&M AgriLife Extension.

People usually don’t know they’ve been bitten until the following morning, when they notice unexplained reddened areas on the skin of their faces and arms.

Where Have Kissing Bugs Been Reported?

These mostly nocturnal bloodsucking parasites have been found in 32 states, mostly in the southern U.S., but as far north as Pennsylvania and New Jersey, according to the CDC.

How Many People Have Chagas?

Experts estimate that about 300,000 people in the United States have been infected by the parasite transmitted by the kissing bug, but only about 2 percent of them are aware of it.

Antiparasitic medications such as benznidazole and nifurtimox are nearly 100 percent effective at curing the disease when started early in the acute phase of infection. For people with chronic infection, these medications can slow the progression of heart damage, although they may not cure the infection in this stage.

Chagas disease can remain silent for years.

“Most people living with Chagas disease are unaware of their diagnosis, often until it’s too late to have effective treatment,” according to Dr. Judith Currier, chief of infectious diseases at UCLA Health.

The itch from kissing bug bites can be excruciating. It varies from person to person, ranging from none at all to severe, and can last for a week or longer. While some people experience only mild itchiness or swelling, others may have a strong allergic reaction, leading to welts or hives.

When the person who is bitten scratches the itchy bite, they rub the parasite into the wound, which is how it enters the bloodstream, according to Shaun Yang, a professor of clinical microbiology at the David Geffen School of Medicine at UCLA.

Where Do Kissing Bugs Hide?

Kissing bugs are found in a variety of outdoor settings, including:

• Beneath porches;
• Between rocky structures;
• Under cement;
• In rock, wood, brush piles, or beneath bark;
• In rodent nests or animal burrows;
• In outdoor dog houses or kennels; and
• In chicken coops or houses.

In the U.S., most indoor structures are built with plastered walls and sealed entryways to prevent insect and vermin infestations. However, the CDC says some immature stages of the bug (wingless, smaller nymphs) inside may be an indication of infestation. When the bugs are found inside, they are likely to be in one of the following settings:

• Near pet resting areas;
• In areas of rodent infestation;
• In and around beds and bedrooms, especially under or near mattresses or nightstands.

What Can Be Done About Them?

If you find a kissing bug in your home, don’t touch it with your bare hands. Instead, use a glove or small plastic bag to collect the bug, Texas A&M extension specialists advise.

To kill the bug and any parasite it may be carrying, put it in the freezer for a few hours or set the container outside in the sun until the bug dies.

“Roach hotels” or other bait formulations do not work against triatomine bugs.

Few pesticides are labeled for use against the bugs, but products intended for indoor use against indoor pests. For best results, choose a pyrethroid insecticide: permethrin, bifenthrin, cyfluthrin, esfenvalerate or lambda cyhalothrin, Texas A&M Extension says.

If insecticides are used, treat room corners and edges, window and door frames, pet houses, and other suspected entry points.

The CDC advises a licensed pest-control operator should be consulted by those considering the use of insecticides. Also, long-lasting insecticide-treated bed nets and curtains have been shown to kill these bugs.

Other precautions to prevent house infestation include:

• Sealing cracks and gaps around windows, walls, roofs, and doors;
• Removing wood, brush, and rock piles near your house;
• Using screens on doors and windows and repairing any holes or tears;
• If possible, make sure yard lights are not close to your house (lights can attract the bugs);
• Sealing holes and cracks leading to the attic, crawl spaces below the house, and to the outside;
• Having pets sleep indoors, especially at night;
• Keeping your house and any outdoor pet resting areas clean, in addition to periodically checking both areas for the presence of bugs.

Are Look-Alikes Dangerous, Too?

There are multiple look-alikes, including some non-triatomine reduviid bugs, that don’t feed on human blood. They include the wheel bug and the western corsair.
Neither is especially dangerous to humans, but both deliver painful bites that can cause pain, swelling and numbness. Wheel bug bites are known to be intensely painful with effects lasting longer than a wasp sting, while western corsair bites are milder and less painful.

They’re not vectors of parasitic diseases, and are generally considered to be beneficial predators that feed on other bugs.

Some plant-feeding bugs, such as the leaf-footed bug, also resemble the triatomine. If you are unsure if the bug you’ve found is a triatomine, you may wish to consult with an expert, such as an entomologist, for clarification.

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