- Chagas disease, also known as “kissing bug” disease, has become endemic in the U.S.
- The condition has been found as far north as Pennsylvania.
- If untreated, Chagas disease can be lethal.
A once-central and South American disease, Chagas has now made its way into the United States. According to a recent report from the Centers for Disease Control and Prevention (CDC), Chagas disease has been identified in 32 states.
This disease, caused by a parasite found in the droppings of the triatomine bug, poses serious heart risks if not diagnosed in time. Since it’s not traditionally prevalent in the U.S. and can often show no symptoms, diagnosing it is quite challenging. “If this is contracted in the U.S., Chagas disease isn’t usually on anyone’s radar,” states Thomas Russo, M.D., a professor and chief of infectious disease at the University at Buffalo in New York.
Here’s more information about where these “kissing bugs” have been found and how to identify Chagas disease.
Where has Chagas disease spread in the U.S.?
The CDC’s new report refers to Chagas disease as “endemic,” indicating its regular occurrence in the U.S. Human infections have been noted in the following states:
- Arizona
- Arkansas
- California
- Louisiana
- Mississippi
- Missouri
- Tennessee
- Texas
Additionally, the disease has been found in animals in these states:
- Alabama
- Florida
- Georgia
- Kentucky
- Maryland
- Nebraska
- New Mexico
- North Carolina
- Oklahoma
- South Carolina
- Virginia
Triatomine bugs have been spotted in 32 states, reaching as far north as Pennsylvania and Wyoming. However, they are primarily found in the southern U.S. “Some areas seem worse off due to the species of bugs present,” notes Norman L. Beatty, M.D., an infectious disease expert and lead author of the CDC report. “Certain species seek out hosts for blood meals—I mean, that could be your pets or even you.”
What is Chagas disease and how does it spread?
Chagas disease is triggered by the parasite Trypanosoma cruzi and typically spreads through contact with the triatomine bugs, as per the CDC. The kissing bug feasts on the blood of animals and humans, then transmits the parasite through its feces.
“It’s not the bite itself that spreads infection,” explains Dr. Russo. “They defecate while feeding. If the site of the bite gets scratched, the feces can enter the wound.” He adds that transmission can also occur if the droppings come into contact with the eyes or mouth.
Chagas disease symptoms
Chagas disease has two phases: acute and chronic. The acute phase occurs in the weeks or months following infection. Some may not show any symptoms, while others could experience:
- Fever
- Fatigue
- Body aches
- Headache
- Rash
- Loss of appetite
- Diarrhea
- Vomiting
- Swelling around the eyelids
Typically, individuals don’t show symptoms in the chronic phase. However, up to 30% of those infected could develop serious health concerns, including:
- Heart problems: enlarged heart, heart failure, irregular heart rhythms, or sudden death
- Digestive issues: enlarged esophagus or colon, leading to difficulties with eating or bowel movements
Why is Chagas disease deadly?
The chronic phase is the danger zone, according to Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. “The serious concern lies in how Chagas affects the heart during this phase.” Dr. Russo adds that individuals may face strokes or issues with their central nervous system during this stage. “The morbidity and mortality are significantly associated with the chronic phase,” he states.
Estimates suggest that around 280,000 individuals in the U.S. have undiagnosed Chagas disease.
What to do if you spot a kissing bug
Kissing bugs measure about ½ inch to an inch long, according to Jody Gangloff-Kaufmann, Ph.D., an expert in urban pest management. They can be dark brown or black with reddish or orange markings, featuring an hourglass shape with a wider abdomen than thorax, and a long, cone-shaped head.
According to Dr. Beatty, adult kissing bugs can be mistaken for various insects known as “assassin bugs.” They exhibit a “cone-nose” appearance, two prominent compound eyes, and a straight blood-sucking straw that remains tucked under the head when not feeding, unlike most assassin bugs that have a curved straw. “Also, it’s rare to see kissing bugs during the day,” he points out.
Typically nocturnal, kissing bugs are drawn to light, as noted by the Texas Department of State Health Services. If you spot one outside, it’s best to keep your distance. Should you encounter a kissing bug indoors, you can capture it in a jar and freeze it or crush it—though it’s crucial to avoid contact with the insides. “The risk of catching Chagas disease is low, particularly in southern states, but still exists,” she warns. Dr. Beatty notes that commercial pesticides are generally effective against these bugs.
Thoroughly clean any areas where the bug may have been with a bleach-and-water solution (10% bleach to 90% water), as advised by the TDSHS.
To prevent kissing bugs from entering your home, Gangloff-Kaufmann suggests sealing gaps around doors, windows, and any openings for wires and pipes.
Chagas disease treatment
While anti-parasitic treatments for Chagas do exist, Dr. Russo emphasizes their effectiveness is greatest when administered early. The medications benznidazole and nifurtimox are commonly used. Beyond that, doctors generally focus on managing symptoms, according to Dr. Adalja.
“The further north you go, the less prevalent this bug tends to be,” Dr. Russo observes. “However, with ongoing climate change, we could see cases surface in more regions.”
