It is definitely feeling like summertime here in America, specifically Texas, where I live. This week, the high temperature reaches 100 degrees Fahrenheit multiple times. During these kinds of summer days, I find myself spending a lot of time outdoors recreationally exploring water holes and hiking. With all the outdoor time, I’ve also come across so many different types of bugs and contemplated how many of these bugs can cause vector-borne infectious diseases. There is one disease in particular that has been at the front of my mind after attending an insightful conference over diseases in nature last month – Chagas disease.
Chagas disease is caused by a parasite called Trypanosoma cruzi and transmitted to people and animals by insects called Triatomines, or more commonly known as “kissing bugs.” Uniquely, these vectors are only found in the Americas (mainly Latin America). The vector, or insect, can infect a person or animal when it takes a blood meal bite near a wound, mouth, eye or other mucus membrane and then deposits feces near the bite. If the human or animal rubs the infected feces into their eye or mucus membrane then the parasite will begin its life cycle, multiply and cause disease.
Chagas disease is tricky to diagnose because it causes mild to no symptoms at all and can go from an acute stage to a relatively quiet chronic stage. Fever and swelling near the bite is common in those that experience symptoms in the acute stage. In some very rare cases, people can experience inflammation of the heart or brain. After the acute stage, most will enter the chronic stage of Chagas disease. Most people will never have any other problems associated with the disease at this point. However, 20-30% can develop life-threatening medical problems associated with the chronic disease including heart rhythm abnormalities, a heart that does not pump correctly, or a dilated esophagus or colon that can cause issues with eating or passing stool. Antiparasitic treatment is recommended for all cases under the age of 50 that have not developed medical problems from the chronic stage. This treatment is typically through the drug nifurtimox or benznidazole.
Chagas diseases does not only affect humans. Dogs have been found to be significantly impacted as well if they ingest bugs or are passed the disease congenitally from their mother. Symptoms in dogs include: fever, loss of appetite, lethargy, swollen lymph nodes, liver or spleen. Many owners don’t notice these symptoms because they are similar to other diseases and resolve over time. If a dog develops a chronic infection, they can develop deadly heart disease which can result in heart failure or sudden death. Unfortunately, there is no medication that has been found to be effective for treating Chagas in dogs and no vaccine against the disease in dogs or humans.
The disease has gotten much attention in the news and public health realm as of recently. CDC deemed it a “neglected tropical disease” and has devoted time to learning more about the disease and its impact. The public health burden of the disease in the United States is uncertain because many states are not required by law to keep track of the number of confirmed cases. As immigration increases in America, specifically from Latin America to the U.S., we are seeing increasing numbers of Chagas reports. In Texas, a research group from A&M that studies kissing bugs extensively has even created a collaborative project where citizens can send in bugs to have identified and be counted for. This study emphasizes the importance of “citizen science” – where the community can contribute to the advancement of scientific research through their participation in the study by sending in insects. They even have provided an interactive map on their website that shows where kissing bugs have been submitted from in the state of Texas.
If you’re interested in seeing a picture of a kissing bug, check out this link from the Texas A&M research site. The photos are taken by Dr. Gabriel Hamer and show the kissing bugs that can be found in Texas as well as the ones found across the United States.
If you live in the Americas, keep your eyes peeled for these bugs this summer and know when to seek care. This article by USA today, hits on some places that the bug can be found including: under porches, cement, in between rock, wood or brush and in outdoor dog houses or chicken coops. If you do come across these bugs and are interested in submitting them to the Texas A&M research team, check out this link. They have a few FAQ’s and reminders on how to handle the bug. Happy summer and bug swatting season!