The Deadly ‘Kissing Bug’ Disease Has Quietly Spread Across the U.S. What Is It?

Millions of people around the world are estimated to have Chagas disease, a potentially fatal, parasitic illness that can lie dormant for years after the initial infection. Some 280,000 people in the U.S. are among them, according to the Centers for Disease Control and Prevention (CDC), but the disease is not officially considered endemic to the country like it is in 21 others in the Americas. Public health experts argued in a report published in this month’s issue of the Centers for Disease Control and Prevention’s (CDC) Emerging Infectious Diseases journal that it should be. “Increasing evidence” of the parasites that cause Chagas disease “challenges that nonendemic label,” the experts wrote, noting that “kissing bugs,” which can transmit the parasite to humans, have been identified in 32 states. The report acknowledged that data were “inadequate” to prove that the presence of the kissing bugs is increasing in the U.S., but said that the bugs are “increasingly recognized because of frequent encounters with humans” and “increased research attention.” “Labeling the United States as non–Chagas disease–endemic perpetuates low awareness and underreporting,” the experts wrote. You may never have heard about Chagas disease before. Here’s everything you need to know about it. How do you get Chagas disease? Chagas disease is caused by the parasite Trypanosoma cruzi. The parasite can be spread to a person from an insect called the triatomine bug, more colloquially known as the “kissing bug,” according to the Mayo Clinic. If a kissing bug ingests blood from an animal infected with the parasite, then the bug can also become infected with it. Kissing bugs generally bite people while they sleep, and then defecate. Their feces leave parasites on a person’s skin, and the parasites can go into a person’s body via the eyes, mouth, or an open wound. Chagas disease doesn’t spread from person to person, but other sources of infection can come from eating uncooked food that has stool from bugs infected with the parasite, getting donor blood or a donor organ from an individual who was infected with the parasite, or being in a place where there are wild animals infected with the parasite. What are the symptoms? Many people who have been infected don’t have any symptoms. People with Chagas disease can have acute illness, and may experience relatively mild symptoms that can last for weeks or months, including swelling at the infection site, fever, rash, and body aches, among others, according to the Mayo Clinic. These symptoms generally dissipate over time, but if the infection isn’t treated, the disease can linger in the body and even progress to a chronic phase.  Some people may experience chronic symptoms 10 to 20 years after becoming infected, according to the Mayo Clinic, though the CDC notes that many people don’t experience symptoms even while in the chronic phase. But roughly 20-30% of people who are infected develop severe symptoms, including a range of heart issues—such as heart failure, irregular heartbeat, or even death—and digestive issues—such as an enlarged esophagus or colon, which could cause problems with eating or going to the bathroom. Where in the U.S. have “kissing bugs” been detected? Various species of kissing bugs are most commonly found in states in the southern part of the U.S., but have also been identified in several midwestern states.  Autochthonous human cases of Chagas disease, meaning infections that were acquired in the same region where the cases were reported, have been confirmed in at least 8 states: California, Arizona, Texas, Tennessee, Louisiana, Missouri, Mississippi, and Arkansas, according to the report in the Emerging Infectious Diseases journal. How can you protect yourself? At the moment, there are no vaccines or drugs that can prevent someone from getting Chagas disease, according to the CDC.  But the Mayo Clinic recommends that people living in high-risk places take a number of steps to protect themselves, including using netting with insecticide over their bed, using insecticides to kill insects inside their home, and using insect repellent on their body. The Mayo Clinic also advises that people avoid sleeping in a mud or thatch house, since kissing bugs thrive in those environments.