‘The Kissing Bug’ and Chagas Disease

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The Kissing Bug
A Silent Assassin - The Kissing Bug

A silent disease is spreading rapidly in the United States and other countries, claiming lives of patients but still going unnoticed. It is called the Chagas disease. Chagas disease, also known as American trypanosomiasis, is a tropical parasitic disease caused by the protozoan Trypanosoma cruzi. It is spread mostly by insects known as Triatominae or kissing bugs.

‘The kissing bug’ is a real bug. They are members of Triatominae, a subfamily of Reduviidae. They are also known as conenose bugs, kissing bugs, assassin bugs, or vampire bugs. Other local names for them used in the Latin Americas include barbeiros, vinchucas, pitos, and chinchbut.

The name may sound cute and romantic at first but wait till you know what they do. These bugs earned the name ‘kissing bugs’ because they usually bite around the thin skin of the lips or eyes. Both people and animals can be infected. The disease is not caused by the bug itself but by a parasite, the bug carries inside it. This parasite, called Trypanosoma cruzi, enters the human body through the wound caused by the bug’s bite.

After piercing the skin, the kissing bug defecates in the wound. Not too romantic now, is it! The feces of the bug carries the parasite which then enters the human bloodstream and causes the disease trypanosomiasis or the Chagas disease eventually. The parasite can also enter the human body if the wound is rubbed and feces enters the eyes or mouth of the victim.

Organ transplantation, blood transfusion, breastfeeding, and accidental laboratory exposure may also transmit the disease from one person to another. Chagas disease can also be spread congenitally from a pregnant woman to her baby through the placenta and accounts for approximately 13% of stillborn deaths in parts of Brazil.

This bug is called a silent assassin because there is no pain felt after its bite and since it usually bites people while they are asleep, patients who eventually develop the Chagas disease may never know initially if they were ever bitten by an insect.

Chagas Disease
Chagas Disease – Mode of Transmission, Symptoms, and Cause

Over the course of the infection, its symptoms keep changing. In the early stage, symptoms are typically either not present or mild, and may include fever, swollen lymph nodes, headaches, or local swelling at the site of the bite. After 8–12 weeks, individuals enter the chronic phase of the disease and in 60–70% it never produces further symptoms. The other 30 to 40% of people develop further symptoms 10 to 30 years after the initial infection, including enlargement of the ventricles of the heart in 20 to 30%, leading to heart failure. 10% of people may acquire an enlarged colon or esophagus.

Although it has gained more popularity in recent years, the Chagas disease is not a new disease. Cases were discovered as early as 1909 by the Brazilian doctor Carlos Chagas.

Currently, there is no vaccine available against Chagas disease. Prevention is generally focused on decreasing the numbers of the insect that spread it and decreasing their contact with humans. Early infections are treatable with medication but the treatment becomes less effective and more difficult if the disease has been present in a person for too long. Benznidazole or nifurtimox are currently being used to treat Chagas disease. Medication nearly always results in a cure if given early. Once Chagas disease reaches the chronic phase, medications won’t cure the disease.

The kissing bugs are mostly found in rural areas. People suffering from the disease mostly have poor living conditions. The bugs usually live inside cracks in cement or wood and in thatched roofs, in the crevices of rocks, in bushes, trees, and animal shelters. The occurrence has also been found in urban areas where living conditions are poor and unhygienic.

The disease was generally considered by many to be mild – even asymptomatic in some cases. But according to a new study published in the journal PLOS Neglected Tropical Diseases, the infection has claimed much more deaths than once believed, many of which are reportedly going unrecognized.

All of the above said, not every kissing bug is a carrier of the parasite and in such cases bite may not cause disease at all. But there is no way to know for sure therefore taking precautionary measures will keep you safe from the insect’s bite and eventually the Chagas disease.

The Kissing Bug

10 Things to Know about ‘Kissing Bugs’

In order to stay safe and prevent the Chagas disease from happening, understanding the bug and its life cycle is important. 10 facts to remember about the kissing bug are as follows:

  • The Appearance of the Bug – Kissing bugs can be recognized by their ‘cone-shaped’ head, thin antennae, and thin legs. All of the U.S. species are mainly black or very dark brown, with red, orange or yellow ‘stripes’ around the edge. Their bites are generally not painful since their goal is to bite and feed without being detected, and they are mainly active at dusk or night.
  • Protection from the Bug – Do not ever touch a kissing bug with your bare hands! The Trypanosoma cruzi parasite occurs in the feces of kissing bugs, and their bodies may be contaminated. All surfaces with which the bug came into contact should be thoroughly cleaned with a bleach solution.
Occurrence of Kissing Bugs in US
The Occurrence of the Kissing Bugs in the United States
  • The Habitat of the Bug – Triatomine or kissing bugs mostly live outdoors, but they do make their way into our homes as well. These bugs are typically found in southern Unites States, Central America, South America, Mexico, and even as far as southern Argentina.
  • Food of the Bug – Triatomines are mainly nocturnal pests which feed on the blood of vertebrates. These bugs live in close proximity to their blood host and rely on various sensory systems to locate these hosts. Kissing bugs are very sensitive to carbon dioxide exhaled by mammals (including humans), which is how the insects find their food.
  • The Lifespan of the Bug – The lifespan of the kissing bug is approximately one year in the United States with the southern species living even longer.
  • Awareness Regarding the Bug There is quite a bit of misinformation regarding kissing bug bites. Early accounts of kissing bug bites state that the bite was extremely painful and even dangerous. However, this theory has been largely proven incorrect since most patients diagnosed with the Chagas disease were unaware that they were even bitten.
  • Symptoms of the Bite – These bugs bite at night while individuals are sleeping and lead to small, raised skin lesions that swell. The swelling tissue from the bite may last up to seven days with severe reactions lasting up to a month. Additionally, those who experience severe reactions wake in the middle of the night after being bitten with an intense feeling of itchiness and difficulty breathing.
  • Chagas Disease – Due to the kissing bug’s bite, a parasite is transferred into the victim’s body. In the case of human beings, this parasite causes the Chagas disease. The incidence of this disease is increasing.
  • Treatment of Chagas Disease – It is crucial to contact a health professional immediately if bitten. Although most of the times, victims do not know they have been bitten. It is painless and asymptomatic. That is why it keeps growing inside the victim undiagnosed. Currently, benznidazole or nifurtimox is used to treat the disease only in its initial stages. If the disease has been there undiagnosed for a long time, these medicines do not work.
  • Prevention – In order to prevent infestation and contact with the insect, there are some precautionary measures that should be taken. Precautions may include sealing any cracks around walls, windows, doors, and roofs, removing wood, brush, and rock near your home, use screens on windows and doors and repair any holes, seal cracks in the attic or any crawlspaces, have your pets sleep indoors, and keep your pet’s space clean.
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