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Health Officials Warn Deadly Chagas Risk from Kissing Bugs Spreading North in US

Sun April 28 2019 2:20 pm  https://www.arlingtoncardinal.com/?p=576457
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POTENTIALLY DEADLY KISSING BUG COMPARED TO HARMFUL BEDBUGS AND HARMLESS STINK BUGS

Kissing bugs are blood-sucking insects that can transmit the potentially fatal Chagas disease. They are commonly found in Central and South America, though in September, the CDC warned that they had been reported in Maryland, Pennsylvania and Virginia.

Several media sources are reporting that The Centers for Disease Control is warning residents in the U.S. that the deadly “kissing bug” is moving north. Illinois is included in the list. The Kissing Bug Triatoma sanguisuga is known to be able to enter homes from outdoors through cracks.

There are no recent published accounts of any encounters or bites in Illinois. However, in Delaware a child was bitten in the face by a Kissing Bug, but fortunately the bug tested negative for the presence of the organism that causes Chagas disease.

In July 2018, a family from Kent County, Delaware reported that their daughter was bitten on the face. The Kissing Bug is known to prefer to bite children near their mouths. The family contacted the Delaware Division of Public Health (DPH) and the Delaware Department of Agriculture (DDA) to request assistance identifying the insect that had bitten their child’s face while she was watching television in her bedroom during the late evening hours.

The parents were concerned about possible disease transmission from the insect. The insect was preliminarily identified as Triatoma sanguisuga (a “kissing bug”) by staff members from DDA. Triatomines are blood-sucking insects that feed on animals and humans.

Subsequently, the insect was sent to CDC, where species-level identification was morphologically confirmed. A conventional polymerase chain reaction testing of the triatomine hindgut was negative for T. cruzi (the organism that causes potentially deadly Chagas disease).

Bloodmeal analysis detected a human bloodmeal; apparently from the Delaware girl who was bitten. She had no ill effects.

This finding represents the first confirmed identification of T. sanguisuga in Delaware.

Chagas disease, also called American trypanosomiasis, is caused by infection with the parasite Trypanosoma cruzi. The parasite is primarily transmitted to humans by triatomine bugs (commonly known as kissing bugs). Although most people infected with the parasite remain without symptoms, about 20-30 percent develop serious complications making it a significant public health concern.

Risk of Chagas Still Low in US


According to the CDC, even where the parasitic organism T. cruzi is circulating, not all triatomine bugs are infected with the parasite. Also, the likelihood of human T. cruzi infection from contact with a triatomine bug in the United States is low, even when the bug is infected, according to the CDC.

South of the United States, it is estimated that 6.6 million people — mostly in Mexico, Central America and South America — have Chagas disease as of 2015, and Chagas was estimated to result in 8,000 deaths in 2015.

Precautions to prevent house triatomine bug infestation include locating outdoor lights away from dwellings such as homes, dog kennels, and chicken coops and turning off lights that are not in use. Home owners should also remove trash, wood, and rock piles from around the home and clear out any bird and animal nests from around the home. Cracks and gaps around windows, air conditioners, walls, roofs, doors, and crawl spaces into the house should be inspected and sealed. Chimney flues should be tightly closed when not in use and screens should be used on all doors and windows. Ideally, pets should sleep indoors, especially at night, and outdoor pet resting areas kept clean. Finally, homeowners might consider using a licensed pest control professional for insect control.

Acute symptoms of Chagas include fever, fatigue, body aches, muscle pain, headache, rash, loss of appetite, diarrhea, nausea, and vomiting. The signs on physical examination can include mild enlargement of the liver or spleen, swollen glands, and local swelling (a chagoma) where the parasite entered the body.

The most recognized marker of acute Chagas disease is known as Romaña’s sign, which includes swelling of the eyelids on the side of the face near the Kissing Bug bite wound or where bug feces were deposited or accidentally rubbed into the eye. Rarely, people may die from the acute disease due to severe inflammation/infection of the heart muscle (myocarditis) or brain (meningoencephalitis). The acute phase also can be severe in people with weakened immune systems.

If symptoms develop during the acute phase, they usually resolve spontaneously within three to eight weeks in approximately 90% of individuals. Often infected people are symptom free.

The chronic stage that develops later affects the nervous system, digestive system and heart. About two-thirds of people with chronic symptoms have cardiac damage, including dilated cardiomyopathy, which causes heart rhythm abnormalities and may result in sudden death. Fatal Chagas disease cases are mostly due to heart muscle damage.

About one-third of patients in the chronic phase develop digestive system damage, resulting in dilation of the digestive tract (megacolon and megaesophagus), accompanied by severe weight loss. Swallowing difficulties (secondary achalasia) may be the first symptom of digestive disturbances and may lead to malnutrition.

About 20–50% of individuals with intestinal involvement also exhibit cardiac involvement. Up to 10% of chronically infected individuals develop neuritis that results in altered tendon reflexes and sensory impairment. Isolated cases of Chagas exhibit central nervous system involvement, including dementia, confusion, chronic encephalopathy and sensory and motor deficits.

Stink Bugs
Stink Bugs can be mistaken for Kissing Bugs because of their similar flat shape and profile. The brown marmorated stink bug (Halyomorpha halys) is common in Illinois, and it enters homes similarly the way that Kissing Bugs enter homes — via crack, attics, fireplace with open flues, etc. The Stink Bug is an agricultural pest, but does not infect humans and does not bite.

Both species are capable of flying.

Bed bugs do not look like Kissing Bugs, but they are blood suckers like Kissing Bugs. Bed bugs are not known to transmit disease, but they can cause anemia, secondary bacterial infections, anaphylaxis, asthma and annoying red spots or wheals with itching. Bed bugs don’t fly.

STINK BUGS

Entomologist Gary Hevel at the Smithsonian’s National Museum of Natural History in Washington, D.C., explains the recent invasion of brown marmorated stink bugs (stinkbug) in the U.S. and how to get rid of them.

BED BUGS

Liz Bonnin investigates an increasingly common and unwelcome guest — the bedbug. She visits Dr James Logan in his laboratory where he volunteers to let one of the little critters feast on his blood.

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