The Hidden Threat: The Kissing Bug

bugcut-2400

These seven tropical diseases are closer to home than you think. Lurking in your Dallas-area backyard is Chagas disease, caused by a parasite that infects more than 300,000 Americans. The disease can cause heart failure and death in humans and dogs and is often missed by doctors.

Or maybe you live near a typhus hot spot such as Houston? Spread by rat-biting fleas, typhus causes headaches, fever, chills and a rash.

Farther north, close to the Oklahoma border, Texans have been plagued by skin boils and sores caused by a disease called leishmaniasis — also known as the Baghdad boil. Many have suffered for years because doctors have misdiagnosed them with staph infections and given them the wrong treatment.

You’ve already heard of West Nile virus, another tropical disease that has strong-armed its way into Texas. West Nile virus has infected close to 5,000 Texans since 2002. But the real number of humans infected is probably 25,000, since about 80 percent of people who are infected don’t show symptoms.

Now get ready to meet two new tropical diseases on their way to you. Dengue and chikungunya are viruses spread by mosquitoes. Common in the Caribbean and South America, they’re being lured to the U.S. by a combination of rising temperatures and poverty.

Don’t expect your doctor to save you from these tropical diseases. Medical students spend a few days learning about this group of infections, and studies show that many health care providers in Texas and the U.S. are unaware that these infections are here or on their way.

Americans living with diseases such as Chagas can go undiagnosed for many years, by which time the infection can cause irreversible damage to the heart.

Dr. Seema Yasmin’s reporting on this project was undertaken while she was a National Health Journalism Fellow at the University of Southern California’s Center for Health Journalism. Yasmin, a physician and former CDC epidemiologist, is a professor at the University of Texas at Dallas.

Not just tropical

Kissing Bug

Chagas disease

About: A parasite spread by the blood-sucking kissing bug — so-called because the bug likes to bite us on the face around the lips and eyes. Kissing bugs poop where they eat, and when we scratch the bite, we rub the poop and the parasite into our skin. About a third of people infected with the parasite, called Trypanosoma cruzi, develop heart disease. One in 10 suffer digestive or nerve issues.

 

Spread by: The dime-sized kissing bug, which lives in rats’ nests and wood piles and in the nooks of furniture and cracks in homes.

 

Symptoms: Swollen eyelids, breathing problems, chest pain, heart failure, death.

 

Testing: Blood test.

Treatment: Anti-parasitic drugs that can be 60 percent to 85 percent effective if given early.

 

Illustrations by Troy Oxford/The Dallas Morning News

Report: The bed bug has become insecticide resistant

Not picky: Head lice along with bedbugs are becoming tough to exterminate.

Not picky: Head lice along with bedbugs are becoming tough to exterminate.

Did you hear about the two bed bugs that met in the mattress? They were married in the spring.

It’s an Ellen DeGeneres joke but if you have ever been a victim of cimex lectularius and rows of terrible itching bites you’ll know it’s no laughing matter.

A new study to be published early in the new year conducted by the Department of Medical Entomology, Westmead Hospital and the University of Sydney reveals that the common bed bug in NSW has developed resistance to insecticides.

Report co-author Cameron Webb, medical entomologist with University of Sydney and NSW Health Pathology, says bed bugs don’t discriminate about where they set up residence and that includes some top Sydney hotels.

“It doesn’t matter to the bed bug whether it is a five star hotel or a backpacker’s hostel, they still arrive in people’s belongings and set up camp,” he said. “The financial implications are far greater for the five star hotel.

“We know there has been evidence of a resurgence in bed bugs over the last decade and this paper shows that the local Sydney strains are resistant to insecticides which explains that resurgence.”

The research compared the Sydney strain to a strain susceptible to insecticides. The study found that to exterminate the Sydney bed bug compared to the susceptible strain it required 250 times as much of the insecticide bendiocarb, 370,000 times as much deltamethrin and 1,235 million times as much permethrin.

It concluded: “The inability to control bed bugs with existing products and insecticides will necessitate a reconsideration of control methodologies and product registration processes employed against this resurgent pest. This research has significant operational implications for bed bug control and the registration process of new products in Australia.”

Mr Webb said a similar problem existed with head lice with reports that they are also gaining resistance to some of the commonly used insecticides but more research was needed.

“When you are using products that contain an insecticide it provides an opportunity for insecticide resistance to develop inside the headlice populations,” he said.

NSW Health advice is to put a conditioner on the hair and comb it with a headlice comb but he said it was easy to miss eggs and for the condition to spread in schools, especially in young girls.

The bed bug resurgence is also happening in the US and features in a book Unnatural Selection just published here by Emily Monosson an American environmental toxicologist.

She says antibiotics, pesticides and pollution are all exerting intense selection pressure on all manner of things including gonorrhea (new strains are more easily spread and resist treatment even with strong antibiotics) as well as bed bugs, different varieties of flu, and weeds in agriculture showing resistance to pesticides.

She writes of bed bugs “We almost had them beat only to face a pest that has managed to regroup and return with better defenses. Yet even those pests we wish to eradicate persist, too many others never slated for destruction – bees, damsel flies, frogs and songbirds –face extermination, if not extinction.”

“We live in dangerous times with infectious diseases rapidly evolving beyond our medical reach returning us to a pre-antibiotic age.”

“We beat life back with our drugs, pesticides and pollutants, but life responds. It evolves.”

In the US she says seven million pounds of antibiotics are tossed used. The appetite in Australia is similar. The National Antimicrobial Prescribing Survey released in November found 30 per cent of prescriptions were deemed to be inappropriate mainly due to unnecessary use of antimicrobials and incorrect duration of treatment.

Data on the amount of pesticides used in Australia is not publicly available.

Sydney ~Tim Barlass~ December 28, 2014

no_spray

Links between Pyrethroids and Childhood Brain Cancers – Medical Studies Indicating Health Hazards from Pyrethroid Pesticides

Sumithrin (Anvil), resmethrin (Scourge) and permethrin (often used in household bug sprays) each belong to a class of pesticides known as pyrethroids. Sumithrin and resmethrin were not among the pyrethroids specifically studied in all medical studies reported on this page, but these pesticides are closely related to each other.

Links between pyrethroids and breast cancer

Several studies indicate pyrethroids disrupt the endocrine system by mimicking the effects of the female hormone estrogen. This in turn can cause breast cancer in women and lowered sperm counts in men. When estrogen levels are elevated, old cells are not removed from the body and cell proliferation occurs, whether benign or malignant.
Mount Sinai School of Medicine: This study examined four pyrethroid pesticides, including sumithrin. It concludes “Overall, our studies imply that each pyrethroid compound is unique in its ability to influence several cellular pathways. These findings suggest that pyrethroids should be considered to be hormone disruptors, and their potential to affect endocrine function in humans and wildlife should be investigated.” [Environmental Health Perspectives, vol. 107, no. 3, March 1999, pages 173-177.]
The Roger Williams General Hospital, Brown University: This study on pyrethroids concludes “Chronic exposure of humans or animals to pesticides containing these compounds may result in disturbances in endocrine effects.” [Journal of Steroid Biochemistry, March 1990, volume 35, issue 3-4, pages 409-414.]
Cambridge University: A report issued in June 2000 by the Royal Society in England and written by a group from Cambridge University called for international cooperation to deal with the dangers posed by endocrine-disrupting chemicals, including pyrethroids, and recommends reducing human exposure to these chemicals.

Links between insecticides and testosterone decreases

University of Greifswald: Several pesticides used as herbicides, insecticides and fungicides known to be endocrine disrupting chemicals were examined in this series of German studies. Acute and chronic pesticide exposure led to changes in sex hormone concentrations, with concentrations of testosterone decreasing one day after acute exposure. These studies found “a hormonal and immune suppression after acute exposure.” [“Disruption of male sex hormones with regard to pesticides,” Toxicology Letters, June 30, 1999;107(1-3):225-31 ]

Links between pyrethroids and childhood brain cancers

A study of pesticides and childhood brain cancers has revealed a strong relationship between brain cancers and compounds used to kill fleas and ticks, according to a report published in Environmental Health Perspectives. The study concludes “The specific chemicals associated with children’s brain cancers were pyrethrins and pyrethroids (which are synthetic pyrethrins, such as permethrin, tetramethrin, allethrin, resmethrin and fenvalerate) and chlorpyrifos (trade name: Dursban).” [Janice M. Pogoda and Susan Preston-Martin, “Household Pesticides and Risk of Pediatric Brain Tumors,” Environmental Health Perspectives, vol. 105, no. 11 (November 1997), pages 1214-1220.] The EPA, in June 2000, halted sales of Dursban.

Links between pyrethroids and neurological damage

Several studies have indicated neurological damage resulting from exposure to pyrethroids, and some of the damages have been found to be long term.
Ludwig Maximilians University: This study, conducted by the Physiological Institute at Ludwig Maximilians University in Munich, Germany, found that although “a majority of complaints following an acute pyrethroid intoxication disappeared after the end of exposure,” several effects were still seen in patients after more than two years. Among these long-term symptoms were “(1) cerebro-organic disorders (reduced intellectual performance with 20%-30% reduction of endurance during mental work, personality disorder), visual disturbances, dysacousia, tinnitus; (2) sensomotor-polyneuropathy, most frequently in the lower legs; (3) vegetative nervous disorders,” including increased heat-sensitivity and reduced exercise tolerance due to circulatory disorder. The study concludes “Many of these patients exhibit pathological autoimmune diagnostical findings and developed autoimmune diseases.” [Toxicology Letters, 1999 June 30;107(1-3):161-76.]
Uppsala University: This study, conducted by the Department of Environmental Toxicology at Uppsala University in Sweden studied mice, not humans, but found that “low-dose exposure” to pyrethroids “resulted in ³irreversible changes in adult brain function in the mouse” when exposed during the growth period. This occurred at levels of exposure less than what was found to affect adult mice. The study also found “neonatal exposure to a low dose of a neurotoxic agent can lead to an increased susceptibility in adults to an agent having a similar neurotoxic action, resulting in additional behavioral disturbances and learning disabilities.” [Neurotoxicology, 1997;18(3):719-26.]
Northwestern University Medical School: A series of investigations conducted at Northwestern’s Department of Molecular Pharmacology and Biological Chemistry in Chicago, has found neurological damage from pyrethroids. One study, conducted by international expert Toshio Narahashi, finds nervous-system damage from pyrethroids to be comparable to DDT. This study found that “Detailed voltage clamp and patch clamp analyses have revealed that pyrethroids and DDT modify the sodium channel to remain open for an extended period of time.” The result of this damage is “potent effects on the nervous system.” [“Nerve membrane ion channels as the target site of environmental toxicants,” Environmental Health Perspectives,1987 April;71:25-9.]. A separate study found that pyrethroids cause “membrane depolarization, repetitive discharges and synaptic disturbances leading to hyperexcitatory symptoms of poisoning in animals.” This study found that only 1% “of sodium channel population is required to be modified by pyrethroids to produce severe hyperexcitatory symptoms.” [“Neuronal ion channels as the target sites of insecticides,” Pharmacol Toxicology, 1996 July;79(1):1-14.]

Links between pyrethroids and thyroid damage

A study conducted by four scientists on a variety of pesticides found a connection to thyroid damage, although this study was conducted on rats and not on humans. The study concludes “exposure to organochlorine, organophosphorus, and pyrethroid insecticides for a relatively short time can suppress thyroid secretory activity in young adult rats.” The study also said a decrease in body weight seen “suggests that pyrethroid insecticides can inhibit growth rate.” [Journal of Applied Toxicology, vol. 16, no. 5, pages 397-400, 26 references, 1996.]
No Spray Coalition Inc.
Hotline (718) 670-7110   €   http://www.nospray.org   €   P.O. Box 334, Peck Slip Station, New York, NY 10272-0334

The No Spray Coalition is the lead plaintiff in a lawsuit filed in federal court against the City of New York seeking a permanent halt to mass pesticide spraying. For more information, please email us at: mitchelcohen@mindspring.com, pdolack@gis.net or afrime2@aol.com.

Penn Study Shows Bed Bugs Can Transmit Parasite that Causes Chagas Disease

Penn_Medicine

Like the “Kissing” Bug, Bed Bugs Can Transmit Deadly Parasite Via Feces

PHILADELPHIA — The bed bug may be just as dangerous as its sinister cousin, the triatomine, or “kissing” bug. A new study from Penn Medicine researchers in the Center for Clinical Epidemiology and Biostatistics demonstrated that bed bugs, like the triatomines, can transmit Trypanosoma cruzi, the parasite that causes Chagas disease, one of the most prevalent and deadly diseases in the Americas.

In a study published online this week in the American Journal of Tropical Medicine and Hygiene, senior author Michael Z. Levy, PhD, assistant professor in the department of Biostatistics and Epidemiology at the University of Pennsylvania’s Perelman School of Medicine, and researchers at the Universidad Peruana Cayetano Heredia in Peru conducted a series of laboratory experiments that demonstrated bi-directional transmission of T. cruzi between mice and bed bugs.

In the first experiment run at the Zoonotic Disease Research Center in Arequipa, Peru, the researchers exposed 10 mice infected with the parasite to 20 uninfected bed bugs every three days for a month. Of about 2,000 bed bugs used in the experiment, the majority acquired T. cruzi after feeding on the mice.  In a separate experiment to test transmission from bug to mouse, they found that 9 out of 12 (75 percent) uninfected mice acquired the parasite after each one lived for 30 days with 20 infected bed bugs.

In a third experiment, investigators succeeded in infecting mice by placing feces of infected bed bugs on the animal’s skin that had either been inflamed by bed bug bites, or scraped with a needle. Four out of 10 mice (40 percent) acquired the parasite by this manner; 1 out of 5 (20 percent) were infected when the skin was broken by the insect’s bites only. A final experiment performed at the Penn bed bug lab in Philadelphia demonstrated that bed bugs, like triatomines, defecate when they feed.

“We’ve shown that the bed bug can acquire and transmit the parasite. Our next step is to determine whether they are, or will become, an important player in the epidemiology of Chagas disease,” Levy said. “There are some reasons to worry—bed bugs have more frequent contact with people than kissing bugs, and there are more of them in infested houses, giving them ample opportunity to transmit the parasite. But perhaps there is something important we don’t yet understand about them that mitigates the threat.”

T. cruzi is also especially at home in the guts of bed bugs.  “I’ve never seen so many parasites in an insect,” said Renzo Salazar, a biologist at the Universidad Peruana Cayetano Heredia and co-author on the study. “I expected a scenario with very low infection, but we found many parasites—they really replicate well in the gut of the bed bugs.”

Wicked Cousins

Bed bugs and kissing bugs are distant cousins but share many striking similarities. Both insects hide in household cracks and crevices waiting for nightfall and the opportunity to feed on sleeping hosts. They are from the same order of insects (Hemiptera) and both only feed on blood.  (One main difference is their size: kissing bugs are five times as big as a bed bug). With so much in common, it seemed logical to the authors that the kissing bug’s most infamous trait, the transmission of T. cruzi, is also shared by the bed bug.

Other investigators have shared this suspicion. In 1912, just three years after Carlos Chagas described the transmission of the disease by kissing bugs, French parasitologist Émile Brumpt recounted that he had infected almost 100 bed bugs exposed to an infectious mouse, and then used them to infect two healthy mice. Decades later an Argentine group replicated his work.  These experiments, largely ignored during the recent bed bug resurgence, missed one key point.

“Mice can hunt and eat bed bugs,” said Ricardo Castillo-Neyra, DVM, PhD, coauthor and postdoctoral fellow at the Universidad Peruana Cayetano Heredia and Penn. “The older studies were almost certainly only documenting oral transmission of the parasite. Our work shows for the first time that bed bugs can transmit the parasite when their feces are in contact with broken skin, the route by which humans are usually infected.”

Emerging Problem

More people in the U.S. are infected with T. cruzi now than ever before. The Centers for Disease Control and Prevention estimates that the number of Chagas disease cases in the U.S. today could be as high as 300,000.

“There have always been triatomine bugs and cases of Chagas disease in the U.S., but the kissing bugs we have here don’t come into homes frequently like the more dangerous species in South and Central America do,” Levy said. “I am much more concerned about the role of bed bugs. They are already here—in our homes, in our beds and in high numbers. What we found has thrown a wrench in the way I think about transmission, and where Chagas disease could emerge next.”

Equally worrying is the invasion of bed bugs into areas where Chagas disease is prevalent, especially in countries where traditional insect vectors of the parasite have been nearly eliminated, Levy said.  In these areas, bed bugs will be repeatedly exposed to T. cruzi, and could re-spark transmission where it had been extinguished.

“Bed bugs are harder to kill than triatomines due to their resistance to common insecticides.” Levy said. “No one is prepared for large scale bed bug control. If the parasite starts to spread through bed bugs, decades of progress on Chagas disease control in the Americas could be erased, and we would have no means at our disposal to repeat what had been accomplished.”

Often referred to as a silent killer, Chagas disease is hard to diagnose in its early stages because the symptoms are mild or absent. The parasites are hidden mainly in the heart and digestive muscle and over time can cause cardiac disorders and sometimes digestive or neurological problems. In later years, the infection can lead to sudden death or heart failure caused by progressive destruction of the heart muscle. Although there are some drugs to treat Chagas disease, they become less effective the longer a person is infected.

The long asymptomatic period of Chagas disease complicates surveillance for new outbreaks of transmission. In Arequipa, Peru, thousands became infected with the parasite before a case appeared in the hospital. The same could happen in cities in the United States if the parasite were to emerge in the bed bug populations, the authors say.

“Carlos Chagas discovered T. cruzi in triatomine insects before he saw a single case of the disease,” Levy said. “We need to learn from his intuition—check the bugs for the parasite.”

Other co-authors of the study include Aaron W. Tustin, Katty Borrini-Mayorí and César Náquira.

November 14, 2014

###

Carlos Slim Foundation Gives $2.6 Million to Battle Chagas Disease

GEN

Sep 30, 2015

The Carlos Slim Foundation has contributed $2.6 million to the National School of Tropical Medicine at Baylor College of Medicine for the Chagas Vaccine Initiative, in an ongoing effort to fight one of the major neglected tropical diseases in Latin America.

Chagas disease, also known as American trypanosomiasis, is found in the poorest areas of the Americas. It is a vector-borne disease, caused by the single celled parasite called Trypanosoma cruzi, which is transmitted to humans by triatomine “kissing” bugs.

The disease, which affects millions of people in the American continent, as well as in the U.S., is an important cause of heart disease in Latin America. Today, between 5 and 10 million people live with Chagas disease in this region, including more than 1 million who suffer severe heart disease known as Chagasic cardiomyopathy. It is estimated that one in four people infected with Trypanosoma cruzi will go on to develop heart complications.

“Together with the Carlos Slim Foundation and a consortium of partners in Mexico and elsewhere, including the Autonomous University of Yucatán and the Center for Research and Advanced Studies of Mexico (CINVESTAV), we are working to develop an innovative therapeutic vaccine to prevent the dreaded cardiac complications of Chagas disease, which include heart conduction disturbances, aneurysms and even sudden death,” said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor and president of the Sabin Vaccine Institute, in a statement.

“This first vaccine may be used alongside existing medicines, such as benznidazole, in order to improve its performance and the clinical outcome of the disease. Because transmission of Chagas disease now also occurs in Texas, we believe that is a neglected tropical disease vaccine that will be used both here and abroad,” added Dr. Hotez.

The Chagas Vaccine Initiative was launched in 2010 with the goal of accelerating Chagas disease vaccine research and development to establish the feasibility of developing and testing a therapeutic vaccine while enhancing and strengthening research and development capacity in Mexico.

Through the Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development—a Product Development Partnership—researchers at Baylor have been working for the last five years to develop and test a bivalent vaccine for the treatment of chronic Chagas disease.

The goal for the next phase is to accelerate one of the lead vaccine candidate antigens into a regulatory filing and begin a first-in-human study, while continuing to enhance biotechnology capacity in Mexico.

Penn Study Shows Bed Bugs Can Transmit Parasite that Causes Chagas Disease

Penn_Medicine

Like the “Kissing” Bug, Bed Bugs Can Transmit Deadly Parasite Via Feces

PHILADELPHIA — The bed bug may be just as dangerous as its sinister cousin, the triatomine, or “kissing” bug. A new study from Penn Medicine researchers in the Center for Clinical Epidemiology and Biostatistics demonstrated that bed bugs, like the triatomines, can transmit Trypanosoma cruzi, the parasite that causes Chagas disease, one of the most prevalent and deadly diseases in the Americas.

In a study published online this week in the American Journal of Tropical Medicine and Hygiene, senior author Michael Z. Levy, PhD, assistant professor in the department of Biostatistics and Epidemiology at the University of Pennsylvania’s Perelman School of Medicine, and researchers at the Universidad Peruana Cayetano Heredia in Peru conducted a series of laboratory experiments that demonstrated bi-directional transmission of T. cruzi between mice and bed bugs.

In the first experiment run at the Zoonotic Disease Research Center in Arequipa, Peru, the researchers exposed 10 mice infected with the parasite to 20 uninfected bed bugs every three days for a month. Of about 2,000 bed bugs used in the experiment, the majority acquired T. cruzi after feeding on the mice.  In a separate experiment to test transmission from bug to mouse, they found that 9 out of 12 (75 percent) uninfected mice acquired the parasite after each one lived for 30 days with 20 infected bed bugs.

In a third experiment, investigators succeeded in infecting mice by placing feces of infected bed bugs on the animal’s skin that had either been inflamed by bed bug bites, or scraped with a needle. Four out of 10 mice (40 percent) acquired the parasite by this manner; 1 out of 5 (20 percent) were infected when the skin was broken by the insect’s bites only. A final experiment performed at the Penn bed bug lab in Philadelphia demonstrated that bed bugs, like triatomines, defecate when they feed.

“We’ve shown that the bed bug can acquire and transmit the parasite. Our next step is to determine whether they are, or will become, an important player in the epidemiology of Chagas disease,” Levy said. “There are some reasons to worry—bed bugs have more frequent contact with people than kissing bugs, and there are more of them in infested houses, giving them ample opportunity to transmit the parasite. But perhaps there is something important we don’t yet understand about them that mitigates the threat.”

T. cruzi is also especially at home in the guts of bed bugs.  “I’ve never seen so many parasites in an insect,” said Renzo Salazar, a biologist at the Universidad Peruana Cayetano Heredia and co-author on the study. “I expected a scenario with very low infection, but we found many parasites—they really replicate well in the gut of the bed bugs.”

Wicked Cousins

Bed bugs and kissing bugs are distant cousins but share many striking similarities. Both insects hide in household cracks and crevices waiting for nightfall and the opportunity to feed on sleeping hosts. They are from the same order of insects (Hemiptera) and both only feed on blood.  (One main difference is their size: kissing bugs are five times as big as a bed bug). With so much in common, it seemed logical to the authors that the kissing bug’s most infamous trait, the transmission of T. cruzi, is also shared by the bed bug.

Other investigators have shared this suspicion. In 1912, just three years after Carlos Chagas described the transmission of the disease by kissing bugs, French parasitologist Émile Brumpt recounted that he had infected almost 100 bed bugs exposed to an infectious mouse, and then used them to infect two healthy mice. Decades later an Argentine group replicated his work.  These experiments, largely ignored during the recent bed bug resurgence, missed one key point.

“Mice can hunt and eat bed bugs,” said Ricardo Castillo-Neyra, DVM, PhD, coauthor and postdoctoral fellow at the Universidad Peruana Cayetano Heredia and Penn. “The older studies were almost certainly only documenting oral transmission of the parasite. Our work shows for the first time that bed bugs can transmit the parasite when their feces are in contact with broken skin, the route by which humans are usually infected.”

Emerging Problem

More people in the U.S. are infected with T. cruzi now than ever before. The Centers for Disease Control and Prevention estimates that the number of Chagas disease cases in the U.S. today could be as high as 300,000.

“There have always been triatomine bugs and cases of Chagas disease in the U.S., but the kissing bugs we have here don’t come into homes frequently like the more dangerous species in South and Central America do,” Levy said. “I am much more concerned about the role of bed bugs. They are already here—in our homes, in our beds and in high numbers. What we found has thrown a wrench in the way I think about transmission, and where Chagas disease could emerge next.”

Equally worrying is the invasion of bed bugs into areas where Chagas disease is prevalent, especially in countries where traditional insect vectors of the parasite have been nearly eliminated, Levy said.  In these areas, bed bugs will be repeatedly exposed to T. cruzi, and could re-spark transmission where it had been extinguished.

“Bed bugs are harder to kill than triatomines due to their resistance to common insecticides.” Levy said. “No one is prepared for large scale bed bug control. If the parasite starts to spread through bed bugs, decades of progress on Chagas disease control in the Americas could be erased, and we would have no means at our disposal to repeat what had been accomplished.”

Often referred to as a silent killer, Chagas disease is hard to diagnose in its early stages because the symptoms are mild or absent. The parasites are hidden mainly in the heart and digestive muscle and over time can cause cardiac disorders and sometimes digestive or neurological problems. In later years, the infection can lead to sudden death or heart failure caused by progressive destruction of the heart muscle. Although there are some drugs to treat Chagas disease, they become less effective the longer a person is infected.

The long asymptomatic period of Chagas disease complicates surveillance for new outbreaks of transmission. In Arequipa, Peru, thousands became infected with the parasite before a case appeared in the hospital. The same could happen in cities in the United States if the parasite were to emerge in the bed bug populations, the authors say.

“Carlos Chagas discovered T. cruzi in triatomine insects before he saw a single case of the disease,” Levy said. “We need to learn from his intuition—check the bugs for the parasite.”

Other co-authors of the study include Aaron W. Tustin, Katty Borrini-Mayorí and César Náquira.

November 14, 2014

###

Where There’s Bedbugs There’s Chagas?

Bedbugs Could Spread Nasty Chagas Parasite

Thu, 28 May 2015, 05:04 AM by Lee Shearer

Some new medical research gives some added urgency to a once-common admonition of mothers: Don’t let the bedbugs bite.

The little blood-sucking insects are capable of transmitting Chagas disease, University of Pennsylvania School of Medicine researcher Michael Levy told ecologists meeting in Athens’ Classic Center Wednesday.

But whether they could ever become an important vector for transmitting the tropical disease remains to be seen. Levy was addressing fellow scientists at the annual Ecology and Evolution of Infectious Disease conference, a gathering of ecologists, medical researchers and others interested in connections between infectious disease ecology and other fields.

Little-known in North America, Chagas disease is caused by a parasite called Trypanosoma cruzi, and transmitted mainly by a kind of insect called triatominae, or kissing bugs. Kissing bugs suck blood, like bedbugs, but that’s not precisely how they pass on the T. cruzi parasite. That happens when they defecate on skin after feeding; a person who scratches the itchy little wound may rub the kissing bug feces into the wound, along with the parasites in the feces.

The disease affects millions of people in Central and South America. Tens of thousands of people in the United States may be infected — but most people who have the disease don’t know they are infected, said Levy, a professor in the University of Pennsylvania’s Perelman School of Medicine.

Most infected people don’t have symptoms beyond early infection, but a large minority develop more serious symptoms 10 to 30 years later — symptoms which can include enlarged heart ventricles and heart failure. The long lag makes it hard to keep track of the disease’s spread.

Levy and fellow researchers did experiments to see if mice infected with T. cruzi could pass the parasites on to bedbugs, and if bedbugs could in turn transmit the parasite to mice. In both cases, the answer was yes.

That’s potentially a serious issue Levy said, because of the widespread distribution of bedbugs nowadays. The creatures were nearly eliminated by the use of the pesticide DDT, now banned in the United States, but in the past couple of decades they’ve made a big comeback.

When researchers surveyed one Philadelphia census tract, about 11 percent said they had bedbug infections in their homes, said Levy.

Levy and his fellow researchers added a couple of other worrisome observations when they wrote about their experiments recently in the American Journal of Tropical Medicine and Hygiene.

There are kissing bugs infected with T. cruzi in the United States, but for the most part they’ve been kept outdoors — but bedbugs are now seemingly everywhere.

And not only are bedbugs making a big comeback, new populations are showing resistance to the pesticides historically used to eliminate them, they wrote.

And treating houses for bedbugs is expensive — around $1,200, far more expensive than treating a house for kissing bugs, he said.

Researchers have still more questions to answer, Levy said.

“We have no idea what bedbugs feed on in the field,” he said — do they feed on mice or dogs, for example?

And ultimately, they hope to have a better idea of just how serious a risk bedbugs pose of transmitting T.cruzi and Chagas disease, he said.

A session on Ebolas virus dynamics and control closes out the conference on Friday.

Benign Symptoms May Signal Something More Dangerous: Chagas Disease

Contributed by Sharon Van Zweiten — Body aches. Fever. Vomiting. Swelling, around the site of a possible bug bite. You could just have the flu. But if you’ve been bitten by the kissing bug, an assassin bug or a bedbug, you could be at risk for a deadly disease: Chagas.

Caused by the parasite Trypanosoma cruzi, Chagas is transmitted by blood-sucking bugs—and according to a recent study—by  the everyday bed bug. When Chagas-carrying bedbugs emerge in numbers, hundreds of millions of people worldwide will become more vulnerable to the deadly disease.

Chagas disease detection is only possible through screenings, which may include:
·      Blood culture
·      Chest x-ray
·      Echocardiogram
·      Electrocardiogram
·      Blood smear
·      Enzyme-linked immunoassay (ELISA) to detect signs of infection

Factors Leading to Chagas Deaths
Left undetected and/or untreated, Chagas may thrive even during apparent periods of remission. Victims may not show any signs of the disease for as long as 20 years. But, 20-30 percent of Chagas victims will develop chronic symptoms that can result in irreversible and fatal damage.
·      Abnormal heart rhythms can lead to sudden death.
·      Permanent and irreversible heart damage caused by Chagas over several years can cause heart failure.
·      Chagas-related digestive issues including constipation, abdominal pain and other disorders can ultimately affect the heart.
·      Damage to the esophagus that can result in swallowing difficulties or choking.

Chagas disease kills more people in Latin America than any other infectious disease, including malaria, tuberculosis and HIV. Now, doctors say it’s come home to the United States. A research term at Baylor says the diagnosis rate is low because of low awareness among US health professionals.

Map indicating presence of Chagas infections

Map Indicating reports of Chagas infections

According the CDC, about 300,000 people in the US with Chagas, were infected before they came to the US from Latin America. While only 23 cases have been reported in people who haven’t traveled outside the US since 1955, the epidemic of infections and the increase of travel plus the incubation period forecasts a possible spike in the number of cases here.

Prevention is the best defense.

Shocking News: Chagas Disease Affects over 300,000 Americans

Chagas disease, endemic to Mexico, Central America and South America, affects approximately 8 million people south of the American border. Due to increased immigration, Chagas has taken hold in the United States, too, where more than 300,000 people are estimated to be affected with the Trypanosoma cruzi infection, transmitted mainly by blood-sucking “kissing bugs.” But that’s not all.

map of the United States showing where Triatomine bugs have been ___(1)

Map of States Where Kissing Bugs Were Reported.

According to a CDC report published on the Internet and last updated July 13, 2013, most people in the U.S. with Chagas disease “acquired their infections in endemic countries.”

Why be concerned? First, Chagas may go undiagnosed while continuing to do damage, because its symptoms mimic America’s number-one killer: heart disease. But if the parasitic infection goes untreated, Chagas continues to erode the heart organ. Second, evidence now indicates that bed bugs may spread the parasites linked to Chagas disease, as well. Scientific American divulged that  a study released in November 2014 “raised the specter of Chagas from another more familiar insect pest: bed bugs,” which are found all over the country. Biting bed bugs have been found to transmit the [Chagas carrying] parasite between mice. There is conjecture in scientific circles that it may be just a matter of time before bed bugs begin spreading Chagas to humans, as well.

According to a report in Scientific American (December 10, 2014), “Every year, the hearts of millions of Central and South Americans are quietly damaged by parasites. During the night, insects called kissing bugs emerge by the hundreds from hiding places in people’s mud-and-stick homes to bite their sleeping victims. The bugs defecate near the punctured skin and wriggling wormlike parasites in the bug poop may enter the wound and head for their victims’ hearts. There, in about a third of victims, they damage the organs for decades before causing potentially lethal heart disease. Around 12,000 people worldwide die each year from the ailment, called Chagas disease.

CDC estimates that more than 300,000 persons with Chagas disease live in the United States. Most people with Chagas disease in the United States acquired their infections in endemic countries. Although there are triatomine bugs in the U.S., only rare vectorborne cases of Chagas disease have been documented, according to the CDC report. However, the “kissing bug” responsible for most Chagas transmission is a blood eater with similar traits to the bed bug.

The bed bug effect has not been demonstrated yet among people but these studies have made some physicians and scientists wonder if they have underestimated the chance of acquiring Chagas in this country. “We are very likely missing [Chagas] cases,” said a May 2014 editorial in The American Journal of Medicine. “A systemic survey of the high-risk population in the U.S. is urgently needed.”

What does it all mean? We need to remain vigilant in combatting both bedbugs and the encroachment of kissing bugs in this country. And we must adapt lifestyle to create an effective, lasting barrier between bed bugs and us.

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Information and Perspectives on Bed Bug Prevention, Protection and Safety

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Information and Perspectives on Bed Bug Prevention, Protection and Safety

Bed Bug Blog

Information and Perspectives on Bed Bug Prevention, Protection and Safety

Information and Perspectives on Bed Bug Prevention, Protection and Safety