‘Kissing bug’ sickens more in Los Angeles than Zika and few know they have it – deadly Chagas disease

This insect bites people near the lips or eyes, inserts bacteria, then about 20 years later, the victim suffers a heart attack. Olive View-UCLA Medical

March 28, 2016 |by Susan Abram | Daily News, Los Angeles

This insect bites people near the lips or eyes, inserts bacteria, then about 20 years later, the victim suffers a heart attack.  Olive View-UCLA Medical Center is working to help detect Chagas. The clinic is holding community screenings across the San Fernando Valley to find people who may be infected.

Some call it the kissing bug because it leaves a painless bite near a sleeping person’s lips.

But among health experts, including those from the federal government, the cone-headed Triatomine is no prince awakening a sleeping beauty. It’s an assassin, because it leaves behind a parasite in its love bite that can be deadly.

Photos of the dime-size insect hang inside Dr. Sheba Meymandi’s medical office as if on a wanted poster. The bug, she said, carries the Chagas disease, which can cause heart failure if left untreated.

An estimated 300,000 people across the United States may have Chagas disease, Meymandi said, and the only place in the nation where it’s treated is the clinic she oversees at Olive View-UCLA Medical Center in Sylmar. Started in 2007, the Chagas clinic has treated 200 people, but Meymandi and her team said they are ready to take on more patients.

That’s why she and her staff are working with primary physicians at the four hospitals and 19 health clinics overseen by the Los Angeles County Department of Health Services. In addition, Providence Health & Services will offer Chagas screenings at a dozen free health clinics on Sundays at churches across the San Fernando Valley for the rest of the year. An upcoming screening will be held from 1 to 5 p.m. April 3 at New Hope of the Nazarene, 15055 Oxnard St, Van Nuys, California.

“It’s very clear that we need to diagnose early and treat early before the onset of complications,” said Meymandi, a cardiologist. Ten percent of those with Chagas suffer from heart failure, one of the most expensive conditions to treat, costing $32 billion year nationwide, she said. That figure could rise to $70 billion by 2030.

Chagas disease was once considered exotic, but more is known about it now than about the Zika virus. Still, most people have no idea they have it or, once they do, lack information about where to receive treatment, Meymandi said.

The disease is most common in rural Mexico and Latin America, researchers have said, adding that it kills more people in South America than malaria.Meymandi said anyone who was born in Mexico or South America should have a blood test.

But U.S.-born residents also are infected. The insect is present in more than 20 states. At least 40 percent of raccoons tested in Griffith Park carried Chagas disease, Meymandi said.

“Most of the people we see and treat in the U.S. have had it for decades,” Meymandi said. “We have the bug here, we have the parasite here. You can definitely acquire Chagas in the United States.”

An infected insect, which hides in dwellings made from mud, adobe, straw or palm thatch, crawls out at night to feed on blood. It is called the kissing bug because it feeds on a sleeper’s face, then defecates on the wound, leaving a parasite behind.

Infection takes place when the parasite enters the body through mucous membranes or broken skin, caused when the sleeper scratches the wound, eyes or mouth, according to the federal Centers for Disease and Prevention. The parasite can lie dormant for years, then cause heart disease, and if not found and treated, death.

Symptoms can include fever, fatigue, body aches, headaches, rash, loss of appetite, diarrhea and vomiting. But sometimes there are no symptoms until decades later.

Only two drugs exist to treat Chagas disease, and neither is approved by the U.S. Federal Drug Administration yet, though both can be provided through the CDC, Meymandi said.

“It’s very simple to treat,” Meymandi said. “But the process to go get the drugs is a challenge.”

Jose Duran, a Bellflower resident, said he learned he had Chagas disease after he tried to donate blood seven months ago. He said he would have never known he had Chagas disease otherwise. He had no symptoms.

“I went to donate blood for the first time, because I heard it was good for you to donate once in a while,” he said. Then he received a phone call.

It’s not uncommon for people to learn they have Chagas disease after donating blood, Meymandi and others said. In 2006, the Red Cross isolated 21 cases of Chagas in Southern California donors. In 2007, the figure more than doubled to 46. In 2008, there were 55 cases.

The National Red Cross would not provide additional figures.

“I got scared. I was like, wow, what is this?” the 40 year old Duran said of his reaction,when he learned what he had.

As a child, Duran lived on a ranch in Querétaro, a small state in north-central Mexico. His brother also tested positive for Chagas. He doesn’t remember being bitten, he said.

Duran was referred to the Chagas clinic and, after two months of treatment, learned Thursday he was in good health.

“Most people don’t know they have this,” he said. “If they get tested, they can get well.”

#SayNOtoPESTICIDES!

 

Messing with BedBugs’ Genes Could Carry Other Risks?

Bed Bugs Will Outlive All Of Us Unless We Screw With Their Genes

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photo:  Bluejake/Sara Bibi/Gothamist

Bed bugs, like cockroaches and new seasons of The Bachelor, seem impossible to eradicate from the face of the Earth, no matter how many exterminators our landlords call to spray that one time and then never, ever again. But Science says there’s some small hope for the extinction of a moviegoer’s biggest fear—screwing with their genome.

Scientists have managed to map the genome of the common bed bug, revealing some fun things about the little suckers. For instance, bed bugs are actually able to break down toxins, like the ones an exterminator might use, to render them harmless, allowing them to survive even when you try to whack them with bug killer. They’ve also been MUTATING, producing genes that make them resistant to certain insecticides and making it all the more difficult to eradicate an infestation. Another fun fact is that bugs’ genes vary from location to location—a Brooklyn bed bug will have a different genetic sequence from a Queens bed bug, though both are equally disgusting.

Bed bugs also inbreed, and their sex is quite violent. This violent sex has been well-documented, and for those of you who have not yet seen Isabella Rossellini’s bed bug porno, you’re welcome, and sorry:

The takeaway here is that bed bugs have been able to hold us hostage for a long time, but scientists might be able to murder them, provided they make a few genetic tweaks. First, though, let’s kill all the mosquitoes.

[A. Steiner:  So…..Messing with Genes Could Carry Other Risks – YES!]

#SayNOtoPESTICIDES!

Zika has nothing on deadly Chagas disease. Chagas disease is a much bigger problem.

February 1, 2016 | by Cal Crilly | Global Research

“Although a causal link between Zika infection in pregnancy and microcephaly has not, and I must emphasize, has not been established, the circumstantial evidence is suggestive and extremely worrisome,” WHO Director-General Margaret Chan said, reported by Reuters. “An increased occurrence of neurological symptoms, noted in some countries coincident with arrival of the virus, adds to the concern.”

Pesticides in Brazil and Pernambuco state are more likely to be the cause of microcephaly and birth defects than Zika virus and the links below speak for themselves.

“The farmers of Brazil have become the world’s top exporters of sugar, orange juice, coffee, beef, poultry and soybeans. They’ve also earned a more dubious distinction: In 2012, Brazil passed the United States as the largest buyer of pesticides.

This rapid growth has made Brazil an enticing market for pesticides banned or phased out in richer nations because of health or environmental risks.”

Why Brazil has a big appetite for risky pesticides

“According to the latest figures available from Brazil’s health ministry, published on 20 January, 3,893 cases of microcephaly have been recorded since the start of 2015. Pernambuco accounts for 1,306 of those, around a third of the total. In 2014, there were 150 cases across the whole of Brazil.” [1]

City at centre of Brazil’s Zika epidemic reeling from disease’s insidious effects

The most obvious cause of birth defects in this area is direct contact and absorption of pesticides.

“A study of pesticide use on tomatoes in the Northern State of Pernambuco, Brazil, indicates high exposure to pesticide workers and poor application methods which threaten the ecology of the area.”

“Women washed the pesticide application equipment, generally in the work environment, without protective clothing or without observing the recommended three-fold washing process. [2]

Poisoning assessment

Many of the pesticides used were hazardous organochlorine and OP insecticides. Of the workers interviewed, 13% suffered some type of acute poisoning that required first-aid treatment; 28% reported nausea during application of pesticides; and the majority experienced some symptoms immediately after exposure. 36% reported health problems related to the immune system (frequent itching of skin, eyes, and nose; or fever); 36%, skeletal/muscular problems (pains in joints); 33%, central and peripheral nervous system problems (dizziness, numbness in superior limbs, alterations in sleep patterns, and vomiting); 28%, digestive system problems; 25%, sensory organ problems; 18%, cardiovascular problems; 13%, respiratory system problems; and 11%, with urinary-genital system problems

Reproductive effects

Of the women workers, 32% reported being pregnant more than five times, 53% reported having prenatal examinations, 97% reported that they were not poisoned by pesticides during pregnancy. Almost three-quarters of the women (71%) reported miscarriages, and 11% reported having mentally and/or physically impaired offspring.

Neuro-psychological symptoms

Symptoms of minor psychiatric disturbances were observed in 44% of women and 56% of men surveyed (in the general Brazilian population, the prevalence is 5% to 15%)”

“The results of the laboratory analysis showed the maximum residue limits (MRLs) are regularly exceeded: methamidophos in 25% of the samples, and ETU in 78%. ETU can cause goitres (a condition in which the thyroid gland is enlarged), birth defects and cancer in exposed experimental animals. ETU has been classified as a probable human carcinogen by the US EPA. The organochlorine insecticide, endosulfan, which is banned for use on tomatoes was detected in 28% of samples at levels of up to 510 parts per billion.”

“It is important to introduce education on the hazards of pesticides and good agricultural practices in the school curriculum as many children accompany their family members into the fields”

Tomato production in Brazil:  Poor working conditions and high residues threaten safety

“Pesticides were found in the milk from 11 farms and one milk cooler (Fig.1), totalizing 12 positives milk samples. The main pesticide was fenthion, detected in four samples of 12 (33.33%), followed by dimethoate (25%), coumaphos (8.33%) and malathion (8.33%). In CB group, the pesticides detected were carbofuran (25%), aldicarb (16.67%) and carbaryl (8.33%). In some samples, two or more active principals were detected, what explains percentages over 100%. The frequency of pesticides found in this study is in agreement with Araújo et al. (2000) that noted that the most pesticides commonly used in Pernambuco are from OP class, followed by CB and pyrethroids.” [3]

Organophosphorus and carbamates residues in milk and feedstuff supplied to dairy cattle

“It is very well known that acute or chronic increase of retinoic acid (RA)levels leads to teratogenic effects during human pregnancy and in experimental models.

The characteristic features displayed by RA embryopathy in humans include brain abnormalities such as microcephaly, microphtalmia and impairment of hindbrain development; abnormal external and middle ears (microtia or anotia), mandibular and mid facial underdevelopment, and cleft palate. Many craniofacial malformations can be attributed to defects in cranial neural crest cells.” [4]

Pesticides Used in South American GMO-Based Agriculture

“There has been ongoing controversy regarding the possible adverse effects of glyphosate on the environment and on human health. Reports of neural defects and craniofacial malformations from regions where glyphosate-based herbicides (GBH)…” [5]

Glyphosate-Based Herbicides Produce Teratogenic Effects on Vertebrates by Impairing Retinoic Acid Signaling

“The report says that national consumption of agrochemicals is equivalent to 5.2 litres of agrochemicals per year for each inhabitant. Agrochemical sales increased from USD 2 billion in 2001 to 8.5 billion in 2011. The report names GM crops as a key cause of the trend: “Importantly, the release of transgenic seeds in Brazil was one of the factors responsible for putting the country in first place in the ranking of agrochemical consumption – since the cultivation of these modified seeds requires the use of large quantities of these products.” [6]

The report continues:

“The cropping pattern with the intensive use of pesticides generates major harms, including environmental pollution and poisoning of workers and the population in general. Acute pesticide poisoning is the best known effect and affects especially those exposed in the workplace (occupational exposure). This is characterized by effects such as irritation of the skin and eyes, itching, cramps, vomiting, diarrhea, spasms, breathing difficulties, seizures and death.

“Already chronic poisoning may affect the whole population, as this is due to multiple exposures to pesticides, that is, the presence of pesticide residues in food and the environment, usually at low doses. Adverse effects of chronic exposure to pesticides may appear long after the exposure, and so are difficult to correlate with the agent. Among the effects that can be associated with chronic exposure to pesticide active ingredients are infertility, impotence, abortions, malformations, neurotoxicity, hormonal disruption, effects on the immune system, and cancer.”

Brazil’s National Cancer Institute Names GM Crops as Cause of Massive Pesticide Us [7]

Health information systems and pesticide poisoning at Pernambuco [8]

Most of this is not new, with Pernambuco it’s just concentrated.

The Long Battle Over Pesticides, Birth Defects and Mental Impairment

There may be links with mosquitos and Zika virus but time will tell, if they manage to reduce the mosquito problem with more insecticides that may be a good thing but if birth defects keep rising in these areas it will be the pesticide use to blame.

If that happens we might have to start thinking about what on earth we are doing?

#SayNOtoPESTICIDES!

The Hidden Threat: The Kissing Bug

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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

‘Kissing Bug’ Disease, Chikungunya, and Dengue Arrive in US Amid Rising Temperatures

Healthline
Faraway tropical countries no longer have the market cornered on painful bug-borne illnesses.

'Kissing Bug' Disease, Chikungunya, and Dengue Arrive in US

Chagas, dengue, and chikungunya are likely to become more familiar words in the United States in coming decades. Once limited to climates more tropical than our own, these infectious diseases are now increasingly affecting Americans.

There have always been a handful of Americans who return from tropical travel infected with these diseases. But experts think it’s likely that they will take root here.

As the climate continues to warm, the insects that spread these diseases from one person’s bloodstream to another’s will inhabit larger swaths of the map, according to the United Nations International Panel on Climate Change (IPCC). The habitats of the mosquitoes that carry dengue and chikungunya are already expanding in the United States.

“Climate change is definitely having an effect on parasitic disease worldwide,” said Patricia Dorn, Ph.D., a Chagas expert at Loyola University New Orleans. But, she said, we’re also getting better at testing for these diseases, so part of what looks like an uptick in cases is really an uptick in diagnoses.

For patients, the difference is academic: They’re being diagnosed with diseases they may have never heard of — and their doctors may not know to look for them.

Chagas Disease: It’s Not Just in Rural Areas

Chagas is the latest addition to the list of tropical diseases that Americans have to fear. The disease initially has few symptoms — possibly a fever, rarely some swelling at the site of the bug bite — but if left untreated the parasites accumulate in the cardiovascular system and cause heart damage in 1 in 3 patients.

Triatomine, or “kissing,” bugs spread Chagas disease — though their nickname puts an overly positive spin on what they do: suck the blood of a mammal host and then defecate. The feces spread the parasite that causes the disease.

Chagas is widespread in Latin America and has rarely been considered endemic to the United States, but experts say that’s because we weren’t looking for it.

In 2007, Chagas was added to the list of tests performed on donated blood. Those who tested positive were contacted and interviewed. It suddenly it became clear that at least a few of the 300,000 Americans who tested positive for Chagas disease had not traveled to Latin America.

Triatomine

Bugs in the triatomine family capable of spreading the disease inhabit the bottom two-thirds of the United States. The now-outdated conventional wisdom said that the bugs, which bite at night, only fed only on humans living in thatched huts in rural areas.

“The dogma for years was, ‘We live in improved housing; we have air conditioning — yeah, the bugs are here but they live in wooded areas and we’re just not in contact with them.’ Our most recent study shows that that dogma is wrong,” Dorn said.

A forthcoming study co-authored by Dorn documents that triatomine bugs in Louisiana often feed on human blood. Among the bugs that had fed on humans, 4 in 10 tested positive for the Chagas parasite.

A Texas study published in October used blood donation data to identify five people who had been infected with the virus in Texas.

As the climate continues to warm, triatomine bugs will likely push further northward. And as forested lands are cleared, the bugs are likely to feed more often on humans.

Just this week, a study suggested that bedbugs could spread the parasite, too. But Dorn and Melissa Nolan Garcia, M.P.H., who co-authored the Texas study, said those findings don’t mean much on the practical level.

Although bedbugs are seemingly capable of transmitting the parasite, they probably don’t, based on empirical data. Among different triatomine species, some are far more efficient at transmitting the Chagas parasite, and even the most efficient do so only once in a thousand bites.

“We think that our bugs have better manners,” said Dorn, referring to U.S. triatomine bugs. “In Latin America the better vector takes a blood meal and defecates at the same time. The studies that we did showed that the bug took the blood meal — it was from a mouse — and left the host and defecated later.”

What does all this mean for patients? It means that those who hunt and camp in the South and those who have traveled to Latin America should get screened for Chagas.

“It’s a simple blood test,” Nolan Garcia said.

However, U.S. doctors don’t necessarily know what to do about Chagas. Dorn told the story of a California woman who got a “really scary letter” telling her that she’d been permanently banned from blood donation after testing positive for Chagas. But when she went to her doctor, he didn’t know how to treat her.

The only two drugs to treat Chagas disease are available through the Centers for Disease Control, which has dubbed Chagas a “neglected parasitic infection” and targeted it for public health action.

Nolan Garcia compared treatment with these drugs to “chemotherapy.”

The parasites settle in the heart tissue, and to eliminate them, the drugs have to kill off some healthy tissue too. The treatment is recommended for patients younger than 50 and on a case-by-case basis for those older than 50.

Dengue Fever: It’s Creeping up from Latin America

Dengue is a mosquito-borne viral infection so painful that it’s also called “breakbone fever.” Found throughout the world in tropical and subtropical regions, it’s rarely fatal. Those infected a second time with a different strain of the virus risk developing a more severe form of the disease called dengue hemorrhagic fever; without good medical care, 1 in 5 patients die from this form of the disease.

Dengue has become more common since the 1950s. In the Americas, it’s become at least five times more prevalent since the 1980s. But only in this century has it crept into the United States. Hawaii saw a cluster of infection in the early 2000s, but in recent years Texas and Florida have been U.S. hotspots.

Last year, there were 49 confirmed cases of locally transmitted dengue in the United States. So far this year, all of the hundreds of reported dengue cases along the U.S.-Mexico border have come in from Latin America, Texas public officials told Healthline. However, Florida has confirmed six local cases.

Some counties in Mississippi may also be at “extreme risk” for domestic transmission, experts say.

The mosquitos that carry the dengue virus, Aedes aegypti and Ae. albopictus, are expanding their range, in part due to climate change. As they do, more Americans will be at risk.

I do think it’s a real possibility that we could have sustained transmission [of dengue] in parts of the U.S., in the southern U.S. in particular, and in parts with lower socio-economic status.
Crystal Boddie, UPMC Center for Health Security

“I do think it’s a real possibility that we could have sustained transmission in parts of the U.S., in the southern U.S. in particular, and in parts with lower socio-economic status,” said Crystal Boddie, M.P.H., at the Center for Health Security at the University of Pittsburgh Medical Center in Baltimore.

Window screens, air conditioning, and an indoor job all diminish one’s risk of infection.

The United States won’t be hit as hard as developing countries, where screens are rare and air-conditioning is a luxury reserved for the very rich. But as dengue becomes more common, U.S. doctors will have to learn to diagnose it and provide the right kind of palliative care.

“The initial symptoms are pretty similar to the flu. It’s hard to distinguish if it’s dengue or flu,” Boddie said. “It’s difficult to diagnose if you’re not looking for it specifically.”

The good news is that, because dengue is so widespread in other parts of the world, researchers have been trying to develop a vaccine. Five candidates are currently being tested in advanced clinical trials.

Chikungunya

Chikungunya has symptoms similar to dengue and is spread by the same two types of mosquito. The two diseases often arise in the same places, but more people get sick from chikungunya because infected mosquitos are about three times as likely to transmit it.

Standing water

The disease is less likely to be fatal than dengue, but it’s painful enough to have earned its own colorful name. Chikungunya m­eans, roughly, “writhing disease” in a local language of East Africa, where it first emerged.

“It’s not a trivial disease,” said Roger Nasci, Ph.D., the chief of the Arboviral Diseases Branch at the CDC. He described “prolonged, debilitating joint pain where people just can’t get out of bed.”

About 1 in 3 chinkungunya patients will experience joint pain for months or even years after they recover from the initial infection. There are currently no medications to treat chikungunya and there is no vaccine to prevent it.

Until chikungunya entered India in 2005 and infected 2 million people, it wasn’t on the global health community’s radar. Last year, it earned still more attention when it jumped the Atlantic, sickening people on several Caribbean islands. This year, there have been 11 cases of locally transmitted chikungunya in Florida.

Public health officials say more domestic infections are “inevitable.”

The CDC is trying to educate doctors to make them aware of chikungunya and dengue. Beginning in 2010, doctors were required to report cases of dengue. On Jan. 1, 2015, they’ll be obligated to report chikungunya cases as well.

Mosquitoes breed in pools of standing water, so removing these breeding sites is a top priority. Nasci said the CDC is working with local mosquito control programs to try to limit the number of tires, buckets, and other outdoor sites that collect rainwater. In that one respect, climate change may actually help curb mosquito populations, as California and other Western states experience record droughts.

Healthline News | Cameron Scott | November 20, 2014

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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

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Information and Perspectives on Bed Bug Prevention, Protection and Safety

Information and Perspectives on Bed Bug Prevention, Protection and Safety