Deadly CHAGAS: An Emerging Infectious Disease Threat In U.S.

October 1, 2015 | by Judy Stone | Forbes

Chagas, a parasitic disease, is the latest invisible killer infection to be recognized as a growing threat here. The infection is transmitted by the Triatomine bug, known as the “kissing” bug. The bugs infect people through bites—often near the eyes or mouth—or when their infected feces are accidentally rubbed into eyes or mucous membranes. Some transmission occurs from mother to child during pregnancy. Occasionally, transmission is through contaminated food or drink.   Triatoma sanguisuga – CDC/James Gathany

Most people in the U.S. with Chagas disease probably became infected as children, living in Latin America. The infection often has few symptoms early on, but after several decades, strikes fatally, often with sudden death from heart disease. I suspect that, similar to Lyme disease, the magnitude of disease and deaths from the protozoan parasite, Trypanosoma cruzi, which causes Chagas disease, is unrecognized in the U.S.

 2014 map of blood donors testing positive for CHAGAS disease. 

In Latin America, however, up to 12 million people might be infected, with a third going on to develop life-threatening heart complications. Chagas is a major cause of congestive heart failure and cardiac deaths, with an estimated 11,000 people dying annually, according to the WHO.

There are an estimated 300,167 people with Trypanosoma cruzi infection the U.S., including 40,000 pregnant women in North America. There are 30,000-45,000 cardiomyopathy cases and 63-315 congenital infections each year. Most of the people come from Mexico, El Salvador, Guatemala, Honduras, or Argentina; Bolivia has the highest rate of Chagas in the world.

But in the U.S., we don’t often think of Chagas. Even as an infectious disease physician, I’ve never treated anyone with it, and it is not on my radar. So when a physician sees a patient who may have come to the U.S. as a child, and now has diabetes and hypertension, he or she is likely to attribute the heart disease to that and not look for infection. In fact, though, there are large pockets of undiagnosed disease. For example, a survey in Los Angeles of patients with a new diagnosis of cardiomyopathy who had lived in Latin America for at least a year, found 19% had Chagas disease, and they had a worse prognosis than those without the infection.

There are other reasons Chagas is overlooked. One is that Chagas is not a reportable disease except in four states, and Texas only began reporting in 2010. Most cases here have been detected by screening of blood donations, which has found about 1 in every 27,500 donors to be infected, according to CDC. However, a 2014 survey showed “one in every 6,500 blood donors tested positive for exposure to the parasite that causes Chagas disease.” A map of positive donations is here. While the triatome bugs are most common in the southern half of the U.S., they are actually quite widespread, as shown here.
Much bigger barriers to diagnosis are social and cultural. Many patients lack health insurance. Others are undocumented immigrants fearing deportation. Health literacy and language barriers are huge. There is a stigma associated with the diagnosis, as there is for many patients with TB, as Chagas is associated with poverty and poor living conditions. As Daisy Hernández noted in her excellent story in the Atlantic, “it’s hard, if not impossible, for moms with Chagas and no health insurance to see the doctors who would connect them to the CDC” and “patients don’t necessarily have savings in case they have adverse reactions to the medication and can’t work.”

There are pockets of Chagas in the states, including Los Angeles, the Washington metropolitan area, and the Texas border, where there are large immigrant communities from endemic areas. But I suspect that with climate change, we’ll see more Chagas in the southwest U.S., as more triatomine bugs are found further north. One recent study found more than 60% of the collected bugs carried the Trypanosome parasite, up from 40-50% in two similar studies. There are also now seven reports of Chagas infection that are clearly autochthonous, or locally acquired. University of Pennsylvania researcher Michael Levy has shown that bedbugs might be capable of transmitting Chagas, but no one has shown that they actually do. Entomologist and Wired author Gwen Pearson nicely explains why bedbugs are an unlikely vector and notes that you “far more likely to be injured by misusing pesticides to try to exterminate” them.

There’s more bad news. Treatment for Chagas is effective if given early in infection, although with significant side effects. There is no effective treatment for late stages of gastrointestinal or cardiac disease. A newly released study showed that benznidazole was no more effective than placebo in reducing cardiac complications, even though it reduced levels of parasites in the blood.

   Trypanasoma cruzi parasite in heart tissue – CDC

The two drugs available to treat Chagas, benznidazole and nifurtimox, are not yet FDA approved and are only available through the CDC under investigational protocols. Both carry significant side effects. Treatment of children with early Chagas is generally effective but, as with many drugs, treatment is hampered by lack of data on pediatric dosing and limited formulations. There is little research funding for new drug development, with less than US $1 million (0.04% of R&D funding dedicated to neglected diseases) focused on new drugs for Chagas disease, according to the Drugs for Neglected Diseases Initiative (DNDi).

Where do we go from here? The most immediate and cost-effective proposals are to increase surveillance for disease and screening of high-risk populations. Since the most effective treatment is given early in the course of infection, screening of pregnant women and children is a priority, as is education for these women and Ob-Gyn physicians.
While there is no effective treatment for advanced disease, efforts are underway to develop a vaccine against Chagas. The National School of Tropical Medicine at Baylor College of Medicine just received a boost from a $2.6 million grant from the Carlos Slim Foundation for their initiative.

Chagas, like sickle cell, highlights disparities in access to screening and early treatment for serious illnesses disproportionately affecting the poor and people of color. While a moral and ethical issue, the choices made to gut public health programs for “cost saving” will also be unnecessarily costly in the end.

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Deadly Chagas disease in the U.S., affecting people and animals – primarily dogs. Watch out for “kissing bugs”, aka “love bugs”.

November 18, 2015 | by Robert Herriman | Outbreak News Today

Chagas disease, the parasitic infection caused by Trypanosoma cruzi, is found mainly in Latin America, where it is mostly transmitted to humans by the feces of triatomine bugs, known as “kissing bugs”.

The Triatoma or “kissing” bug. Image/CDC

However, in several areas of the United States Chagas is ever present, according to Dr. Peter Hotez, founding dean of the National School of Tropical Medicine at Baylor College of Medicine, who told me in 2013 the number of cases of Chagas disease in the United States to be somewhere between 300,000 and 1 million. The United States is ranked 7th among nations for the amount of cases.

Texas is definitely one state that is battling the neglected tropical disease. According to Texas health officials:

In Texas, approximately 45% of the collected triatomine bugs have tested positive for T. cruzi, and Chagas is considered an endemic disease in dogs. From 2013 to 2014, 351 cases of Chagas disease in animals, primarily dogs, were reported from approximately 20% of Texas counties, representing all geographic regions of the state. Locally-acquired human cases are uncommon, but some have been reported. From 2013 to 2014, 39 human cases of Chagas disease were reported: 24 were acquired in another country, 12 were locally-acquired, and the location of acquisition was unknown for 3.

Local transmission means that the kissing bugs in Texas are infected with the parasite, causing it to spread to humans.

Chagas disease is transmitted naturally in North, Central, and South America. In parts of Mexico and Central and South America, where Chagas disease is considered highly endemic, it is estimated that approximately 8 million people are infected.

Chagas in Texas/Texas Department of Health

The Triatoma or “kissing” bug frequently carry for life the parasite, Trypanosoma cruzi. T. cruzi is a comma shaped flagellated parasite and the cause of an acute and chronic disease called Chagas.

The triatoma bug can be found in poorly constructed homes, with cracks and crevices in the walls or those with thatch roofs. They can also be found in palm trees and the fronds.

Usually at night while sleeping, the insect feeds on people or other mammals. While feeding the insect defecates and the infected feces gets rubbed into the bite wound, eyes abrasions or other skin wounds.

The parasite invades macrophages at or near the site of entry. Here they transform, multiply and rupture from the cells 4-5 days later and enter the blood stream and tissue spaces.

Initial infection with Chagas is typically asymptomatic. Acute disease may manifest symptoms after a couple of weeks.

Reddening of the skin (Chagoma) or edema around the eye (Romana’s sign) may be seen, albeit uncommon.

Fever, malaise, enlarged liver and spleen are part of the acute syndrome. 10% of people develop acute myocaditis with congestive heart failure. This acute disease can be fatal.

After a latent period which may last for years, the infected person may develop chronic disease (20-40%). The most serious consequences are cardiomyopathy (in certain areas it’s the leading cause of death in men less than 45 years of age) and megacolon/megaesophogus.

Trypanosoma cruzi can also be transmitted via congenital transmission (mother to baby), through blood transfusions and organ transplants, and some cases of transmission through feces contaminated food.

About 150 mammals beside humans may serve as reservoirs of the parasite. Dogs, cats, opossoms and rats are among the animals.

Benznidazole and nifurtimox are 100 percent effective in killing the parasite and curing the disease, but only if given soon after infection at the onset of the acute phase, according to the WHO.

There is no vaccine for Chaga’s, so preventive measures should include insecticide spraying of infested houses.

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Watch the lifecycle of parasite that causes deadly Chagas disease – transmitted by the Kissing Bug…aka the Love Bug – both cousins to the BedBug

The cause of Chagas disease is the parasite Trypanosoma cruzi, which is transmitted to humans from a bite from an insect known as the triatomine bug. These insects can become infected by T. cruzi when they ingest blood from an animal already infected with the parasite.
This video was produced by Dirceu Esdras Teixeira, Marlene Benchimol, Wanderley de Souza and Paul Crepaldi on August 30, 2012.

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BedBugs reported in some of NYC’s swankiest hotels. They were always there; and it’s getting worse. More important to follow as BedBugs transmit deadly Chagas disease.

February 8, 2016 | by Leonard Greene | New York Daily News
It’s not just the fleabags and flophouses.

Bedbugs have been reported in some of the city’s swankiest hotels with a list that includes the Waldorf Astoria the Millennium Hilton and the New York Marriott Marquis.

According to the Bedbug Registry, a nationwide database of bedbug reports and complaints, bedbug sightings in New York hotels have jumped more than 44 percent between 2014 and 2015.

The Millenium Hilton at 55 Church Street in New York New York.
Google Maps Street View

The Millenium Hilton at 55 Church Street in New York New York.

The data focused on establishments that are members of the Hotel Association of New York City.

Of the 272 association members, 65 percent, or 176 members, have had a guest file at least one complaint about bedbugs at the property.

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Michelle Bennett/Getty Images/Lonely Planet Image

Taxi cabs outside Waldorf Astoria Hotel.

Eighteen hotels had a combined 363 complaints, representing 42 percent of all bedbug complaints.

“I stayed in room 2306 for one night,” a Millennium Hilton guest wrote in a complaint to the hotel in 2014. “I found blood on my sheets and a live bug on my bed. I ended up with 60 plus bites.”

At the Times Square Doubletree guest said a stay there last year left hundreds of bite marks on the face, neck arms and hands.

“Extreme case of bed bug attacked on my entire upper body,” the guest wrote.” Went home to Florida a day early and ended up in my local emergency room.”

Research Entomologist Jeffrey White shows off some bedbugs at a informational bedbug conference at 201 Mulberry Street in Manhattan Wednesday.

Warga, Craig/New York Daily News

Last month, a California couple posted a YouTube video about their $400-a-night Central Park hotel room nightmare. The couple found dozens of bedbugs beneath their mattress at the Astor on the Park Hotel.

Lisa Linden, a spokeswoman for the hotel association, said hotels in New York are addressing the issue.

“Bedbugs are a global issue that extend beyond hotels,” Linden said.

”Every member of the Hotel Association of NYC that we are aware of has an active anti-bedbug program in place. If a problem arises, it is dealt with immediately and effectively.”

Scientists who recently studied the bloodsucking creatures in the city’s subway system discovered a genetic diversity among bedbugs depending upon the neighborhood where they were found.

They said the discovery could lead to better insecticides.

#SayNOtoPESTICIDES!

California study examines genetic diversity of Kissing Bugs…concludes deadly Chagas disease may be underdiagnosed in U.S.

January 21, 2016 | MedicalXpress.com

Trypanosoma cruzi is a protozoan parasite that can cause an insidious onset of Chagas disease, a fatal cardiac disease in humans and dogs. The parasite is transmitted via triatomine insects, commonly called kissing bugs. In Latin America T. cruzi is recognized as an economically important parasite; however, there is limited research regarding its spread and virulence in the USA. As a result, while the genetic diversity of the T. cruzi parasite has been well studied in Latin America less is known about the strains endemic to the USA.

“Chagas disease should be considered as a potential cause of cardiac illness in humans and dogs.”

Researchers from the University of California, Davis, and the London School of Hygiene and Tropical Medicine assessed the prevalence of T. cruzi from northern and southern California regions. The researchers used a combination of methods to obtain triatomine insects, including active collection via black light traps and the enlistment of private property owners and public health officials in specimen submission. DNA was extracted from the specimens and screened for T. cruzi via molecular techniques. Positive samples were genetically typed into one of six recognized T. cruzi subgroups (TcI – TcVI). Finally, the researchers performed genetic analyses to examine the potential virulence of the California T. cruzi samples as compared to infective T. cruzi strains from Latin America.

Of the 29 specimens from northern California 55% were infected, while T. cruzi was detected in 34% of the 53 samples collected from one of the southern California locations. Two separate subtypes were found—with 20 parasites falling into the TcI subgroup and 2 into TcIV. The TcIV subgroup was not detected in the northern California region. Genetic analyses did not reveal any particular unique characteristics to distinguish the California samples from several Latin American strains known to infect humans.

This research suggests that the apparent rarity of locally-acquired Chagas disease in the USA is unlikely due to any genetic difference in the infectious capabilities of the parasite. Rather, the fact that local triatomine species (e.g. Triatoma protracta) do not frequently colonize human homes, likely translates to decreased T. cruzi transmission. Alternatively, locally-acquired Chagas disease may simply be underdiagnozed. At present only four states in the USA list Chagas disease as a reportable illness, and California is not among them. This means that the public, as well as physicians and veterinary practitioners, may have decreased awareness of the dangers posed by this disease.

Based on this research, in areas where Triatoma protracta populations are evident, Chagas disease should be considered as a potential cause of cardiac illness in humans and dogs.

The study is published in PLOS Neglected Tropical Diseases.

Research concludes: Congenital transmission of deadly Chagas disease is a risk in ANY country

January 22, 2015 | News Report-Staff News Editor | Women’s Health Weekly

New Orleans, LA – Tulane University research stated, “Chagas disease is caused by the parasite Trypanosoma cruzi and is endemic in much of Latin America.  With increased globalization and immigration, it is a risk in any country, partly through congenital transmission.”

A quote from the research from Tulane University, “The frequency of congenital transmission is unclear.  To assess the frequency of congenital transmission of T. cruzi. PubMed, Journals@Ovid Full Text, EMBASE, CINAHL, Fuente Academica and BIREME databases were searched using seven search terms related to Chagas disease or T. cruzi and congenital transmission.  The inclusion criteria were the following:  Dutch, English, French, Portuguese or Spanish language; case report, case series or observational study; original data on congenital T. cruzi infection in humans; congenital infection rate reported or it could be derived.  This systematic review included 13 case reports/series and 51 observational studies.  Two investigators independently collected data on study characteristics, diagnosis and congenital infection rate.  The principal summary measure–the congenital transmission rate–is defined as the number of congenitally infected infants divided by the number of infants born to infected mothers.  A random effects model was used.  The pooled congenital transmission rate was 4.7% (95% confidence interval: 3.9-5.6%).  Countries where T. cruzi is endemic had a higher rate of congenital transmission compared with countries where it is not endemic (5.0% versus 2.7%).  Congenital transmission of Chagas disease is a global problem. Overall risk of congenital infection in infants born to infected mothers is about 5%.

Tulane University research concluded “The congenital mode of transmission requires targeted screening to prevent future cases of Chagas disease.”

#SayNOtoPESTICIDES!

The Bumbles and KiltronX…Empowering our Children to Educate & Deal with Fear of Bed Bugs through Music, Song & Dance

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Listen to hit Bedbug song by The Bumbles & The Honeybees Too below.

Florida born children’s performers The Bumbles & The Honeybees Too have teamed up with WestPoint Home and KiltronX, along with Bongiovi Productions, to deliver a socially responsible message removing the social stigma surrounding bedbugs.

Song

 

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Dr. Christy Cugini of Naples, Florida, a well-known endocrinologist, philanthropist and creator of The Bumbles and The Honey Bees Too, will be performing hit children’s bedbug song and “The Stomp” dance.

Now that bedbugs are known to transmit the deadly Chagas disease and carry 40 other pathogens, including MRSA, it is time for preparedness and action!

Click here for more information about The Bumbles & The Honeybees Too.

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“All Walls Down” song – The Solution to tropical diseases and the bedbug problem is through Tolerance & Mindfulness of each other

Music and song lead the message and movement to help each other.  Radiate positive vibes with the smash-hit song “All Walls Down”.

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Enjoy this smash-hit song written by KiltronX and Joe Beaty [Mind Like Water] and produced and recorded by Tony Bongiovi at the famous Power Station Studio.   This song was created to bring awareness of the risk of Chagas disease through bedbugs and kissing bugs (aka “love bugs”).

Chagas disease has already affected as many as 50 million people in the world and as many as 1.5 million people in the U.S. alone.

We are all connected.  If the poor are more exposed to the deadly Chagas disease then we ALL are.  The free roaming love bugs & kissing bugs and undercover bedbugs do not discriminate – nor do they ask for a financial statement before sucking the blood of their victims.

Bedbugs can be found in all states and all cities and love bugs and kissing bugs have spread outward and up through all states bordering the Gulf of Mexico, along the Atlantic coast, the West coast and north.

Dr. Peter Hotez of the National School of Tropical Medicine says “low-income neighborhoods … are at greater risk for infection”.  Because of their predilection for the poor, Hotez calls these infections “the forgotten diseases [Chagas] of forgotten people”.

Chagas disease not only affects humans but also their pets – be it horses, dogs, cats, livestock.  Our pets are among the most innocent and have no protection.

Awareness and preparedness are crucial to saving lives.

#SayNOtoPesticides!

 

New Year, New Things for 2016 at WestPoint Hospitality

January 18, 2016 |WestPoint Hospitality Newsletter

As we kick off 2016, WestPoint Hospitality would like to introduce to you to a few new things you can expect from us this year. For our team, 2016 is all about YOU, our valued partners!  We are creating valuable new programs and products for the hospitality market and want to make sure you are on the front line with all the tools you need to make 2016 the BEST yet!

BedBug Prevention

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In 2015, WestPoint Hospitality partnered with KiltronX Enviro Systems to bring Live Free Bedbug Barrier Systems into the hospitality market. These products are unlike any other treatment currently on the market because they not only kill bedbugs they also create a preventative barrier to keep an infestation from ever starting.

Marriott sheets rated #1 Overall by Good Housekeeping

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In recent tests done by GH Institute Pros, Marriott’s Signature Sheet Set was rated #1 in durability, softness, and wrinkle resistance.  WestPoint Hospitality is pleased to be the manufacturer and supplier of these award winning sheets.

New Informational Website

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Our new website provides information on all of our products and innovations along with a resource library where you can download our latest sell sheets.  This website can be used by your sales team as a great resource or by your customers looking for unique product selections.

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DryFast®, UltraTouch and Millennium are all names you will hear a lot this year. These new sheeting lines are part of our new Fresh White movement, to bring a clean, crisp look.
From the opening price point of Ultra Touch, through the wide range of thread counts found in Millennium, to the cost saving performance of DryFast, we have a sheet solution for you!

Partner Services

Services

We’re more than just another provider of hospitality textile products– we’re your one-stop shop for business development. We invest in the resources, programs, and people that help you find and close more deals.
These are just a few of the benefits of participating in our Partner Services Program:

  • Private Label Programs Onsite Training
  • Live Webinars
  • Partner Marketing Opportunities Strategic Planning

For more information contact us at 864-653-2374 or Sara.Crain@wphome.com
WestPoint Hospitality
391 College Ave, Clemson SC 29631

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Study shows deadly Chagas disease in horse from Texas

January 2016 | Research Gate

“Trypanosoma cruzi, agent of Chagas disease in humans and dogs, were sporadically detected within segments of thoracic spinal cord.”

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BY Laura K Bryan, Sarah A Hamer, Sara Shaw, Rachel Curtis-Robles, L. D. Auckland, Carolyn Hodo, Keith Chaffin, Raquel Rech

Abstract

A 10-year-old Quarter Horse gelding presented to the Texas A&M University Veterinary Teaching Hospital with a six month-history of ataxia and lameness in the hind limbs. The horse was treated presumptively for equine protozoal myeloencephalitis (EPM) based on clinical signs but was ultimately euthanized after its condition worsened. Gross lesions were limited to a small area of reddening in the gray matter of the thoracic spinal cord. Histologically, trypanosome amastigotes morphologically similar to Trypanosoma cruzi, the agent of Chagas disease in humans and dogs, were sporadically detected within segments of the thoracic spinal cord surrounded by mild lymphoplasmacytic inflammation. Ancillary testing for Sarcocystis neurona, Neospora spp., Toxoplasma gondii and Leishmania spp. was negative. Conventional and real time polymerase chain reaction (PCR) of affected paraffin embedded spinal cord were positive for T. cruzi, and sequencing of the amplified T. cruzi satellite DNA PCR fragment from the patient was homologous with various clones of T. cruzi in GenBank.

While canine Chagas disease cases have been widely reported in southern Texas, this is the first report of clinical T. cruzi infection in an equid with demonstrable amastigotes in the spinal cord. In contrast to previous instances of Chagas disease in the central nervous system (CNS) of dogs and humans, no inflammation or T. cruzi amastigotes were detected in the heart of the horse.

Based on clinical signs, there is a potential for misdiagnosis of Chagas disease with other infectious diseases that affect the equine CNS. T. cruzi should be considered as a differential diagnosis in horses with neurologic clinical signs and histologic evidence of meningomyelitis that originate in areas where Chagas Disease is present.

The true prevalence of T. cruzi in horses and the role of equids in the parasite life cycle require further study.

This is a pre-print version of the article before peer review and further editing by Veterinary Parasitology. The article was accepted and the corrected version is available at the publisher’s website:

http://www.sciencedirect.com/science/article/pii/S0304401715300832

http://dx.doi.org/10.1016/j.vetpar.2015.11.016