‘Chagas Considered Emerging Global Disease’ – CSUF Researchers study spread of Plague to Parasites. Note, Kissing Bugs are cousins to Bed Bugs.

Back in 2011 we had alarming find: Bedbugs with ‘superbug’ germs MRSA and VRE

BBB

May 14, 2011 | by Christian Nordqvist | MNT, Medical News Today

Not only are there more bed bugs about in North America in Europe, but more of them appear to be carrying two types of superbugs – methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE) – bacteria that are resistant to antibiotics and very hard to treat when there is an infection.

Staph infection caused by MRSA is extremely difficult to treat because it is resistant to most antibiotics, including oxacillin, peicillin, methicillin, amoxicillin, and even methicillin.

VRE bacteria are resistant to vancomycin, an antibiotic. They are strains of the genus Enterococcus.

Bed bugs, also known as Cimex lectularius (Cimicidae) are tiny wingless insects that feed exclusively on the blood of warm-blooded animals, including humans. During their evolution they have become common nest parasites, infesting bird nests and bat roosts. Some bed bugs have learnt how to thrive in our nests, meaning our homes, and especially our beds. A baby bed bug is called a nymph and is about the size of a poppy seed. Adults reach about ¼ of an inch in length. They have an oval, flattened shape. Both adults and young are visible to the naked eye.

Bed bugs feed on us when we are asleep. As they feed we feel nothing, the process is painless. They inject a small amount of saliva into human skin while they feed. If they keep feeding on the same human night after night, that person can eventually develop a mild to intense allergic response to their saliva.

The study’s Canadian researchers wrote:

“Further studies are needed to characterize the association between S. aureus and bedbugs. Bed bug carriage of MRSA, and the portal of entry provided through feeding, suggests a plausible potential mechanism for passive transmission of bacteria during a blood meal. Because of the insect’s ability to compromise the skin integrity of its host, and the propensity for S. aureus to invade damaged skin, bed bugs may serve to amplify MRSA infections in impoverished urban communities.”
This latest report informs that the MRSA phenotype found in bed bugs is the same as those identified in many Eastside (Vancouver) patients infected with MRSA.

The scientists believe that the bed bugs probably promote the spread of MRSA in impoverished and overcrowded communities. The study took place in a poor part of Vancouver.

The researchers examined five bed bugs that had been taken from three patients staying at St. Paul’s Hospital – they all lived in Downtown Eastside, a poor part of Vancouver. In that part of Vancouver, MRSA infection incidence and cases of bed bugs had been rising steadily over the last few years. The scientists wanted to determine whether the two were linked.

They examined the bed bugs and found that three samples carried MRSA, while another two had VRE.

We still do not know whether the humans infected the bed bugs or the other way round. Further research is needed to determine where exactly on/in the bed bug the bacteria were – inside them or on their backs.

If bed bugs are able to carry and spread MRSA like the anopheles mosquito spreads malaria, we could be looking at a completely new vector of human disease.

Study author, Marc Romney, said:

“Even though this is a small study, it suggests that bedbugs may be playing a role in the transmission of MRSA in inner-city populations where bedbug infestations are a problem.”

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Woman warns – her dog was given ‘kiss of death’ from Kissing Bug bite

April 3, 2016 | by Nestor Mato | CBS 4 News

Many triatomine bugs carry the parasite Trypanosoma cruzi, which causes Chagas disease.

San Benito woman warns about potentially deadly Chagas disease spread by ‘kissing bug’

For Lisa Leal’s dog, a bug bite became the kiss of death.

A triatomine bug — commonly called a kissing bug — bit her 8-month-old dog.”I feel bad because she’s been given, literally, a death sentence,” said Leal, who lives in San Benito.

Many triatomine bugs carry the parasite Trypanosoma cruzi, which causes Chagas disease.

“The bugs are found in houses made from materials such as mud, adobe, straw, and palm thatch. During the day, the bugs hide in crevices in the walls and roofs,” according to the Centers for Disease Control and Prevention website. “During the night, when the inhabitants are sleeping, the bugs emerge. Because they tend to feed on people’s faces, triatomine bugs are also known as ‘kissing bugs.'”

Chagas disease may later cause intestinal and cardiac complications, including sudden death.

Leal’s dog is already suffering heart problems.

Veterinarian Noel Ramirez said there’s no sure way to avoid Chagas disease.

“It happens within city limits. It happens out in the country,” Ramirez said. “There’s not a whole lot of prevention that we can do.”

In humans, Chagas disease can be diagnosed with a blood test. Treatment varies depending on the symptoms.

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CDC Warns Tennessee Of Kissing Bug, deadly Chagas Disease

November 24, 2015 |NewsChannel 5

To prevent Kissing Bug  infestation the CDC recommends that you:

  • Seal cracks and gaps around windows, walls, roofs and doors
  • Remove wood, brush and rock piles near your house
  • Use screens on doors and windows and repair any holes or tears
  • Seal holes and cracks leading to the attic, crawl spaces below the house, and to the outside
  • Have pets sleep indoors, especially at night
  • Keep your house and any outdoor pet resting areas clean, in addition to periodically checking both areas for the presence of bugs
If you suspect you’ve found a kissing bug, the CDC says don’t squash it. Instead, place it in a container and fill with rubbing alcohol or freeze in water and take to your health department.

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11 things parents need to know about kissing bugs, aka ‘love bugs’ but are NOT, both ARE cousins to BedBug and deadly Chagas Disease

Baby_Chagas.jpg

December 4, 2015 | by Dr. Peter Hotez, President of Sabin Vaccine Institute

Experts at the National School of Tropical Medicine at Baylor College of Medicine have been studying Chagas disease and working on a therapeutic vaccine for it. Here are the important things to know about the kissing bug and about Chagas disease:

1.  Chagas disease, also known as American trypanosomiasis, is a serious infection caused by a parasitic microorganism, Trypanosoma cruzi, and is transmitted by kissing bugs.

2.  Chagas disease is a leading cause of heart disease resulting in a debilitating and often fatal condition known as Chagasic cardiomyopathy. One in six people with Chagasic cardiomyopathy will die within five years.

3.  An estimated 9 million people are infected in the Western Hemisphere, mostly in impoverished areas. According to the World Health Organization, the largest number of people living with Chagas disease are in poor areas of Argentina, Brazil and Mexico, while Bolivia has the highest percentage of people infected.

4.  The infection can be passed from mother to baby. There are an estimated 40,000 pregnant women in North America alone who have Chagas, and they will transmit the infection to their babies around 5 percent of the time.

5.  The CDC estimates that 300,000 cases occur in the United States, mostly imported from Latin America.

6.  Scientists at the National School of Tropical Medicine at Baylor, including Drs. Kristy Murray and Melissa Nolan Garcia, have uncovered a previously unrecognized level of transmission in the state of Texas.

7.  A high percentage of the kissing bugs in Texas are infected with the trypanosome parasite and show evidence of feeding on human blood.

8.  Dogs, cats and horses also can be infected.

9.  Researchers are finding cases among hunters and campers, as well as people who live in poverty in Texas. Those with extended outdoor exposure appear to have the greatest risk of acquiring the disease.

10.  Repeat exposures are likely necessary to acquire infection.

11.  Drug treatments are available, but they do not always work and are highly toxic. In collaboration with the Sabin Vaccine Institute and the Texas Children’s Hospital Center for Vaccine Development, the National School of Tropical Medicine is developing a new therapeutic vaccine for Chagas disease.

About Dr. Peter Hotez, president of Sabin Vaccine Institute: The US Science Envoy, Dean for the National School of Tropical Medicine, Texas Children’s Hospital Chair in Tropical Pediatrics and President-Sabin Vaccine Institute.

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Deadly Chagas Disease – Transmitted from Mother to Baby – Listen as Dr. Peter Hotez answers questions about neglected parasitic infections including deadly Chagas Disease

With the Center for Disease Control and Prevention naming five neglected parasitic infections as a priority for public health action, Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, said he is excited about the “renewed commitment to control and prevent them.

“Houston and Texas in many respects represent ‘ground zero’ for many of America’s neglected tropical diseases, including parasitic infections,” said Hotez.  “We’re at the confluence of poverty and a subtropical climate – two of the major factors that promote these infections, which in reality are major health disparities in the United States. Unfortunately, these diseases have been overshadowed by better known infections, even though parasitic infections are much more common.”

The five infections include Chagas disease, cysticercosis, toxocariasis, toxoplasmosis and trichmoniasis. These diseases disproportionately affect Americans who live in extreme poverty and can cause serious illnesses including heart failure, pregnancy complications, seizures and even death.

Dr. Hotez responded to some questions about neglected parasitic infections and what is being done about them.
Hotez co-authored the opening editorial in the American Journal of Tropical Medicine and Hygiene, part of a series of articles that coincide with the CDC’s announcement to put focus on these neglected parasitic infections.

The National School of Tropical Medicine at Baylor College of Medicine was established in 2011 to address neglected tropical diseases and other infections through education, research and clinical care.

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Leading cause of death in Men is caused by Chagas Disease & Heart failure 

Chagas Disease affects approximately 20 million worldwide, killing 50,000 each year, yet is practically unknown to most in the general public in the US.

If infected, you may not even know initially you have Chagas disease. It can slowly destroy your internal organs, and if you do not die from the acute stage, can cause death in the chronic stage, 10-20 years later.

Chagas is spreading worldwide — due to lack of knowledge and indifference.

Endemic in 21 countries, with 18-20 million infected and another 120 million people at risk

25% of the population of Latin America is at risk of acquiring Chagas Disease

More than 100,000 Latin American immigrants living in the United States are chronically infected and a potential source of transmission of the disease by means of blood transfusions

The disease is lethal, especially for children, and debilitates patients for years.

Previously thought to be endemic in Mexico, South and Latin America, other areas of the world such as the US and Europe are considering testing all blood donations for the parasite, T. cruzi, for the parasite that causes the disease due to travel patterns and rural migrations of populations to urban areas. 

 Chest radiograph of a Bolivian patient with chronic Trypanosoma cruzi infection, congestive heart failure, and rhythm disturbances. Pacemaker wires can be seen in the area of the left ventricle.

Infected triatomine bugs, that transmit T.cruzi, are found in North, Central and South America. Blood banks in selected cities of the continent vary between 3.0 and 53.0% -making the prevalence of T. cruzi infected blood higher than that of Hepatitis B, C, and HIV infection

In parts of South America, Chagas’ heart disease is the leading cause of death in men less than 45 years of age.

Blood transfusions in the US should be screened for antibodies to T.Cruzi; currently U.S. blood banks do not routinely conduct this screening.  

Numerous acute and chronic cases of the disease have been reported in domestic dogs in Texas, Oklahoma, Louisiana, South Carolina and Virginia

It is not known how many dogs or humans in the US actually have the disease due to lack of testing and reporting

The disease may be transmitted by the bite of an infected triaomine, (reduviid, “kissing”, or “assassin”) bugs, or through blood transfusion or transplacentally

In Texas infection rates in kissing bugs are reported to be 17-48%, in other states infection rates may not be known due to lack of knowledge about the disease and inadequate studies with regards to sampling bugs for the disease

The kissing bugs, or carriers of this disease, could be as close as your backyard.

Posted in August 3, 2012 | by CHAGAS Disease Biology Blogspot

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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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