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

#SayNoToPesticides!

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.

#SayNoToPesticides!

BedBugs Destroyed My Life – “Don’t Bring Them Home!”

  
March 19, 2016 | by Maryam Shah | Toronto Sun

She may be the unluckiest renter in Toronto.
Kathleen says bedbugs have forced her to move 11 times in the past six years.

The 45-year-old doesn’t even want her last name used because she says she’s already lost one job over the tiny critters.

“I was a normal person, I had a job and a nice apartment and this has completely broken my life,” she said.

She claims she first picked them up in 2010 after volunteering at a community centre in Regent Park.

That marked the beginning of a “downward spiral.”

Kathleen says she lost her job because she “made the mistake” of coming clean with her employers.

“I literally walked away with nothing but my health card in some cases, just trying to completely rid myself of them, only to end up in other buildings that were also infested,” she explained.

Now she lives outside of Toronto and wants all three levels of government — and the scientific community — to recognize bedbugs are a “national crisis.”

That’s why she spent Friday with placards outside City Hall, demanding more action in the battle against bedbugs.

“I went through all the proper protocol,” Kathleen said. “This isn’t a landlord and tenant issue anymore.”

She even had a friend — a private landlord from St. Catharines — dress up like a brown bedbug called Badness the Bedbug, which attracted curious looks from passersby.

The city’s website says if a landlord refuses to help with bedbugs, the tenant can contact a legal clinic, the landlord and tenant board, or Toronto Public Health.

#SayNoToPesticides!