Scientists are advocating for U.S. health authorities to recognize Chagas disease, often referred to as the ‘kissing bug disease,’ as endemic.
This parasitic infection is primarily associated with Central and South America, but human cases are increasingly being reported in Missouri and seven other states.
The insects responsible for spreading the disease have been identified in both Missouri and Illinois, prompting the need for reevaluation of its status in the United States.
In a recent article published in the Journal of Emerging Infectious Diseases, the authors emphasize the importance of classifying Chagas disease as endemic to raise awareness and improve public health responses.
They argue that labeling the United States as non-endemic contributes to low awareness and underreporting.
This scenario has serious implications, as patients infected with the parasite can develop various symptoms, including fever, rash, and swelling, which can ultimately lead to severe cardiac and digestive complications.
Phil Budge, an infectious disease doctor at Washington University, noted that while there have been increasing reports of Chagas at low levels, the officially recognized status of non-endemic remains, which could hinder effective response strategies.
‘People have noticed this infection is likely occurring more often,’ Budge stated.
He clarified that the goal of the authors is not to alarm the public but to foster a greater understanding of the disease, which could lead to better diagnostics and increased research efforts.
The authors of the article are affiliated with various academic institutions across Florida, California, and Texas, while the CDC publishes the journal in which their findings appeared.
Chagas disease is transmitted through the feces of a kissing bug carrying the parasite.
The parasite can enter a human’s body through a wound or an insect bite, or by coming into contact with mucous membranes, such as in the eye or mouth.
Daniel Hoft, director of St. Louis University’s Division of Infectious Diseases, Allergy and Immunology, warns that these kissing bugs are migrating northward into southern U.S. states.
He described a ‘slow creep’ of these vectors from Latin America into the U.S. over the past decade.
Ellen Santos, an epidemiologist, has conducted studies determining the prevalence of these kissing bugs in the St. Louis area.
Her research, published in the Journal of Medical Entomology, reveals that these bugs have been detected in numerous counties throughout Missouri and Illinois, with some specimens testing positive for the Chagas parasite.
Santos noted that while the potential exists for infection, the likelihood of widespread transmission remains relatively low due to certain lifestyle factors in the U.S.
People in the United States are less inclined to sleep outdoors, which reduces their chances of being bitten by these bugs.
Furthermore, the U.S. species of kissing bugs does not defecate as easily after feeding, which decreases the risk of transmitting the parasite, she explained.
‘It’s really gross, it’s fascinating,’ Santos remarked, conveying the peculiar nature of the disease vector.
Symptoms of Chagas disease can be mild and often mimic other illnesses, leading many to remain unaware they are infected.
Many individuals only discover they carry the parasite when tested for it during medical procedures or blood donations.
An example of this occurred in Missouri in 2017, when a person’s donated blood was found to be positive for Chagas disease, as documented in a state health report.
This case underscored the reality that infections may be occurring locally.
After becoming aware of her infection, the patient underwent screening for heart issues, revealing chronic infection of cardiac tissue.
She subsequently received treatment with anti-parasitic medication for her condition.
According to the Missouri Department of Health and Senior Services, only one case has been officially documented in the state.
Budge emphasized that recognizing the disease as endemic could lead doctors to conduct screenings in patients showing compatible signs and symptoms, potentially facilitating earlier treatment and preventing serious health complications.
Hoft expressed hope that the publication of this article will amplify interest in Chagas disease, particularly as his laboratory has developed two potential human vaccines for the infection, which remain in early testing phases.
He lamented, ‘The hardest thing for me to get funded is Chagas,’ indicating a need for increased research funding and support to advance understanding and treatment of this disease.
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