Dangerous 'Kissing' Bug Marches North in US

Kathleen Doheny

April 29, 2019

The CDC's recent report about a "kissing bug" identified in Delaware for the first time has sparked concerns as the potentially deadly bug marches its way north from Latin America through the Carolinas and beyond. Kissing bugs carry a parasite that causes Chagas disease, which can lead to serious heart and stomach problems.

So are we in for a summer invasion of these bloodsucking insects that are far from romantic?

Probably not, says kissing bug expert Rachel Curtis-Robles, PhD, a post-doctoral researcher and epidemiologist at Texas A&M University in College Station. Kissing bugs are nothing new. Eleven different species of the bugs — known as triatomine bugs — are in the U.S., the CDC says. And 28 states have reported them, the Texas A&M research team says. The bugs are also typically found in Mexico, Central America, and South America.

It's not the bug itself that causes the disease, but a parasite it may carry.

About 300,000 people with Chagas disease live in the U.S., but most were infected in parts of Latin America where the disease is most common. The likelihood of getting the infection in the United States is low, even if the bug is infected, the CDC says.

The news is a good reminder, experts agree, that people should be aware of the bug, what to do if bitten, and how to lessen the risk.

More on Kissing Bugs

Kissing bugs don't actually kiss. They got their nickname because they tend to bite  people around the mouth or another part of the face, Curtis-Robles says. They are nocturnal, and your face is often the only body part exposed during sleep.

"They are attracted to the carbon dioxide we all breathe out," says Sarah Gunter, PhD, an assistant professor of pediatrics and Chagas disease researcher at the National School of Tropical Medicine, Baylor College of Medicine in Houston. And they are looking for blood as their meal.

But it's not the bite itself that transmits the parasite.

Here's the super-disgusting part: The bug bites and then defecates. "The parasite is in the feces," Gunter says. "If the feces from an infected insect gets into the wound, that is when we see an infection."

Transmission usually happens when a person accidentally rubs the feces into the bite wound or into a mucous membrane such as the eye or the mouth, the CDC says.

Identifying the bugs isn't simple, since there are a lot of look-alikes. Most species in the U.S. are mainly black or very dark brown, Curtis-Robles says. They have red, orange, or yellow "stripes" around their edges, thin antennae, and legs and a cone-shaped head.

Complicating the issue, most people don't report feeling a bite, Curtis-Robles says. Kissing bugs hang out indoors or out, preferring cracks and holes in older housing. Outdoors, they live beneath porches, in brush piles, or in rodent nests, outdoor dog houses, or chicken coops.

Possible Symptoms

Not everyone has symptoms. Some people have an allergic reaction to the saliva of the bug, the CDC says. They may have itching, swelling, hives, and severe redness.

There may be swelling if the parasite gets into the body through the skin or mucous membranes. Or it could cause swelling around the eye.

The infection eventually gets to the bloodstream, and it can affect the cells of the heart and digestive tract. "About one-third of people infected go on to the chronic form of the disease," Gunter says.

Complications of chronic Chagas disease may include heart rhythm problems that can cause sudden death, an enlarged heart that doesn't pump blood well, and an enlarged esophagus or colon that can cause problems with eating or passing stool.

"If someone is worried about being infected, they should first talk to their physician," Curtis-Robles says. A doctor can request blood tests to see if antibodies to the parasite are present. If infected, a patient may see an infectious disease specialist or a heart doctor for treatment with anti-parasitic drugs.

The bugs can also bite dogs, and they can get the same heart issues as people, but in a shorter timeline, Gunter says.

Happy Ending in Delaware

The insect found in Delaware, which had bitten a child as she watched television at night in her bedroom in July 2018, was sent to the CDC, which confirmed it was a kissing bug but found it negative for the parasite. The girl had no ill effects, according to a CDC report published April 19.

SOURCES:

Sarah Gunter, PhD, assistant professor of pediatrics and Chagas disease researcher, National School of Tropical Medicine, Baylor College of Medicine, Houston.

Rachel Curtis-Robles, PhD, post-doctoral researcher, epidemiologist, and co-founder of the Kissing Bug Citizen Science Program, Texas A&M University, College Station.

CDC: Morbidity & Mortality Weekly Report, April 19, 2019.

CDC: "Parasites — American Trypanosomiasis (also known as Chagas Disease)."

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