Chagas, the “kissing bug disease,” might just be one of the most misunderstood, underreported, and neglected diseases in the US. In a new study, scientists took a deep dive into this unusual parasitic disease among the Latin American community in Houston, Texas, and discovered that the infection is surprisingly underdiagnosed.
Chagas disease is caused by a microscopic parasite called Trypanosoma cruzi that’s spread by blood-sucking bugs known as triatominae, or "kissing bugs." They get this adorable-sounding name for a very uncute reason: their habit of feeding from around the lips of people while they sleep. After feeding, the bug poops near the small wound, through which the parasite is passed onto the human.
Chagas is common in parts of Central America and South America, where it infects around eight million people, but the US Centers for Disease Control and Prevention (CDC) estimates that 300,000 people in the US also host the parasite. Although there are triatomine bugs in the US, the majority of these cases are thought to have been picked up in Latin America.
However, the true scale of the number of infections in the US is only a rough estimate.
As reported in the CDC journal Emerging Infectious Diseases, researchers tested 97 Latinx patients with generic decreased heart function in Houston for T. cruzi infection. They found that seven percent of the patients tested positive, although they had no idea they were infected with the parasite. The patients were born in El Salvador, Honduras, Mexico, and Venezuela. Only two of the patients had even heard of Chagas disease, and just one was aware of how it was spread.
The disease can often go undiagnosed because the initial stage of infection is vague and nonspecific, according to the World Health Organization. For under half of cases, people will present with a skin lesion or a purplish swelling of the lid of one eye. Others might experience a fever, headache, enlarged lymph glands, paleness, muscle pain, difficulty in breathing, swelling, and chest pain. In the chronic stage, the parasite hides in the heart and digestive muscle and can lead to heart problems. Eventually, in later years, the infection can lead to sudden death through cardiac arrhythmias or heart failure.
If caught early, the infection can be effectively treated with the antiparasitic drug benznidazole. However, the drug becomes significantly less effective the longer the infection has resided.
Texas A&M University maintains a live database of kissing bug spottings in the US, showing that most of them in the US tend to be found in the southern stretches of the country. However, cases are seen as northerly as Adair in Iowa, Mesa in Colorado, New Castle in Delaware, Morgan County in Indiana, and more.
While the parasitic infection was once seen as a disease limited to Latin America, it’s clear that the obscure disease is perhaps more common in parts of the US than previously appreciated.