How can I reduce my family’s risk for becoming infected with Chagas’ disease
1. The first step towards reducing your risk of acquiring the disease is through knowledge. Educating yourself and your family about the following three areas may help you to reduce your risk of acquiring the disease.
A. Identification of the insect: see the page on Kissing Bug photos: View Kissing Bug Photos and make sure all members of your family area also familiar with the markings of kissing bugs
B. Protection of your Home: Homes should be inspected for any openings through which insects could potentially gain access to your home. Check for any broken screens and repair any screens with holes or those which do not fit tightly and cover any window openings completely. Especially for those who own older homes, it is particularly important to examine any keyholes that may still be in use on older doors, and plug any openings that you find to close access to any unwanted insects entering your home.
C. Insecticide Spray: using an insecticide is always a personal choice and every insecticide must be used cautiously and those using insecticides should carefully read labels and adhere to any precautions in terms of applying the product should you choose to use an insecticide. Products containing permethrin as an ingredient are said to help repel the reduviid bugs. Read the label also of the product to determine how often to spray. Note: (Some of the labels that we have seen on permethrin based products state that the product will be effective for only 21 days. If you choose to hire a professional exterminating service to spray your home, note that many companies will only spray four times a year. If you choose to use an insecticide yourself, make certain to read the label regarding the duration of protection from the product and understand that products we have used and seen, have to be re-applied according to the label every 21 days.)
D. Be particularly careful at dusk or after dark, as the reduviid or kissing bug insects are noctornal or night time insects, meaning that they come out of hiding at night. During the day they are usually found hiding in cracks or crevices, or under piles of debris, but during the night they venture out of their hiding places to obtain a blood meal.
E. Lights often attract reduviid bugs, and opening a door with an outside light turned on in your home, may attract insects to enter your home while the door is opened, so be cautious around any light source.
F. If you have infants or children, make sure to check their crib and linens for any unwanted insects before putting them into bed.
G. Never, ever pick up a Reduviid bug with your bare hands, nor should you touch any areas where you have seen them crawling
H. If you do travel to Central or South America, be particularly careful about what type of accomodations you choose for sleeping.
How is Chagas’ Disease Spread?
People may become infected with Chagas' Disease in several ways:
1. Through the bite of a blood sucking insect, called the Reduviid, Triatomine bugs, or "kissing bugs", approximately 1 inch in size that deposits feces onto the skin of it's victim after feeding on the blood of the unsuspecting person or animal. The insect's bite is painless, however, the feces when left on the skin may cause the area to itch. When the person or animal scratches at the bite wound area, the feces may enter the skin and deposit a parasite which then infects the victim.
2. Through infected organ transplants or blood transfusions: In at least ten third-world countries, screening of their blood supplies are mandatory by law, however, in the Spring of 2006, the United States does not screen the blood supply nor organ transplants for the presence of Chagas' disease. Some are of the opinion that the risk of acquiring Chagas' from a blood transfusion is greater in urban areas because of the larger number of blood transfusions in a metropolitan setting and because migrants from rural areas may enter urban centers and donate blood that is infective for Chagas' disease (Reiche 1996). A South and Central American study in 1993 of 10 countries, and a 1994 study conducted in South America showed that the risk of acquiring Chagas' disease through a blood transfusion was greater than the risk of acquiring some of the more well known diseases such as AIDS or HIV, Hepatitus B, Hepatitus C, and Syphilis (Schumunis 1998).
3. People may also be infected if they touch their eyes, mouth, or any open wounds such as cuts, after touching or coming into contacted with "kissing bug" feces.
4. The kissing bug may also place their feces right into a person's eyes, causing infection
5. Uncooked food that contains infective kissing bug feces can also be a method of transmission
6. Mothers can transmit the disease through pregnancy or birth. The disease has also been documented in cases of mothers who breastfeed. (Bittencourt 1992). It is not known whether the transmission occurs through the mother's milk which has been shown to contain the parasite, or through bleeding nipples.
What Is Chagas Disease?
Chagas' Disease is a deadly parasitic disease. Much of the literature written prior to 2005 or 2006 states that Chagas' is primarily a concern for inhabitants of Central and South American Countries and Mexico. In recent years however, there has been significant population migration of those from endemic countries into the United States and Europe. This had led to increased risks for populations in Europe and the US as the disease spreads outside the traditional geographic boundaries.
It is estimated that 25-30% of infected individuals will suffer irreversible cardiac, neurological, or gastrointestinal problems resulting in death.
Chagas' disease threatens over 120 million people in 21 countries, yet is relatively unknown to the general public.
Symptoms may be varied and many physicians underdiagnose the disease, making it difficult to accurately predict the actual depth of the problem. Parasites invade internal organs and slowly cause affected organs to enlarge and even burst. Further adding to the seriousness of the disease is the fact that once infected, patients may not experience symptoms or death for 10, 20, or even up to 30 years, and the cause of death may mistakenly be attributed to heart failure or other organ failure because Chagas' testing was never performed
In Brazil, Chagas' disease is the leading cause of Chagas disease is also the leading cause of cardiac faliure for men age 20-40 in Brazil
Photos of Kissing Bugs – Carrier of the Chagas’ Disease Parasite
Kissing bugs may also be called "bloodsuckers, "conenose bugs", assassin bugs, or "vinchuca".
Order: Hemiptera, family: Reduviidae.
Chagas Disease in Organ Transplant Recipients
Officials confirm 3 Cases of Chagas Disease - Trypansoma cruzi (T.cruzi) in Organ Transplant Recipients
In a March 15, 2002 report from Morbidity and Mortality Weekly Report (MMWR) there was a report of a 37 year old woman dying approximately 7 months after receiving kidney and pancreas organ transplants from a cadaver. The woman had transplant surgery on March 5th, 2001, and returned to the hospital on April 19th, complaining of illness. Testing at that time revealed T.cruzi parasites in the woman's blood. She was treated with nifurtimox but in October, 2001, died of the disease.
Two other patients were reported to have contracted the disease. One died of complications reportedly unrelated to Chagas disease, and the other, a 69 year old woman, was reportedly treated and at the time of the report, was said to be doing well.
Chagas' disease in humans may not develop into a lethal condition until decades following initial infection, therefore obtaining accurate statistics of patients with advanced stages of Chagas' disease may be difficult.
T. cruzi infection may be transmitted also by blood tranfusion because the parasite may live for at least 18-21 days in refrigerated blood. The parasites may also, according to some experts, survive freezing and thawing.
Some researchers have theorized that the risk of collecting T. cruzi infected blood is highest in the areas of the US where the greatest number of Latin American Immigrants have settled. However, blood units infected with T. Cruzi may be found in any are of the US, because blood components are shipped frequently between varying georgraphic regions of the United States.
In stark contrast to the US policy of not screening the United States Blood supply for T. Cruzi, in Argentina, Brazil, Honduras, Uruguay and Venuzuala blood bank screening is required by law.
Treatment for Chagas’ Disease
There are currently two drugs, nifurtimox and benznidazole which may be helpful in the acute stages of the infection. Both medications, however, have serious side effects limiting their use. Once the disease progresses to the chronic stage there is no known treatment.
Symptoms of Chagas’ Disease
Chagas disease has two stages: acute and chronic.
Symptoms in the acute phase may only occur in about 1% of Chagas cases, and will generally appear approximately one to two weeks following infection.
Acute Stage Symptoms:
- fever
- facial swelling or swelling around the site of the bite
- enlarged and painful lymph glands and fatigue
- In infants or young children severe brain damage causing death may occurThe symptoms may last for 4-8 weeks before disappearing
In the chronic stage of the disease, symptoms may not appear until 10, 20, 30 or even 40 years following infection
Chronic Stage Symptoms:
- Cardiac problems including cardiomyopathy (or an enlarged heart); altered heart rate or heart rhythm abnormalities, or cardiac arrest
- Esophagus enlargement or increasing size of the large bowel causing difficulties with swallowing or severe constipation
Chagas Disease – the Killer Disease – Should you Learn More?
Fast Facts:
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.
- 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.