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A little-known disease is spreading in the U.S., primarily in the state of California, health officials warn.
In a new study published in the CDC journal Emerging Infectious Diseases, researchers state that human cases of Chagas disease have been confirmed in eight states, leading them to recommend that the disease is classified as “endemic.”
“Acknowledging the endemicity of Chagas disease in the United States is crucial for achieving global health goals,” the authors wrote.
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The Centers for Disease Control and Prevention defines a disease as “endemic” when there is a “constant presence and/or usual prevalence” in a population within a specific geographic area — in other words, the “baseline” level of disease within a community.
“Chagas disease (or American trypanosomiasis) is already endemic in South America and Central America, but it has now spread to the Southern U.S., where it is taking hold among insects and animals,” Fox News senior medical analyst Dr. Marc Siegel told Fox News Digital.
What is Chagas disease?
Chagas disease is a parasitic illness spread by triatomine bugs, also known as “kissing bugs,” according to the CDC.
The disease is transmitted when feces from bugs infected with the T. cruzi parasite enter a person’s body, typically through a bite wound or contact with the eyes or mouth.
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“When the kissing bug takes a blood meal, it will eventually defecate and leave the feces somewhere,” lead study author Dr. Norman Beatty, assistant professor of medicine at the University of Florida College of Medicine, told Fox News Digital.
“Sometimes it can ‘poop’ on our skin or mucous membrane while feeding, and then the parasite enters at that site. The bug’s feces can also end up inside or near a home and then be incidentally ingested or rubbed into the skin or mucous membrane.”
Transmission in the U.S. can also occur from congenital infection, where a chronically infected mother can transmit the parasite to a fetus, or from organ transplantation, according to Beatty.
Signs and symptoms
The first stage of Chagas disease, called the acute phase, happens shortly after infection. It is followed by the longer-term chronic phase, according to the CDC.
The disease does not always cause illness, but some people can experience symptoms.
“Chagas can lead to fever, fatigue, rash, body aches and lymph node swelling, and later can lead to digestive issues, heart problems and neurological involvement,” Siegel warned.
“What really matters is whether or not the kissing bug has been found invading homes and harbors the parasite.”
Another hallmark of the disease is eyelid swelling, also known as Romaña’s sign.
In the chronic phase, about 20% to 30% of people with the infection may experience potentially fatal heart issues or serious digestive problems, the CDC states.
Prevalence of the disease
Approximately 300,000 people are living with Chagas disease who acquired the infection in Latin America and the U.S., according to Beatty.
“However, the exact number is unknown — a national prevalence study has never been conducted,” he told Fox News Digital.
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The disease is more likely to occur in states where the kissing bug is found close to where people live, which includes parts of California, Arizona, Texas, Louisiana and Florida, according to the expert.
“What really matters is whether the kissing bug has been found invading homes and harbors the parasite that causes Chagas disease in a particular region,” he said, adding that researchers are “just tipping the iceberg” with their understanding of locally-acquired disease in the U.S.
“Unfortunately, most of the United States is unaware of this ‘silent killer’ and the fact that it is spread by a bug,” he said.
“Our first steps are recognizing that this is an endemic infectious disease, building on improved education among the public and healthcare providers, and allocating funding for research and programs to support testing and additional monitoring.”
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The expert refers to Chagas as a “neglected tropical disease.”
“Our hope as a team researching Chagas here in the U.S. is that we bring awareness to the fact that this infectious disease is being transmitted here and can be deadly,” he told Fox News Digital. “More research and resources are needed so we can help mitigate transmission to at-risk communities, especially those living in rural and agricultural sectors.”
Screening and treatments
In most circumstances, Beatty said, people are bitten by the bug in their bed or home.
“From there, a person will reach out with a picture of that bug, and we start the process of testing and educating on how to prevent the insect from getting in the home and deterring it from wanting to be around a human dwelling.”
Lab screening tests and treatments are readily available, Beatty said, but clinicians are largely unaware that the disease is being transmitted in certain communities.
There are two antiparasitic drugs approved for the treatment of Chagas disease in the U.S. — Benznidazole and Lampit (nifurtimox).
“Currently, there is a clinical trial being conducted to assess a new agent for the treatment of Chagas at certain centers in the U.S. and Latin America,” Beatty said.
There are no vaccines currently available to prevent the disease.
It can be a challenge for patients in rural America to find a provider who understands this disease, Beatty noted.
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“In my clinic, people have traveled from other states to see me in Florida just because they have no one else near them willing to care for them,” the researcher said.
“It is essential that we start educating our future clinicians about Chagas disease and ways to test, treat and manage those infected.”
“People have traveled from other states to see me in Florida just because they have no one else near them willing to care for them.”
Beatty also shared some tips for preventing kissing bugs from entering the home.
That includes removing “harborages” of nesting animals near a home where rodents would reside, such as piles of wood or clutter.
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Sealing up door jambs, window seals and other entry points, as well as placing screens on windows and doors, can also be effective.
Beatty also recommends “judicial use” of residual pesticide-spraying near potential entry points, like door jambs and window perimeters.
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