Dallas, Texas, USA : The American Heart Association (AHA) is warning that the potentially lethal parasitic chagas disease which is spread by ‘kissing bugs’ has taken hold in the US, with more than 300,000 Americans contracting it.
The Chagas disease (American Trypanosomiasis) , which used to be contained in Central and South America (infecting at least eight million people) has reached the US, infecting hundreds of thousands across 27 states. It is also becoming more common in Spain, Italy, France, Switzerland, the UK, Australia and Japan.
A statement from the American Heart Association (AHA), aimed at increasing global awareness among physicians, warns that US doctors need to learn to recognize and treat Chagas before a devastating outbreak occurs.
“Early detection of Chagas disease is critical, allowing prompt initiation of therapy when the evidence for cure is strong,” wrote Caryn Bern, professor of epidemiology and biostatistics at the University of California in San Francisco, in the online statement.
Doctors can detect the disease through a simple blood test and, if caught early, it can be treated by medication. “If untreated, infection is lifelong and can be life-threatening,” the CDC warns.
The Chagas disease is caused by a parasite transmitted by a blood-sucking insect called triatomine, known as the “kissing bug,” because it tends to bite people’s faces near their mouth and can cause strokes and heart failure. About 30 percent of infected people can develop life-threatening complications, including chronic heart disease.
The bug then spreads the parasite, known as Trypanosoma cruzi (T cruzi), by defecating near the bite, which the victims can then unwittingly move into the open wound, or their eyes or mouth.
The disease has been labelled a silent killer because 70 percent of people don’t develop any signs of infection. Symptoms can include fever, lethargy, aches, rashes and swollen glands.
Read the American Heart Association Scientific Statement
- Chagas disease is caused by a parasite, transmitted by a blood-sucking insect— Trypanosoma cruzi – and less frequently, from mother to fetus or by contaminated food or drink.
- About one third of infected individuals develop chronic heart disease.
- Though mostly found in Central and South America, Chagas disease has become more common worldwide, including an estimated 300,000 infected persons in the United States.
Chagas disease, caused by infection with a parasite called Trypanosoma cruzi (T cruzi), causes chronic heart disease in about one third of those infected. Over the past 40 years, Chagas disease has spread to areas where it had not traditionally been seen, including the United States, according to a new American Heart Association scientific statement published in the American Heart Association journal Circulation.
The statement. summarizes the most up-to-date information on diagnosis, screening and treatment of T cruzi infection. Infection occurs when feces from the infected blood sucking insect triatomine enters the skin through the bite site or in the eye. Triatomine insects are found in Central and South America, where they infest adobe houses and in the Southern United States. The disease can also be passed through contaminated food or drink, from pregnant mothers to their babies, and through blood transfusions and organ transplants.
The health risks of Chagas disease are well-known in Latin America where most cases are found in countries that include Brazil, Argentina, Bolivia, Paraguay, Mexico and El Salvador. However, doctors outside of Latin America are largely unaware of the infection and its connection to heart disease. Countries where infected individuals have been diagnosed include the United States with an estimated 300,000 cases, Spain with at least 42,000 cases, Italy, France, Switzerland, the United Kingdom, Australia and Japan.
“This statement aims to increase global awareness among physicians who manage patients with Chagas disease outside of traditionally endemic environments,” said Maria Carmo Pereira Nunes, M.D., Ph.D, co-chair of the committee that produced the statement. “This document will help healthcare providers and health systems outside of Latin America recognize, diagnose and treat Chagas disease and prevent further disease transmission,” said Pereira Nunes, who is a cardiologist at the Federal University of Minas Gerais in Belo Horizonte, Brazil.
Although 60-70 percent of people infected with T cruzi never develop any symptoms, those that do can develop heart disease, including heart failure, stroke, life threatening ventricular arrhythmias (heart rhythm abnormalities) and cardiac arrest. In the Americas, Chagas disease is responsible for more than seven times as many disability-adjusted life-years lost as malaria. However, if caught early, an infection can be cured with medications that have a 60 to 90 percent success rate, depending on when in the course of infection the patient is treated.
“Early detection of Chagas disease is critical, allowing prompt initiation of therapy when the evidence for cure is strong,” said statement co-author Caryn Bern, M.D., M.P.H., professor of epidemiology and biostatistics at the University of California in San Francisco.
The risk of infection is extremely low for most travelers and residents of endemic countries. To minimize risk, people should avoid sleeping in houses with un-plastered adobe walls and/or thatch roofs, and avoid unpasteurized sugar cane juice, açai fruit juice and other juices when visiting affected countries.
Other co-authors are Andrea Beaton, M.D., Harry Acquatella, M.D.; Ann F. Bolger, M.D.; Luis E. Echeverría Correa, M.D.; Walderez O. Dutra, Ph.D.; Joaquim Gascon, M.D., Ph.D.; Carlos A. Morillo, M.D.; Jamary Oliveira-Filho, M.D., M.S., Ph.D.; Antonio Luiz Pinho Ribeiro, M.D., Ph.D.; and Jose Antonio Marin-Neto, M.D., Ph.D. Author disclosures are on the manuscript.
The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical and device manufacturers and health insurance providers are available at www at https://www.heart.org/en/about-us/aha-financial-information.
About the American Heart Association
The American Heart Association is devoted to saving people from heart disease and stroke – the two leading causes of death in the world. We team with millions of volunteers to fund innovative research, fight for stronger public health policies, and provide lifesaving tools and information to prevent and treat these diseases. The Dallas-based association is the nation’s oldest and largest voluntary organization dedicated to fighting heart disease and stroke.