Chagas Disease

The kissing bug, also known as triatomine bug, bites and sucks blood from infected animals or people. This is how the bug gets the T. cruzi parasites.

After biting, bugs pass the parasite in their droppings. If these droppings get into someone’s body through a cut in the skin, or near the eyes or mouth, it can lead to infection. People might scratch or rub bug feces into a bite wound, their eyes, or mouth without realizing it, which allows the parasite to enter their body.

Infected triatomine bugs and infected reservoirs, such as raccoons, have been identified in Florida. However, the risk of local transmission to people in Florida is low. There have been cases of local transmission in Texas, Tennessee, California, and Louisiana.

Chagas disease can also be spread through:

• A pregnant woman to her baby
• Blood transfusions
• Organ transplants
• Consuming uncooked food contaminated with feces from infected bugs
• Accidental exposure in a lab

Chagas disease does not spread from person-to-person like a cold or the flu. It also does not spread through casual contact with people or animals who are infected.

Once transmission has taken place, most infected individuals experience an acute illness phase with mild symptoms or nonspecific febrile illness that frequently goes unrecognized.

After 4-8 weeks or more, individuals enter the chronic phase and parasites are generally not detected in the blood. Without treatment, they will remain infected for life.

Some people will remain asymptomatic (indeterminate infection) but others (20-30%) will experience clinical symptoms including cardiac damage. This can range from mild changes on electrocardiogram to severe arrhythmias, cardiomyopathy, and sudden death. The digestive tract can also be involved leading to megaesophagus or megacolon. Finally, the peripheral and central nervous systems can be affected.

If a family member has Chagas disease, you and your family should consider testing, especially if:

• You might have been exposed in the same way when traveling to rural parts of Mexico or Central or South America
• Your mother was diagnosed or infected

Infected individuals should be referred to a local physician or clinic for follow-up care and treatment.

In the U.S., antitrypanosomal medication (nifurtimox or benznidazole) is only available through U.S. Centers for Disease Control and Prevention (CDC). A health care provider should call CDC to determine whether treatment is indicated.

• CDC consult line for physicians is 404-718-4745
• Medications are free of charge for eligible patients and will be shipped directly to a health care provider’s office

If you are traveling or visiting rural areas that might have Chagas disease:

• Stay in well-built places (like air-conditioned or screened hotel rooms). This lowers the risk of contact with infected kissing bugs, which often live in poorly built dwellings and are active at night.
• Spray the places where you’re staying with long-lasting insecticides.
• Sleep under bed nets treated with long-lasting insecticide.
• Wear clothing that covers your skin and use bug spray on skin that’s exposed.
• Do not eat salads, raw vegetables, unpeeled fruits, and unpasteurized fruit juices.