Understanding Chagas Disease: A Rising Concern for Texans

Chagas disease, transmitted by kissing bugs, is gaining recognition as a health risk in the United States, particularly in Texas. This parasitic infection impacts over 7 million individuals globally, primarily in Latin America, and has now begun to be seen as endemic in certain regions of the U.S.

A recent report published in the Emerging Infectious Diseases journal by the Centers for Disease Control and Prevention highlights that Chagas disease is already endemic in 21 countries across the Americas. The report emphasizes the growing evidence of the Trypanosoma cruzi parasite, which causes Chagas disease, being found in kissing bugs, wildlife, and domestic animals within the United States.

Texas has reported cases of Chagas disease since the 1930s, with the first documented U.S. case occurring in Corpus Christi in 1955. Between 2013 and 2023, Texas health authorities identified 273 cases of Chagas disease, with 51 of those being locally transmitted. While some counties in North Texas, such as Dallas, have reported cases, all instances of infection were contracted outside the state.

Health experts, including infectious disease specialists, suggest that while Chagas disease should be monitored, it is currently not a major concern for residents of the Dallas-Fort Worth area. However, raising awareness about the disease is crucial.

Chagas disease is caused by the Trypanosoma cruzi parasite, which is predominantly found in the Americas, particularly in southern regions. The World Health Organization states that this infection leads to more than 10,000 fatalities annually.

The disease is spread when a kissing bug bites an infected animal, consumes its blood, and then excretes the parasite in its feces. If a person touches the infected feces and then their eyes or mouth, the parasite can enter their body. The kissing bug, named for its tendency to bite around the mouth or eyes, can also transmit the parasite through blood transfusions, organ transplants, or mother-to-child transmission.

Cases of Chagas disease have been observed throughout Texas, but locally acquired infections are concentrated in south-central and southern regions of the state. Various wildlife species in Texas carry the parasite, with approximately half of the tested kissing bugs being infected. In North Texas, the predominant species of kissing bug is less efficient at transmitting the parasite, making human exposure less likely.

Kissing bugs are nocturnal, often hiding during the day in crevices in walls and roofs. They emerge at night to feed on sleeping hosts and can be attracted to light, leading them indoors where they may come into contact with humans or pets.

Chagas disease progresses through two phases: acute and chronic. The acute phase may last from weeks to months after infection and often presents with mild symptoms, including fever and fatigue. However, some individuals may experience eyelid swelling, known as the Romaña sign.

About 20% to 30% of those who remain asymptomatic may later develop serious complications, primarily affecting the heart or digestive system. These complications arise because the parasite tends to infect the heart and digestive muscles. If left untreated, chronic Chagas disease can persist for many years.

Infants born with Chagas disease typically show few or no symptoms initially, but if untreated, the infection can last a lifetime. Early diagnosis and treatment are vital, as antiparasitic medications are most effective during the acute phase.

Diagnosis can include blood smears or genetic tests to detect the parasite's DNA. Two antiparasitic drugs, benznidazole and nifurtimox, are available but may have side effects that limit their use. While these medications are more effective in the acute phase, they may help manage chronic infections by reducing parasite levels.

For more information, individuals are encouraged to consult health professionals and stay informed about the symptoms and transmission of Chagas disease.