News reports on ‘kissing bug disease’ risk in N.Va. are overstated, health officials say

July 31

Health officials are cautioning that news reports that the parasitic disease known as chagas could be prevalent in Northern Virginia are overstated.

The state doesn’t report ­cases of the illness, also known as the “kissing bug disease,” because it so rarely diagnosed and is very rarely contracted in the United States, said Margaret Tipple, a public health physician with the state Health Department.

The news reports have been prompted in part by a recent magazine article in which a District cardiologist refers to Northern Virginia as a possible “ground zero” for the disease.

Chagas is caused by the parasite Trypanosoma cruzi, which is transmitted to humans through bites from the triatomine bug, which is common in poor living conditions within parts of Latin America.

The disease is usually asymptomatic, and many of those who acquire it never become ill. But in some people, it can lead to chronic conditions affecting the cardiovascular and digestive systems, resulting in death. The disease is endemic to Central and South America, and the U.S. Centers for Disease Control and Prevention estimates that 8 million people are infected worldwide. Chagas can be spread through congenital transfer from mother to child, contaminated blood transfusions, infected organ transplants, laboratory accidents or, in rare cases, contaminated food or drink, according to the CDC.

In an interview with The Washington Post on Wednesday, cardiologist Rachel Marcus elaborated on her comments in the Atlantic. She said she did not intend to imply that there were a large number of confirmed cases in Northern Virginia. The area is a likely place to find the disease because of the sizable number of residents who have emigrated from Bolivia, where chagas is a major health problem, she said.

An informal study she conducted seemed to support this conclusion, she said. Out of 66 Hispanic immigrants she screened for the disease, 29 percent tested positive. Out of the 66, 34 had come from regions in Bolivia where the disease is prevalent. Seventeen of the those 34 had chagas, she said. This led her to surmise that there needed to be increased awareness of the disease and the need for testing and treatment.

Marcus added that, overall, the risk of someone in Northern Virginia getting the disease, is exceedingly low because the disease does not spread through casual contact.

“It’s not something that should make people fear their neighbor,” she said of chagas. “If there is any fear-mongering because of [my previous statement], that would be a catastrophe.”

Susan Montgomery, an epidemiologist with the CDC, affirmed that the risk is almost exclusively limited to those who may have contracted the disease outside the United States. The CDC estimates that about 300,000 people in this country have chagas that they contracted in their home countries. Montgomery said there have been only 23 reported cases of the disease being contracted in the United States since 1955.

There is virtually no risk of anyone contracting the disease inside the country because of how the disease is transferred between species, she said.

“It’s a different picture here,” Montgomery said.

The triatomine bug thrives in poor housing conditions, nestling in the mud walls and thatched roofs common in parts of Latin America. The bug is the only known vector or agent able to transmit the disease to humans. Montgomery said that triatomine bugs are found in the United States but are not found in same proximity to people as in Latin America. In this country, they tend to be in undeveloped areas where people don’t live.

Roberto Salvatella, a regional consultant on chagas with the Pan American Health Organization for the World Health Organization, said 70 to 80 percent of people with the disease are asymptomatic for life.

Salvatella, who has researched chagas for 32 years, said it is important that people who may potentially be affected consult a doctor or the CDC for screenings and treatment if necessary. The disease is treated with anti-parasitic drugs and specific treatments for symptoms such as a heart murmur.
“There is still much to do, but a lot of progress has been made in the fight against chagas,” Salvatella said.

Ileana Najarro contributed to this report.

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