Autochthonous Chagas Disease in the United States: How Are People Getting Infected?

Beatty, Norman; Klotz, Stephen A.

doi:10.4269/ajtmh.19-0733

Cited by 27 publications

(17 citation statements)

References 40 publications

(71 reference statements)

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“…Natural transmission of T. cruzi in humans and domestic animals remains a significant problem in many countries in Latin America and is a growing concern in the southern United States of America [5][6][7]. T. cruzi and insect species that can vector the infection have likely been present in the USA for at least thousands of years [8] and occasional transmission to humans living exclusively in the USA has been documented [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

High variation in immune responses and parasite phenotypes in naturally acquired Trypanosoma cruzi infection in a captive non-human primate breeding colony in Texas, USA

et al. 2021

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Trypanosoma cruzi, the causative agent of human Chagas disease, is endemic to the southern region of the United States where it routinely infects many host species. The indoor/outdoor housing configuration used in many non-human primate research and breeding facilities in the southern of the USA provides the opportunity for infection by T. cruzi and thus provides source material for in-depth investigation of host and parasite dynamics in a natural host species under highly controlled and restricted conditions. For cynomolgus macaques housed at such a facility, we used a combination of serial blood quantitative PCR (qPCR) and hemoculture to confirm infection in >92% of seropositive animals, although each method alone failed to detect infection in >20% of cases. Parasite isolates obtained from 43 of the 64 seropositive macaques were of 2 broad genetic types (discrete typing units, (DTU’s) I and IV); both within and between these DTU groupings, isolates displayed a wide variation in growth characteristics and virulence, elicited host immune responses, and susceptibility to drug treatment in a mouse model. Likewise, the macaques displayed a diversity in T cell and antibody response profiles that rarely correlated with parasite DTU type, minimum length of infection, or age of the primate. This study reveals the complexity of infection dynamics, parasite phenotypes, and immune response patterns that can occur in a primate group, despite being housed in a uniform environment at a single location, and the limited time period over which the T. cruzi infections were established.

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Section: Introductionmentioning

confidence: 99%

High variation in immune responses and parasite phenotypes in naturally acquired Trypanosoma cruzi infection in a captive non-human primate breeding colony in Texas, USA

et al. 2021

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“…Some homeowners fear being bitten by kissing bugs at night and adopt unusual sleeping habits: using mosquito netting or constructing cloth sleeping sacks designed to reduce exposure of the skin. This behavior is driven by fear that they will contract Chagas disease from the bites, which is clearly not the case [ 8 , 9 ]. However, this fear is impossible to dispel in many bite victims.…”

Section: Resultsmentioning

confidence: 99%

Kissing Bug Intrusions into Homes in the Southwest United States

Klotz

Smith

Schmidt

2021

Insects

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Kissing bugs readily enter homes in the Sonoran Desert and bite the residents. Their saliva is highly antigenic, causing local and systemic skin reactions and life-threatening anaphylaxis. We attempted to determine what characteristics of homesites may have contributed to home intrusion by kissing bugs. Extensive and detailed information about the homes and the home environment was collected from 78 homeowners in Tucson who suffered kissing bug intrusions. Homeowners collected 298 Triatoma rubida in and around their homes. Of the homes entered by kissing bugs, 29 of 46 (63%) contained bugs harboring Trypanosoma cruzi. Although in the aggregate, homeowners were bitten > 2200 times, no individual tested positive for Chagas disease (N = 116). Although yearly intrusion likely occurs in some homes, T. rubida does not domiciliate within homesites in the Desert Southwest. We conclude there is little risk to homeowners for Chagas disease given the current behavior of resident kissing bugs and absent ingesting kissing bug fecal matter.

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Section: Introductionmentioning

confidence: 99%

“…In the United States (US), there are 11 kissing bug species are found to naturally occur in various regions of at least 29 states spanning the southern half of the country [1,2]. Autochthonous Chagas disease (CD) has been reported in the US with increasing awareness and testing due to kissing bug exposures [2]. Four triatomine species are well known to invade human dwellings in the US-namely, Triatoma sanguisuga, T. protracta, T. rubida, and T. gerstaeckeri [2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Anaphylactic Reactions Due to Triatoma protracta (Hemiptera, Reduviidae, Triatominae) and Invasion into a Home in Northern California, USA

Beatty

White

Bhosale

et al. 2021

Insects

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Background: Triatoma protracta is a triatomine found naturally throughout many regions of California and has been shown to invade human dwellings and bite residents. A man living in Mendocino County, California, reported developing anaphylactic reactions due to the bite of an “unusual bug”, which he had found in his home for several years. Methods: We conducted environmental, entomological, and clinical investigations to examine the risk for kissing bug invasion, presence of Trypanosoma cruzi, and concerns for Chagas disease at this human dwelling with triatomine invasion. Results: Home assessment revealed several risk factors for triatomine invasion, which includes pack rat infestation, above-ground wooden plank floor without a concrete foundation, canine living in the home, and lack of residual insecticide use. Triatomines were all identified as Triatoma protracta. Midgut molecular analysis of the collected triatomines revealed the detection of T. cruzi discrete typing unit I among one of the kissing bugs. Blood meal PCR-based analysis showed these triatomines had bitten humans, canine and unidentified snake species. The patient was tested for chronic Chagas disease utilizing rapid diagnostic testing and laboratory serological testing, and all were negative. Conclusions: Triatoma protracta is known to invade human dwellings in the western portions of the United States. This is the first report of T. cruzi-infected triatomines invading homes in Mendocino County, California. Triatoma protracta is a known vector responsible for autochthonous Chagas disease within the United States, and their bites can also trigger serious systemic allergic reactions, such as anaphylaxis.

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Autochthonous Chagas Disease in the United States: How Are People Getting Infected?

Cited by 27 publications

References 40 publications

High variation in immune responses and parasite phenotypes in naturally acquired Trypanosoma cruzi infection in a captive non-human primate breeding colony in Texas, USA

High variation in immune responses and parasite phenotypes in naturally acquired Trypanosoma cruzi infection in a captive non-human primate breeding colony in Texas, USA

Kissing Bug Intrusions into Homes in the Southwest United States

Anaphylactic Reactions Due to Triatoma protracta (Hemiptera, Reduviidae, Triatominae) and Invasion into a Home in Northern California, USA

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