Kissing Bugs Harboring Trypanosoma cruzi, Frequently Bite Residents of the US Southwest But Do Not Cause Chagas Disease

• Published in: The American journal of medicine Vol. 133; no. 1; pp. 108 - 114.e13
• Main Authors: Behrens-Bradley, Nicole, Smith, Shannon, Beatty, Norman L., Love, Maria, Ahmad, Nafees, Dorn, Patricia L., Schmidt, Justin O., Klotz, Stephen A.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-01-2020
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Allergies; Anaphylaxis - epidemiology; Anaphylaxis - etiology; Animals; Arizona - epidemiology; Bug bites; Chagas disease; Chagas Disease - epidemiology; Female; Humans; Hypersensitivity - epidemiology; Hypersensitivity - etiology; Insect Bites and Stings - complications; Insect Bites and Stings - epidemiology; Insect Vectors - parasitology; Kissing bugs; Male; Middle Aged; Triatoma - parasitology; Trypanosoma cruzi; Trypanosoma cruzi - isolation & purification; United States - epidemiology; Young Adult; United States; Arizona; Chagas disease; Kissing bugs; Allergies; Bug bites; Trypanosoma cruzi
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2019.06.016

Kissing bugs are common household pests in the Desert Southwest of the United States. These hematophagous bugs enter homes and suck blood from resident humans and pets. They are vectors of Trypanosoma cruzi, an enzootic parasite in small mammals and the cause of Chagas disease in humans. Autochthonous cases of Chagas disease are rare in the United States despite the presence of the vector and parasite. Environmental and biological factors accounting for this phenomenon need studying.
Homeowners in Bisbee and Tucson, Arizona captured kissing bugs inside homes during 2017-2018. Bugs were tested for presence of T. cruzi by polymerase chain reaction. Residents bitten by kissing bugs were tested for Chagas disease by serology. We evaluated invaded homes in the 2 cities.
Three species of kissing bugs (n = 521) were collected in or near homes. Triatoma rubida was the most common triatomine in Tucson; T. recurva in Bisbee. T. protracta was uncommon. Seventeen percent of bugs captured in Bisbee and 51.1% in Tucson harbored T. cruzi. Bite victims (n = 105) recalled more than 2200 bites. Reactions to bites were common, including 32 episodes of anaphylaxis in 11 people (10.5%). Tests for Chagas disease (n = 116) were negative. Median age of houses was 91 years in Bisbee and 7 years in Tucson. Bisbee houses had pier and beam foundations. Tucson houses were built on concrete slabs.
Kissing bugs harboring T. cruzi readily entered new and old homes. Bites of humans caused severe, life-threatening reactions. There was no serological evidence of Chagas disease among those bitten.